Laboratory testing in burns: What do we order on admission?

Mrs Miranda Pye1

1Concord Burns Unit

This study involved a retrospective audit of laboratory investigations utilized at Concord Repatriation General Hospital’s Severe Burns Injury Unit over a two-month period, from January to February 2016. 62 patients were recruited from the unit’s admission book. The aim of this study was to determine which laboratory investigations are commonly ordered on admission, which tests were commonly abnormal and the cost of the testing conducted.

The audit identified 73 individual laboratory investigations were conducted as baseline results during this period. The most common pathology investigations panels include: electrolytes urea & creatinine, kidney function, full blood count, calcium magnesium & phosphate and liver function. The most common microbiology investigations include superficial wound cultures and MRSA screens. The audit identified several tests undertaken had higher rates of abnormal results. 15% had low sodium levels, 46% elevated white cell count and 27% low albumin. 69% of this sample had positive superficial wound cultures, of which only one was multi-resistant. Based on the data collected and the MBS figures the costs of the laboratory investigations conducted ranged between $25.35 – $169.40. The average cost for each patient’s initial laboratory tests was $85.07.

Overall the frequency of admission laboratory testing for patients within the burns specialty is minimal, with 32% audited not having any form of laboratory testing. This may be due to the minor nature of many of these injuries and the patient’s short length of stay.

Miranda is a clinical nurse specialist. Who began working in her burns nursing career in 2003 as a student nurse, as a RN in 2005 and CNS in 2009. She has experience in all areas of the Burns Unit including Ward, Burns Operating Theatre, Burns Ambulatory Care and Telehealth. In addition to her 12 years’ clinical experience, she has completed a Bachelor’s degree in Nursing, the Graduate Diploma in Nursing Science – Burns Nursing and is currently undertaking her Masters in Nurse Practitioner. Miranda has also been a ANZBA member for 12 years and is currently a member of the ANZBA Nursing executive.

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