Seek advice on management from burns unit

Patients with burns above the neck may have associated airway/lung injury with respiratory failure

Refer to plastic/orthopedic surgeon

Fractures, spinal injury, periosteal burns, destruction of bone matrix and osteonecrosis may occur

Deep electrothermal tissue injury may result in oedema and compartment syndrome

Manifestations of electrical injury include paralysis, autonomic dysfunction, secondary complications such as head or spinal injury, ruptured eardrum, hyphema and vitreous haemorrhage

Arrange CT/MRI if there is evidence of neurological/ocular injury

Cardiac contusion may occur

Incidence of arrhythmia following electrical injury is ∼15%, most benign and transient (atrial arrhythmias, first and second-degree atrioventricular block and bundle branch block)

Monitor ECG; request echocardiography if plasma troponin is raised or if there is significant arrhythmia

May occur due to hypovolaemia (from extravasation of fluid) and rhabdomyolysis (from muscle injury) (Appendix 25.1)

Fluid resuscitation

See Chapter 25 for management of acute kidney injury