Which of the following is a sign of the ebb response after a burn injury?

• A. Hyperglycemia
• B. Increased energy expenditure
• C. Increased body temperature
• D. Increased cardiac output

Answer: (A)

After a burn, the body goes through two phases: an immediate ebb phase followed by a prolonged flow (hypermetabolic) phase. The ebb phase is a brief period of reduced cardiac output, lower energy expenditure, and conservation of blood flow to vital organs. Although overall metabolism is down, stress hormones released in response to injury (like adrenaline and cortisol) can drive the liver to produce glucose, and insulin sensitivity can be impaired. That combination can lead to higher blood glucose levels even as other metabolic processes slow down. In contrast, the signs described for the other phase—increased energy expenditure, higher body temperature, and increased cardiac output—reflect the hypermetabolic flow state, not the initial ebb. So elevated glucose is the best match for the ebb response.