eMedicine Specialties > Emergency Medicine > Environmental

Burns, Thermal: Differential Diagnoses & Workup

Author: Jamie Goodis, MD, Emergency Medicine, Stanford University
Coauthor(s): Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Contributor Information and Disclosures

Updated: Oct 29, 2008

Differential Diagnoses

Burns, Chemical
Burns, Ocular
Electrical Injuries
Hydrofluoric Acid Burns
Smoke Inhalation
Sunburn

Workup

Laboratory Studies

  • Severe burns (ie, full thickness or large surface area partial thickness) require a complete laboratory workup, including the following:
    • CBC
    • Chemistry profile (especially BUN and Cr to determine renal function)
    • Liver function tests
    • Arterial blood gases with carboxyhemoglobin levels
    • Coagulation profile
    • Urine analysis
    • Type and screen
    • Creatine phosphokinase (CPK) and urine myoglobin levels (in electrical injuries) (The presence of myoglobin can signify muscle breakdown as well as impending kidney impairment.)
  • These laboratory studies should be drawn as soon as possible so that they may serve as a baseline as the patient is likely to experience fluid shifts and electrolyte derangements shortly after the burn takes place. 

Imaging Studies

  • Chest radiography
    • Obtain a chest radiograph in all patients whose history or physical examination suggests the possibility of inhalation injury and in those who require intubation to manage the airway.
    • The initial chest radiograph rarely shows significant findings of smoke inhalation.
  • Other plain radiography: On the basis of history and physical findings, obtain other plain radiographs if indicated to identify other associated traumatic injuries.
  • CT scanning: On the basis of history and physical findings, obtain CT scan if indicated to identify other associated traumatic injuries.

Other Tests

  • Fiberoptic bronchoscopy may also be performed for any patient suspected of having an inhalation burn. This may take place after initial stabilization and resuscitation in the ED.

More on Burns, Thermal

Overview: Burns, Thermal
Differential Diagnoses & Workup: Burns, Thermal
Treatment & Medication: Burns, Thermal
Follow-up: Burns, Thermal
Multimedia: Burns, Thermal
References
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References

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Further Reading

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Keywords

burns, thermal burns, thermal injury, heat burn, scalds, burn injury, burn treatment, contact burns, firework burns, fire deaths

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Contributor Information and Disclosures

Author

Jamie Goodis, MD, Emergency Medicine, Stanford University
Jamie Goodis, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents Association, International Society for Mountain Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Debra Slapper, MD, Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital
Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jon Mark Hirshon, MD, MPH, Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine
Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: eMedicine.com, Inc. Consulting fee Consulting

 
 
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