Creatinine Kinase
1
MEETING ABSTRACT Open Access Should serum creatinine kinase levels and an ECG be routinely obtained in low voltage electrical burn injuries? JR Pallett * , M Tunnicliff, JW Keep From London Trauma Conference 2012 London, UK. 4-7 December 2012 Background Initial excess of creatinine kinase (CK) has been shown to correlate with extent of muscle damage in electrical burns.[1] High voltage burns leading to extensive muscle damage, compartment syndrome and rhabodmyolysis is clinically apparent at an early stage. However, the fre- quency of these injuries is rare. Low voltage (<1000V) injuries from domestic appliances are far more common with few if any clinical signs. In order to develop a local guideline, the current practise of investigations ordered in our department was analysed. Methods A retrospective cohort study of all electrical burn injuries at King’s College Hospital Major Trauma Centre over a 4 year period was analysed. Mechanism of injury, serum CK level, ECG findings and outcome were recorded. Results 57 electrical burn injuries were identified from the trauma registry between August 2008 and October 2012. Mechanism of injury was recorded in 40 cases. All were from domestic appliances (< 1000V). A mean age of 34.7yrs (range 10 – 80) was observed. Serum CK levels were taken in 32 cases. In 15 cases, levels were elevated (> 150IU/L) ranging from 164-697. In only 1 of these cases was a superficial burn injury observed. Examination was normal in all the other patients. All patients with abnormal CK levels were discharged from the ED without influencing management and no serial CK levels were taken. 26 cases had documented evi- dence of an ECG being performed, none of which were abnormal. 2 patients with paraesthesia were referred for outpatient electromyography and nerve conduction stu- dies which subsequently showed no abnormality. 1 case was referred to the regional burns unit. The remainder were all discharged directly from the ED. Conclusions For electrical injuries sustained from domestic appliances, in the absence of clinical signs of tissue damage, routine measurement of CK and ECG recording does not appear to influence management and little evidence is available for their current routine use in these patients. Safe levels at which patients can be discharged with abnormal CK levels and need for serial CK level measurements needs to be studied further. Published: 28 May 2013 Reference 1. Pereira C, Fram R, Herndon D: Serum creatinine kinase levels for diagnosing muscle damage in electrical burns. Burns 2005, 31(5):670-671. doi:10.1186/1757-7241-21-S1-S20 Cite this article as: Pallett et al.: Should serum creatinine kinase levels and an ECG be routinely obtained in low voltage electrical burn injuries? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013 21(Suppl 1):S20. Kings College Hospital, London, UK Pallett et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21(Suppl 1):S20 http://www.sjtrem.com/content/21/S1/S20 © 2013 Pallett et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Creatinine Kinase
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MEETING ABSTRACT Open Access
Should serum creatinine kinase levels and an ECGbe routinely obtained in low voltage electricalburn injuries?JR Pallett*, M Tunnicliff, JW Keep
From London Trauma Conference 2012London, UK. 4-7 December 2012
BackgroundInitial excess of creatinine kinase (CK) has been shownto correlate with extent of muscle damage in electricalburns.[1] High voltage burns leading to extensive muscledamage, compartment syndrome and rhabodmyolysis isclinically apparent at an early stage. However, the fre-quency of these injuries is rare. Low voltage ( 150IU/L) ranging from 164-697. In only 1 ofthese cases was a superficial burn injury observed.Examination was normal in all the other patients. Allpatients with abnormal CK levels were discharged fromthe ED without influencing management and no serialCK levels were taken. 26 cases had documented evi-dence of an ECG being performed, none of which wereabnormal. 2 patients with paraesthesia were referred for
outpatient electromyography and nerve conduction stu-dies which subsequently showed no abnormality. 1 casewas referred to the regional burns unit. The remainderwere all discharged directly from the ED.
ConclusionsFor electrical injuries sustained from domestic appliances,in the absence of clinical signs of tissue damage, routinemeasurement of CK and ECG recording does not appearto influence management and little evidence is availablefor their current routine use in these patients. Safe levelsat which patients can be discharged with abnormal CKlevels and need for serial CK level measurements needs tobe studied further.
Published: 28 May 2013
Reference1. Pereira C, Fram R, Herndon D: Serum creatinine kinase levels for
diagnosing muscle damage in electrical burns. Burns 2005, 31(5):670-671.
doi:10.1186/1757-7241-21-S1-S20Cite this article as: Pallett et al.: Should serum creatinine kinase levelsand an ECG be routinely obtained in low voltage electrical burninjuries? Scandinavian Journal of Trauma, Resuscitation and EmergencyMedicine 2013 21(Suppl 1):S20.
Kings College Hospital, London, UK
Pallett et al. Scandinavian Journal of Trauma, Resuscitation andEmergency Medicine 2013, 21(Suppl 1):S20http://www.sjtrem.com/content/21/S1/S20
2013 Pallett et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.
BackgroundMethodsResultsConclusionsReferences
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