Regarding BUN and creatinine levels, elevated serum creatinine levels occur in a significant portion of patients, because of dehydration. Urinalysis may reveal hematuria and proteinuria, which indicate renal involvement. Positive culture findings for Staphylococcus aureus from the conjunctiva, nose, throat, perineum, and skin suggest an infectious cause. No specific imaging studies are indicated. It is, however, the diagnostic procedure of choice to be performed as soon as feasible.
Prehospital care is similar to that of burns.
In severe TEN in which the barrier function of the skin is compromised, contamination and evaporation must be minimized. The patient should be treated as one with extensive burns is treated, that is, with the application of dry, sterile coverings. Fluid and pulmonary status must be carefully monitored. Care is given to minimize fluid and electrolyte loss and prevent secondary infection. Volume and electrolyte replacement, along with respiratory stabilization, are the primary concerns.