Last reviewed: 30 Oct 2020
Last updated: 28 Aug 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • loss of consciousness
  • pre-hospital CPR or defibrillation
  • tachycardia
  • hypotension
  • low Glasgow coma score
  • burns
  • physical injuries

Other diagnostic factors

  • diminished peripheral pulses and poor capillary refill
  • low core body temperature
  • confusion
  • paralysis

Risk factors

  • age <6 years
  • construction industry workers
  • male sex
  • participation in outdoor sports

Diagnostic investigations

1st investigations to order

  • ECG
  • FBC
  • electrolytes
  • LFTs
  • coagulation studies
  • creatine kinase
  • urine myoglobin
  • cardiac enzymes (CK-MB and troponin)
  • toxicology screen
  • CXR
More 1st investigations to order

Investigations to consider

  • plain x-rays
  • head CT
  • head MRI
  • compartment pressure measurements
More investigations to consider

Treatment algorithm

Contributors

Consultant Burns, Plastic & Reconstructive Surgeon

Honorary Senior Lecturer

Queen Victoria Hospital NHS Foundation Trust

West Sussex

UK

Disclosures

BD receives reimbursement for his time as a member of the data monitoring committee for a trial using Nexobrid, a product used in treating burns.

Senior Fellow in Plastic Surgery

Queen Victoria Hospital NHS Foundation Trust

West Sussex

UK

Disclosures

JEB declares that he has no competing interests.

Mr Dheansa and Dr Berner would like to gratefully acknowledge Dr T Grant Phillips, a previous contributor to this topic. TGP declares that he has no competing interests. 

Peer reviewersVIEW ALL

UPMC St. Margaret Family Medicine Residency and Faculty Development Fellowship

Osteopathic Family Practice/Rotating Internship Program

Pittsburgh

PA

Disclosures

SJR declares that he has no competing interests.

Assistant Professor of Neurology and Neurosurgery

SUNY

Buffalo

NY

Disclosures

CCI declares that she has no competing interests.

Chief Physician

Centre for Severe Burns Injuries with Plastic Surgery

Unfallkrankenhaus Berlin (Trauma Hospital Berlin)

Berlin

Germany

Disclosures

BH declares that he has no competing interests.

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