Question

You are receiving a newly admitted patient to the burn unit. Mr. Robinson is a 32-year-old male who was at work when a battery tank exploded. Mr. Robinson has sustained first, second, and third-degree burns. He has no prior medical conditions. His wife has several questions for you.

1. What labs do you expect to have to monitor?

Answer 1

The following laboratory parameters needs to be monitored-

1. Arterial blood gas - this test will help to assess the level of hypoxia and acid base disorder.
2. Blood carboxy hemoglobin level - to diagnose carbon monoxide poisoning
3. Serum creatinine levels and blood urea nitrogen levels - patients of burns suffer from fluid loss. This leads to hypovolemia. This in turn can cause acute kidney injury.
4. Serum electrolytes - sodium, potassium, calcium and phosphorus - to identify electrolytes imbalance.
5. White blood count - to look for any evidence of secondary infection. Damage to the skin exposes patients to infection.
6. Serum pre albumin levels - low levels suggests
   1. Higher incidence of sepsis
   2. Delayed wound healing
   3. Longer hospital stay
   4. Higher organ dysfunction
7. Procalcitonin levels of 0.56 ng/dl are associated with higher incidence of sepsis
8. Wound Swab culture - helps to identify cause of secondary infection.
9. Blood culture ( bacterial and fungal ) - to identify the cause of bacteremia and sepsis.
10. Culture sensitivity report - helps to identify multidrug resistant pathogens and helps to modify the antibiotic therapy.
11. Chest xray - to look for evidence of pulmonary edema , acute respiratory failure and secondary infection.