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Electrical injury

Last reviewed: 6 Nov 2023
Last updated: 22 Nov 2023

Summary

Definition

History and exam

Key diagnostic factors

  • loss of consciousness
  • prehospital CPR or defibrillation
  • tachycardia
  • hypotension
  • low Glasgow Coma Scale score
  • burns
  • physical injuries
More key diagnostic factors

Other diagnostic factors

  • diminished peripheral pulses and poor capillary refill
  • low core body temperature
  • confusion
  • paralysis
Other diagnostic factors

Risk factors

  • age <6 years
  • construction industry workers
  • male sex
  • participation in outdoor sports
More risk factors

Diagnostic investigations

1st investigations to order

  • ECG
  • CBC
  • electrolytes
  • LFTs
  • coagulation studies
  • creatine kinase
  • urine myoglobin
  • cardiac enzymes (CK-MB and troponin)
  • toxicology screen
  • chest x-ray
More 1st investigations to order

Investigations to consider

  • plain x-rays
  • head CT
  • head MRI
  • compartment pressure measurements
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Baljit Dheansa, MBBS, FRCS, MSc, FRCS (Plast)

Consultant Burns, Plastic & Reconstructive Surgeon

Honorary Senior Lecturer

Queen Victoria Hospital NHS Foundation Trust

West Sussex

UK

Disclosures

BD is the Chair of the Data Monitoring Board of a trial studying enzymatic debridement of burns, and Chair of the Steering Committee of a trial studying LASER treatment of scars. He is also an expert witness in medicolegal cases involving burns, and regularly teaches on burn injury to students and health professionals.

Ahmed Hagiga, MBBCh, MRCS, MSc

Plastic Surgery Registrar

Plastic Surgery Department

Queen Victoria Hospital NHS Foundation Trust

West Sussex

UK

Disclosures

AH declares that he has no competing interests.

Acknowledgements

Mr Dheansa and Mr Hagiga would like to gratefully acknowledge Dr Juan Enrique Berner and Dr T Grant Phillips, previous contributors to this topic.

Disclosures

JEB and TGP declare that they have no competing interests.

Peer reviewers

Stephen J. Ritz, DO

UPMC St. Margaret Family Medicine Residency and Faculty Development Fellowship

Osteopathic Family Practice/Rotating Internship Program

Pittsburgh

PA

Disclosures

SJR declares that he has no competing interests.

Catalina C. Ionita, MD

Assistant Professor of Neurology and Neurosurgery

SUNY

Buffalo

NY

Disclosures

CCI declares that she has no competing interests.

Bernd Hartmann, MD

Chief Physician

Centre for Severe Burns Injuries with Plastic Surgery

Unfallkrankenhaus Berlin (Trauma Hospital Berlin)

Berlin

Germany

Disclosures

BH declares that he has no competing interests.

  • Differentials

    • Cardiac arrest
    • Ventricular arrhythmia
    • Illicit drug use
    More Differentials
  • Guidelines

    • Rural adult emergency clinical guidelines, 4.1 ed
    • Guidelines for CPR and ECC
    More Guidelines
  • Patient leaflets

    Burns

    More Patient leaflets
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