Investigations

During the primary survey of the patient with major burns, a number of investigations should be undertaken:

• blood tests:
  • haemoglobin and haematocrit
  • electrolytes
  • urea and creatinine
  • glucose, particularly in children
  • group and save or cross match depending on severity of burn and associated trauma
  • carboxyhaemoglobin, particularly if evidence of inhalation injury
  • arterial blood gases
• electrocardiogram, particularly if:
  • elderly
  • ischaemic heart disease
  • carboxyhaemoglobin > 15%
• urine:
  • dipstix and microscopy
  • consider drug screen in appropriate setting but consent issues need to be addressed
• peak expiratory flow rate, especially in the context of a lower respiratory tract burn with wheezing
• radiology:
  • chest film
  • C-spine views and pelvic film:
    • in the setting of possible trauma e.g. explosion
    • for pelvic films, be alert to the possibility of pregnancy in women of child-bearing age