Creatine phosphokinase elevation in patients presenting to the emergency department with cocaine-related complaints

1997 ◽  
Vol 15 (3) ◽  
pp. 221-223 ◽  
Author(s):  
Francis L Counselman ◽  
Edwin W McLaughlin ◽  
Eric M Kardon ◽  
Anita S Bhambhani-Bhavnani
Keyword(s):  
Emergency Department ◽  
Creatine Phosphokinase

scholarly journals Análise crítica da dosagem de creatinofosfoquinase no Pronto-Socorro Central do Hospital da Irmandade da Santa Casa de Misericórdia de São Paulo / Critical analysis of the creatine phosphoquinase dosage in the Emergency Department of Sao Paulo’s Santa Casa de Misericordia Hospital

2019 ◽  
Vol 64 (1) ◽  
pp. 1
Author(s):  
Marina Miury Sato Rodrigues Alves ◽  
Beatriz Harumi Yuda Nakagome ◽  
Maria Clara De Camargo Traldi ◽  
Mila Carvalho Guachala ◽  
Nathalia Terumi Kawakami ◽  
...  
Keyword(s):  
Emergency Department ◽  
Critical Analysis ◽  
Mitochondrial Membrane ◽  
Muscle Injury ◽  
Creatine Phosphokinase ◽  
Sao Paulo ◽  
High Morbidity ◽  
São Paulo ◽  
Emergency Team ◽  
Serum Creatine Phosphokinase

Introdução: A creatinofosfoquinase sérica (CPK) é um importantemarcador laboratorial de lesão muscular e consisteem uma enzima encontrada na membrana mitocondrial ecitoplasma de miócitos que atua no metabolismo energético.Sua elevação pode acontecer por múltiplos mecanismos(trauma, infarto agudo do miocárdico e exercício físicoextenuante, por exemplo) e, a depender da gravidade doquadro e de fatores predisponentes, pode conduzir a quadrosde Rabdomiólise e suas complicações, como a lesão renalaguda, associados a alta morbimortalidade e necessidadede condutas da equipe de Emergência. Objetivo: Tendo emvista a sua importância, este estudo objetiva traçar o perfilde elevação da CPK no Hospital da Irmandade da SantaCasa de Misericórdia de São Paulo e analisar criticamentea solicitação do exame e sua implicação na conduta e rotinamédica do Pronto-Socorro Central. Conclusão: Tem-seque uma maior consciência e critérios mais exigentes paraa solicitação da dosagem da creatinofosfoquinase sérica noPronto-Socorro poderiam reduzir os gastos hospitalares,otimizar a administração de insumos e beneficiar, por fim,todos os pacientes da instituição.AbstractIntroduction: Serum creatine phosphokinase (CPK) is animportant laboratory marker of muscle injury and consistsof an enzyme found in the mitochondrial membrane andcytoplasm of myocytes that acts on energy metabolism.Its elevation may occur through multiple mechanisms(trauma, acute myocardial infarction and strenuous physicalexercise, for example) and, depending on the severityof the condition and predisposing factors, it may lead torhabdomyolysis and its complications, such as acute renalinjury, being associated with high morbidity and mortalityand the need for Emergency team conduct. Objective:Considering its importance, this study aims to outline theprofile of CPK’s elevation at Sao Paulo’s Santa Casa deMisericordia Hospital and to critically analyze the requestfor the exam and its implication in the medical routineof the Emergency Department. Conclusion: a greaterawareness and more demanding criteria for the request ofserum creatine phosphokinase dosage are necessary in theEmergency Room as a possibility to reduce the hospitalexpenses, optimize the administration of inputs and, also,benefit all the patients of the institution.

scholarly journals A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency

2021 ◽  
Vol 5 (4) ◽  
pp. 432-435
Author(s):  
Rajadurai Meenakshisundaram ◽  
Joshua Joseph ◽  
Prabakaran Perumal ◽  
Akmal Areeb ◽  
Prathap Pancheti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Mental Status ◽  
Creatine Phosphokinase ◽  
Altered Mental Status ◽  
Protective Equipment ◽  
General Anaesthetic ◽  
Airway Protection ◽  
Halogenated Hydrocarbon ◽  
Adequate Knowledge

Introduction: Chloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and adequate knowledge about its toxic effects can lead to serious harm. Case report: A 33-year-old gentleman presented to the emergency department (ED) with altered mental status. Given his depressed mental status, the decision was made to intubate shortly after arrival for airway protection. Further history raised suspicion of occupational chloroform exposure. Brown-colored urine further strengthened suspicion of chloroform poisoning with resultant rhabdomyolysis. Forced alkaline diuresis and N-acetylcysteine were started in the ED. His mental status and respiratory efforts improved on hospital day two, and he was ultimately extubated. Creatine phosphokinase and myoglobin levels were initially high but gradually came down by hospital day six. On hospital day 10, the patient was deemed stable and safely discharged. Conclusion: A patient with chloroform inhalation who suffered resultant rhabdomyolysis and hepatotoxicity was successfully treated with early initiation of forced alkaline diuresis, N-acetylysteine, and hemodialysis.

Analysis of Deliberate Self-Wrist-Cutting Episodes Presenting to the Emergency Department

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 155-160 ◽  
Author(s):  
Jin Kim ◽  
Han Joon Kim ◽  
Soo Hyun Kim ◽  
Sang Hoon Oh ◽  
Kyu Nam Park
Keyword(s):  
Emergency Department ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Interview ◽  
Clinical Variables ◽  
Completed Suicide ◽  
Number Of Patients ◽  
Group A ◽  
Efficacy Of Treatment

Abstract. Background: Previous suicide attempts increase the risk of a completed suicide. However, a large proportion of patients with deliberate self-wrist cutting (DSWC) are often discharged without undergoing a psychiatric interview. Aims: The aims of this study were to investigate the differences in the characteristics and outcomes of patients with DSWC and those with deliberate self-poisoning (DSP) episodes. The results of this study may be used to improve the efficacy of treatment for DSWC patients. Method: We retrospectively reviewed the medical records of 598 patients with DSWC and DSP who were treated at the emergency department of Seoul Saint Mary's Hospital between 2008 and 2013. We assessed sociodemographic information, clinical variables, the reasons for the suicide attempts, and the severity of the suicide attempts. Results: A total of 141 (23.6%) patients were included in the DSWC group, and 457 (76.4%) were included in the DSP group. A significantly greater number of patients in the DSWC group had previously attempted suicide (p = .014). A total of 63 patients (44.7%) in the DSWC group and 409 patients (89.5%) in the DSP group underwent psychiatric interviews. Conclusion: More DSWC patients had previously attempted suicide, but fewer of them underwent psychiatric interviews compared with the DSP patients.

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Metropolitan Area ◽  
Suicidal Behavior ◽  
Mortality Risk ◽  
Illicit Drugs ◽  
Attempted Suicide ◽  
Cox Model ◽  
Emergency Department Admission ◽  
Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

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