For a 12-year-old with circumferential burns and absent pulses in one leg, what is the priority intervention?

In cases of circumferential burns, particularly when accompanied by absent pulses in a limb, the most critical intervention is to assist with an escharotomy. Circumferential burns can create a tourniquet effect due to the tightness of the burn tissue around the limb. This pressure can impair blood circulation, leading to ischemia and potentially resulting in the loss of the limb if not addressed promptly.

An escharotomy involves making an incision through the burned tissue to relieve the pressure and restore circulation. This procedure is essential to prevent further tissue damage and improve perfusion in the affected limb.

While elevation and compression dressings are helpful in managing swelling and improving circulation in some scenarios, they are not appropriate in this case since they do not address the immediate need to alleviate the constricting effect of the burn. Preparation for thrombectomy is also not the priority intervention here, as it pertains to removing blood clots, which is a separate issue that does not directly address the acute problem of burn-related compartment syndrome caused by the circumferential burns.