In severe cases of EM major, prehospital personnel may need to treat respiratory complications and fluid imbalances aggressively, in the same manner as thermal burns. Severe cases of EM major can be life threatening and should be treated in a manner similar to thermal burns. Aggressive monitoring and replacement of fluids and electrolytes are of paramount importance. Provide supportive respiratory care, including suctioning and postural drainage, as needed. Administer empiric antibiotics if clinical evidence of secondary infection exists.
Most authorities advise against routine use of prophylactic antibiotics.
Use analgesics as needed to control pain, which may be severe. Avoid systemic corticosteroids in minor cases. In severe cases, their use is controversial because they do not improve prognosis and may increase risk of complications. Withdrawal of any causative drugs Symptomatic treatment for mild cases For more severe cases, meticulous wound care and use of Burow or Domeboro solution dressings may be necessary. A dermatological physician may be helpful with diagnosis, able to perform skin biopsies when indicated, and may assist with care in all admitted patients.