Burns and Burn Injury Q 8

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What additional laboratory test should be performed on any African American client who sustains a serious burn injury?

  

    A. Total protein

    B. Tissue type antigens

    C. Prostate-specific antigen

    D. Hemoglobin S electrophoresis

    

    

Correct Answer: D. Hemoglobin S electrophoresis

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Sickle cell disease and sickle cell trait are more common among African Americans. Although clients with sickle cell disease usually know their status, the client with sickle cell trait may not. The fluid, circulatory, and respiratory alterations that occur in the emergent phase of a burn injury could result in decreased tissue perfusion that is sufficient to cause sickling of cells, even in a person who only has the trait. Determining the client’s sickle cell status by checking the percentage of hemoglobin S is essential for any African American client who has a burn injury.

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Option A: Burn patients can also have important reduction in albumin level due to a higher vascular permeability in the burn wounds that produces exudation with an important protein loss through the burn wound and acute phase response of plasma protein synthesis in liver that occurs with even a very small percentage of burn skin (0.8%) and that produces a decrease to about 80% of normal albumin and prealbumin levels.

Option B: Immunochemical studies of the sera of patients with severe burns led to the conclusion that as soon as within the first two days following the trauma, tissue antigens sharing common components with those of the burned and normal skin were detected in the blood. The antigens in question were not detected in the sera of healthy subjects and were not identical with the C-reactive protein. Long-term circulation of these antigens, i.e. for 2 to 3 months after burning, was revealed.

Option C: For the detection of prostate cancer, an elevated serum prostate-specific antigen is the most common laboratory abnormality, as the majority of men with early prostate cancer have no symptoms. However, prostate-specific antigen, otherwise known as PSA, is clinically imprecise as benign and malignant processes both can elevate the serum marker.

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