Summary
Definition
History and exam
Key diagnostic factors
- loss of consciousness
- prehospital 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
- CBC
- electrolytes
- LFTs
- coagulation studies
- creatine kinase
- urine myoglobin
- cardiac enzymes (CK-MB and troponin)
- toxicology screen
- CXR
Investigations to consider
- plain x-rays
- head CT
- head MRI
- compartment pressure measurements
Treatment algorithm
Contributors
Authors
Baljit Dheansa, MBBS, FRCS, MSc, FRCS (Plast)
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.
Juan Enrique Berner, MD, MSc, MRCS
Senior Fellow in Plastic Surgery
Queen Victoria Hospital NHS Foundation Trust
West Sussex
UK
Disclosures
JEB declares that he has no competing interests.
Acknowledgements
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 reviewers
Stephen J. Ritz, DO
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.
Catalina C. Ionita, MD
Assistant Professor of Neurology and Neurosurgery
SUNY
Buffalo
NY
Disclosures
CCI declares that she has no competing interests.
Bernd Hartmann, MD
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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