injuries poisoning
Electrical Injuries
Treatment of Electrical Injuries
Shutting off current Resuscitation Analgesia Sometimes cardiac monitoring for 6 to 12 hours Wound care The first priority is to break contact between the patient and the current source by shutting off the current (eg, by throwing a circuit breaker or switch, by disconnecting the device from its electrical outlet). High- and low-voltage power lines are not always easily differentiated, particularly outdoors. CAUTION:To avoid shock, rescuers should not try to disengage anyone entangled in power lines (whether of high or low voltage) until the power is shut off. Patients are resuscitated while being assessed. Prognosis , which may result from trauma or massive burns, is treated. Standard burn fluid resuscitation formulas, which are based on the extent of skin burns, may underestimate the fluid requirement in electrical burns; thus, such formulas are not used. Instead, fluids are titrated to maintain adequate urine output (about 100 mL/h in adults and 1.5 mL/kg/h in children). For myoglobinuria, maintaining adequate urine output is particularly important, while alkalinizing the urine may help decrease the risk of Severe pain due to an electrical burn is treated by the judicious titration of IV opioids. Asymptomatic patients who are not pregnant, have no known heart disorders, and who have had only brief exposure to household current usually have no significant acute internal or external injuries that would necessitate admission and can be discharged. Cardiac monitoringfor 6 to 12 hours is indicated for patients with the following conditions: Overview of Arrhythmias None Chest Pain None Any suggestion of cardiac damage Pregnancy (possibly [ Treatment reference ] and for fetal evaluation) Known heart disorders (possibly) Appropriate Prevention and All patients with significant electrical burns should be referred to a specialized burn unit. Young children with lip burns should be referred to a pediatric orthodontist or oral surgeon familiar with such injuries. 1.Caballero-Carvajal JA, Manrique-Hernández EF, Becerra-Ar C, et al: Secondary maternal-fetal consequences to electrical injury: A literature review.Taiwan J Obstet Gynecol59(1):1-7, 2020. doi: 10.1016/j.tjog.2019.11.001 