MND Clinical reasoning
(to follow)
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? Yes = go to 9
9: Is there full range of movement of the joint? No = go to 10
OR
9: Is there full range of movement of the joint? Yes = go to 11
10: Is it scar restricting? Yes = Shoulder scar restrictions
Shoulder scar restrictions
10: Is it scar restricting? No = unrestricted (scar exercises?)
scar exercises
11: Is it in the red zone of the shoulder? Yes = Increased risk of contractures
Increased risk of contractures
11: Is it in the red zone of the shoulder? No = Low risk (where next?)
Risk prevention
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? No = go to 12
12: Is it on the elbow? Yes = go to 13
13: Is there full range of movement at the joint? No = go to 14
OR
13: Is there full range of movement at the joint? Yes = go to 15
14: Is it scar restricting? Yes = Elbow scar restrictions
Elbow scar restrictions
14: Is it scar restricting? No = unrestricted (where next?)
(see elbow module)
15: Is it on the red zone of the elbow? Yes = Increased risk of elbow contractures
Elbow contractures
15: Is it on the red zone of the elbow? No = Low risk (where next?)
Elbow module
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? No = go to 12
12: Is it on the elbow? Yes = go to 13
13: Is there full range of movement at the joint? Yes = go to 15
15: Is it on the red zone of the elbow? Yes = Increased risk of elbow contractures
Elbow contractures
15: Is it on the red zone of the elbow? No = Low risk elbow contractures
Elbow contractures
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? No = go to 12
12: Is it on the elbow? No = go to 16
16: Is it on the wrist? Yes = go to 17
17: Is there full range of movement at the joint? No = go to 18
OR
17: Is there full range of movement at the joint? Yes = go to 19
18: Is it scar restricting? Yes = Wrist scar restrictions
Wrist scar restriction
18: Is it scar restricting? No = unrestricted (where next?)
Hand/wrist module
19: Is it in the red zone of the wrist? Yes = Increased risk of contractures
Increased risk of contractures
19: Is it in the red zone of the wrist? No = Low risk of contractures (where next?)
Low risk of contractures
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? No = go to 12
12: Is it on the elbow? No = go to 16
16: Is it on the wrist? No = go to 20
20: Is it on the hand/fingers? Yes = go to 21
21: Is there full range of movement at the joints? Yes = go to 23
OR
21: Is there full range of movement at the joints? Yes = go to 22
22: Is it scar restricting? Yes = Hand/wrist scar restrictions
Hand/wrist scar restriction
22: Is it scar restricting? No = unrestricted see Hand module
Hand/wrist module
23: Is it in the red zone of the hand/wrist? Yes = Increased risk of contractures
Increased risk of contractures
23: Is it in the red zone of the hand/wrist? No = Low risk of contractures (where next?)
see hand module
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? Yes = go to 8
8: Is it on the shoulder? No = go to 12
12: Is it on the elbow? No = go to 16
16: Is it on the wrist? No = go to 20
20: Is it on the hand/fingers? No = go to 24
24: Is it on the neck? Yes = go to 25
25: Is there full range of movement? Yes = go to 27
OR
25: Is there full range of movement? Yes = go to 26
26: Is it scar restricting? Yes = Neck scar restrictions
Neck scar restriction
26: Is it scar restricting? No = unrestricted see Neck module
Neck module
27: Is it in the red zone of the neck? Yes = Increased risk of contractures
Increased risk of contractures
27: Is it in the red zone of the neck? No = Low risk of contractures see Neck module
see Neck module
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? No = go to 24
24: Is it on the neck? No = go to 28
28: Is it on the face? Yes = go to 29
29: Is it limiting any neck/facial movement? Yes = Scar restrictions
Face scar restriction
29: Is it limiting any neck/facial movement? No = High risk contractures (where next?)
Face contractures
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? No = go to 24
24: Is it on the neck? No = go to 28
28: Is it on the face? No = go to 30
30: Is it on the trunk? Yes = go to 31
31: Is there full movement at the trunk? Yes = High risk of contractures
Trunk contractures
31: Is there full movement at the trunk? No = Go to 32
32: Is it scar restricting? Yes = Scar restricting
Scar restricting
32: Is it scar restricting? No = Unrestricted
Unrestricted
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? No = go to 24
24: Is it on the neck? No = go to 28
28: Is it on the face? No = go to 30
30: Is it on the trunk? No = go to 33
33: Is it on the lower limb? Yes = go to 34
34: Is it on the hips/pelvis? Yes = go to 35
35: Is there full range of hip movement? Yes = go to 37
OR
35: Is there full range of hip movement? No = go to 36
36: Is it scar restricting? Yes = Scar restricting
Scar restricting
36: Is it scar restricting? No = Unrestricted
Unrestricted
37: Is it in the red zone of the hip/pelvis? Yes = Increased risk of contractures
Increased risk of contractures
37: Is it in the red zone of the hip/pelvis? No = Low risk of contractures
Low risk of contractures
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? No = go to 24
24: Is it on the neck? No = go to 28
28: Is it on the face? No = go to 30
30: Is it on the trunk? No = go to 33
33: Is it on the lower limb? Yes = go to 34
34: Is it on the hips/pelvis? No = go to 38
38: Is it on the knee? No = go to 42
42: Is it on the ankle? Yes = go to 43
43: Is there full range of movement at the ankle? Yes = go to 45
OR
43: Is there full range of movement at the ankle? No = go to 44
44: Is it scar restricting? Yes = Scar restriction
Scar restriction
44: Is it scar restricting? No = Unrestricted
See ankle module
45: Is it in the red zone of the ankle? Yes = Increased risk of contractures
Increased risk of contractures
45: Is it in the red zone of the ankle? No = Low risk of contractures
Low risk of contractures
1: Did burn happen less than 3 hours ago? No = go 2
2: Is the wound healed? Yes = go to 6
6: Has it happened less than 2 yrs ago? Yes = go to 7
7: Is it on the upper limb? No = go to 24
24: Is it on the neck? No = go to 28
28: Is it on the face? No = go to 30
30: Is it on the trunk? No = go to 33
33: Is it on the lower limb? Yes = go to 34
34: Is it on the hips/pelvis? No = go to 38
38: Is it on the knee? No = go to 42
42: Is it on the ankle? No = go to 46
46: Is it on the foot/toes? Yes = go to 47
47: Is there full movement at the toes/foot? Yes = Increased risk of contractures
Increased risk of contractures
47: Is there full movement at the toes/foot? No = Go to 48
48: Is it scar restricting? Yes = Scar restriction
Scar restriction
48: Is it scar restricting? No = Unrestricted
Unrestricted, see foot module