Water loss is related to evaporative and other extrarenal losses and may lead to a hypernatraemia. If the burn is left exposed in an hot environment, sodium free water intake must be increased, but only to achieve a moderate hypernatraemia. Aggressive water load may lead to a low plasma sodium and result in 'burn encephalopathy'. Hyperkalaemia usually associated with severe muscle damage may require correction with insulin and dextrose. A high index of suspicion is required regarding the patient's airway.
Laryngeal oedema develops from direct thermal injury leading to early loss of the airway.
A tracheostomy may be necessary if there is any delay in securing the 'at risk' airway. Again intubation may be required.