Chemical Burns Workup
- Author: Robert D Cox, MD, PhD; Chief Editor: Joe Alcock, MD, MS more...
Laboratory studies depend on the burn type and extent of exposure.
For severe burns, consider the following:
- CBC count
- Creatine phosphokinase
- Coagulation profile
For localized burns, usually no laboratory tests are required.
For hydrofluoric acid burns, consider the following:
For ingestions of caustics, consider the following:
- Pulse-oximetry or ABG if respiratory symptoms
For oxalic acid burns, check calcium.
For chromic acid burns, consider the following:
For monofluoroacetic acid burns, consider the following:
For phenol burns, consider the following:
- CBC count
- Liver function tests
For ingestions, consider the following:
- Chest radiography if any respiratory symptoms
- Abdominal radiography (flat and upright) if signs of peritonitis are present
Endoscopy for ingestions is as follows:
- Perform esophagoscopy and gastroscopy on all patients with symptomatic ingestions and on patients who are asymptomatic but have a history of a significant ingestion of a substance with the potential to cause major injury.[11, 12]
- Findings on esophagoscopy do not correlate well with physical signs and symptoms. Of patients with esophageal injuries, 2-15% have no oral burns.
- Burn findings are classified as superficial, transmucosal, or transmural.
- Esophagoscopy findings are used to guide further treatment. The presence of full-thickness or circumferential burns is associated with future stricture formation.
- The issue of whether to extend the endoscopic examination past the first site of injury is controversial.
Check the pH for any chemical exposure to the eye or for airbag injuries.
Endotracheal intubation is required for severe respiratory symptoms. Direct visualization is recommended to assess the degree of injury.
Bullae resulting from chemical burns should be decompressed and debrided.
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