Management after Electrical Injury
Complication of electrical injury | Comment/management |
---|---|
Burns | Seek advice on management from burns unit Patients with burns above the neck may have associated airway/lung injury with respiratory failure |
Musculoskeletal injuries | 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 |
Neurological and ocular injury | 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 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 |
Acute kidney injury | 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 |
Injury to abdominal | Damage is uncommon |
viscera | Refer to general surgeon if suspected |