Question

You are transporting a patient with 70% second degree burns. He was burned approximately five hours earlier. Would you expect for this patient to be hemodiluted or hemoconcentrated?

Answer 1

A patient with extensive second degree burns is initially hemoconcentrated due to fluid loss but may become hemodiluted over time due to compensatory mechanisms. O negative blood is used for emergency transfusions due to its universal donor status. Hematocrit values reflect the proportion of red blood cells in the blood, while leukocytosis after burns indicates the body's response to injury.

Step-by-step explanation:

A patient with 70% second degree burns would initially be expected to be hemoconcentrated because of the fluid loss from the injured tissues leading to an increase in the concentration of cells and other solutes in the blood. However, as time progresses, the body's compensatory mechanisms kick in to attempt to correct the fluid imbalance. Due to fluid shifts from the intravascular space to the interstitial space (edema) and the body's efforts to replace lost plasma (through mechanisms such as increased thirst), over hours the patient might transition to a state of hemodilution, where the concentration of cells decreases as the volume of plasma increases.

When a patient is presented with severe bleeding and requires an immediate transfusion, the type of blood used is O negative. This is because O negative blood is the universal donor type and is less likely to cause a transfusion reaction in recipients of any blood type. This is crucial in emergency situations where there is no time to type the patient's blood.

If a patient's hematocrit is 42 percent, this means that 42 percent of the blood volume is composed of red blood cells, and therefore approximately 58 percent is plasma, as the total blood volume is equal to the plasma volume plus the volume of the formed elements (red blood cells, white blood cells, and platelets).

A patient might be experiencing leukocytosis after severe burns due to the body's inflammatory response to tissue damage. Leukocytosis is an increased white blood cell count, which is a common response to stress, infection, or inflammation as the body attempts to fight and repair the damage.