Crucial Lab Results Post-Burn: When to Alert the Physician

After a burn injury, regular monitoring of laboratory results is essential to assess the client’s condition and detect any complications early on. However, not all lab values obtained 24 hours post-burn injury warrant immediate physician notification. In this article, we will discuss which specific laboratory result, when obtained, should prompt the nurse to report to the physician immediately.

Importance of Post-Burn Lab Monitoring

Burn injuries can have profound effects on the body’s physiology, including fluid balance, electrolyte levels, and inflammatory responses. Monitoring lab results allows healthcare providers to identify deviations from normal values, assess the severity of the burn, and tailor treatment accordingly.

Laboratory Results to Monitor Post-Burn Injury:

  1. Electrolyte Imbalances:
    • Serum Sodium (Na+): A significant drop in serum sodium levels (hyponatremia) or a marked increase (hypernatremia) can be indicative of fluid imbalances and should be closely monitored.
    • Serum Potassium (K+): Elevated levels of serum potassium (hyperkalemia) can occur due to tissue damage in severe burns. Immediate action is necessary if potassium levels become critically high, as it can lead to cardiac arrhythmias.
  2. Hematological Parameters:
    • Hemoglobin (Hb) and Hematocrit (Hct): A significant drop in hemoglobin and hematocrit levels may indicate ongoing bleeding, and the physician should be notified promptly.
    • Platelet Count: Thrombocytopenia (low platelet count) can result from burn-induced bone marrow suppression or bleeding. A critically low platelet count requires immediate attention.
  3. Renal Function:
    • Blood Urea Nitrogen (BUN) and Serum Creatinine: Elevated BUN and creatinine levels may indicate impaired renal function, a potential complication of severe burns. Immediate notification is warranted in such cases.
  4. Inflammatory Markers:
    • C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR): A rapid and significant increase in these markers may signal an overwhelming inflammatory response or infection, necessitating prompt evaluation and intervention.
  5. Arterial Blood Gas (ABG) Analysis:
    • pH and Partial Pressure of Carbon Dioxide (PaCO2): ABG analysis helps assess acid-base balance and respiratory function. Severe acidosis or acute respiratory distress should be reported immediately.
  6. Coagulation Profile:
    • Prothrombin Time (PT) and Partial Thromboplastin Time (PTT): Prolonged PT and PTT may indicate coagulopathy, a common complication in burn injuries. The physician should be alerted to assess and manage coagulation abnormalities promptly.

The Lab Result Requiring Immediate Notification:

The laboratory result that, when obtained, should prompt the nurse to report to the physician immediately is:

Potassium (K+) Levels:

When potassium levels become critically high (severe hyperkalemia) following a burn injury, it can pose a life-threatening risk to the client, particularly by causing cardiac arrhythmias and cardiac arrest. In such cases, immediate intervention is necessary to lower potassium levels and prevent cardiac complications.

Hyperkalemia in burn patients can result from several factors, including tissue breakdown, potassium release, and impaired renal excretion due to decreased renal perfusion. Therefore, vigilant monitoring of potassium levels is essential, especially in clients with extensive burns or those at risk for hyperkalemia.

Timely Communication and Collaboration

Nurses play a pivotal role in monitoring laboratory results and promptly communicating any concerning findings to the healthcare team, including the physician. Collaboration among healthcare providers is vital to ensure timely intervention and the best possible outcomes for clients with burn injuries.


Monitoring laboratory results is an integral part of caring for clients with burn injuries. While various lab values should be assessed, potassium levels that become critically high (severe hyperkalemia) are the result that necessitates immediate notification to the physician. Recognizing and acting upon such critical values can help prevent life-threatening cardiac complications and ensure the client’s safety and well-being during their recovery from a burn injury.


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