Electrical injury may be caused by exposure to high- or low-voltage electricity or lightning. Electronic control devices (e.g., Tasers) may also cause a mild electrical injury.
Recognition of arrhythmias is an essential element of the initial evaluation of electrical injury.
Most electrical shocks cause no injury.
May cause electrical and thermal burns, and secondary injuries due to a fall, or severe tetany. Pressure wave injury may occur subsequent to electrical blast.
Survivors of high-voltage electrical injury or lightning strikes can have long-term sequelae, and regular follow-up is essential.
Electrical injuries may be caused by exposure to natural lightning or electricity in the home or workplace. Electrical injury includes electrocution, electric shock, burns, and secondary injuries.
History and exam
Key diagnostic factors
- loss of consciousness
- prehospital CPR or defibrillation
- low Glasgow Coma Scale score
- physical injuries
Other diagnostic factors
- diminished peripheral pulses and poor capillary refill
- low core body temperature
- age <6 years
- construction industry workers
- male sex
- participation in outdoor sports
1st investigations to order
- coagulation studies
- creatine kinase
- urine myoglobin
- cardiac enzymes (CK-MB and troponin)
- toxicology screen
- chest x-ray
Investigations to consider
- plain x-rays
- head CT
- head MRI
- compartment pressure measurements
- Cardiac arrest
- Ventricular arrhythmia
- Illicit drug use
- Rural adult emergency clinical guidelines, 4.1 ed
- Guidelines for CPR and ECC
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