Electrical injury is caused by generated electrical current passing through the body, and may include burns, coagulation necrosis of limb arteries, rhabdomyolysis and cardiac arrhythmias (see Table 109.1).

Electrical burns can be direct-contact (potentially causing damage from entry to exit point, with a need to consider the tissues and organs between these two points), electrical arcs (which may cause thermal, flame and direct-current burns), flame (with ignition of clothing) or flash (current does not usually enter the body, but can cause large-surface-area burn, usually only partial thickness) (see Table 109.2).

Management of severe electrical injury consists of resuscitation, with vigorous fluid administration, supportive care on an ICU and involvement of surgical colleagues (plastic, vascular and orthopaedic) to address specific complications (see Table 109.3).