| CBC | Patient | Normal Range |
|---|---|---|
WBC (per mm3) |
15,000 |
5.000-10,000 |
| RBC | 4.2 x 106/uL | 4.2-5.4 x 106/uL |
| Hgb | 12 g/dl | 12-16 g/dl |
| Hct | 48% | 37-45% (female) 45-54% (male) |
| Differential | ||
|
70 | 40-65 |
| Lymphocytes | 29 | 20-40 |
| Monocytes | 1 | 5-10 |
| Platelets (per/mm3) | 250,000 | 120,00-440,000 |
Chemistry Panal |
||
| Sodium | 137 | 135-145 mEq/L |
| Potassium | 3.6 | 3.5-5.5 mEq/L |
| Chloride | 105 | 98-106 mEq/L |
| Glucose | 140 | 80-120 mg/dl |
| Creatine Kinase | 550 units/L | 96-140 units/L |
| BUN | 24 mg/dl | 7-20 mg/dl |
| Creatinine | 0.9 | 0.5-1.2 mg/dl |
| Total Protein | 4.0 gm/dl | 6.0-8.4 gm/dl |
| Albumin | 2.7 gm/dL | 3.4-5.4 gm/dl |
| Globulin | 1.3 gm/dl | 2.3-3.5 gm/dl |
Interpretation of Lab Data: Don't be confused by all of the lab values. We will try and simplify.
CBC
1. White Blood Cells are abnormally high. White cells in the blood are elevated during inflammation and trauma. Under the differential results we see the type of white cells that are high are neutrophils. Neutrophils help fight infection and are the first to the site with inflammation.
2. Red Blood Cells are slightly low as is the Hemoglobin due to the trauma of the burn.
3. The hematocrit (Hct) is the percentage of of the volume of the whole blood that is made up of red blood cells. In burns, the patient has lost a lot of fluid from leaky blood vessels (see Systemic Effects of Burns in the Case Study Workbook). There are more red cells than fluid so the hematocrit is high. You can think about this if you make up a packet of Kool Aid. If you dilute the Kool Aid with 2 qts of water, it tastes about right; it's normal. If I dilute the Kool Aid with 1 cup of water, it's very concentrated. Think of the hematocrit as describing how concentrated the Kool Aid is, only in this case we're talking about how concentrated the blood is. If there's not a lot of fluid in the vessels, the blood is very concentrated. The hematocrit goes up.
Chemistry Panel
1. The glucose value is elevated. The body is under extreme stress. Glucose stores are released from the liver and new glucose is made. This extra glucose is needed as energy for the body to heal.
2. Creatine Kinase is very high. Creatine is a breakdown product from muscles. Because of the damage to the muscles from the burn, creatine kinase is released into the bloodstream.
3. BUN (Blood Urea Nitrogen). This is a breakdown product from protein and also reflects kidney damage.
4. Total Protein, albumin, and globulin values. The patient's total protein is low because proteins have been lost through damaged blood vessels (see Systemic Effects of Burns in the workbook). Albumin is the major blood protein and globulins reflect the rest of the blood proteins.