When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Electrical injury

Last reviewed: 21 Oct 2024
Last updated: 13 Feb 2024

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
Full details

Other diagnostic factors

  • diminished peripheral pulses and poor capillary refill
  • low core body temperature
  • confusion
  • paralysis
Full details

Risk factors

  • age <6 years
  • construction industry workers
  • male sex
  • participation in outdoor sports
Full details

Diagnostic tests

1st tests to order

  • ECG
  • CBC
  • electrolytes
  • LFTs
  • coagulation studies
  • creatine kinase
  • urine myoglobin
  • cardiac enzymes (CK-MB and troponin)
  • toxicology screen
  • chest x-ray
Full details

Tests to consider

  • plain x-rays
  • head CT
  • head MRI
  • compartment pressure measurements
Full details

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

    • 2023 focused update on adult advanced cardiovascular life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care
    • Rural adult emergency clinical guidelines, 4.1 ed
    More Guidelines
  • Patient information

    Burns

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer