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Electrical Injury, Emergency Medicine

Marilyn M. Hallock Reviewed 06/2017
 


Basics

Description

  • Electricity is the flow of electrons through a conductor, across a gradient, from high to low concentration

  • Nature and severity of electrical injuries depend on the voltage, current s...

Diagnosis

Signs and Symptoms

  • Head/neck/ENT:

    • Common entry site for high-voltage injuries:

      • Facial and corneal burns

      • Perforated tympanic membranes

      • Cataracts and optic nerve atrophy may present initially, or d...

Treatment

Pre-Hospital

  • Secure scene; turn off power source for high-voltage incident

  • Assume traumatic injury in unstable or unconscious patient:

    • Spinal immobilization

  • Standard basic life support/advanced ...

Follow-Up

Disposition

Admission Criteria

  • Documented loss of consciousness

  • Dysrhythmias, abnormal EKG, or evidence of myocardial damage

  • Suspicion of deep tissue damage

  • Myoglobinuria or acidosis

  • Burn criteria...

Pearls and Pitfalls

  • Prolonged cardiac monitoring is probably unnecessary in asymptomatic patients with normal EKG, no dysrhythmias, and exposure to <240 V

  • With significant electrical burn injuries, ...

Additional Reading

  • Bailey  B, Gaudreault  P, Thivierge  RL. Cardiac monitoring of high-risk patients after an electrical injury: A prospective multicentre study. Emerg Med J.  2007;24(5):348–352.

  • ...

Codes

ICD9

994.8 Electrocution and nonfatal effects of electric current 

ICD10

T75.4XXA Electrocution, initial encounter 

SNOMED

  • 371708003 Injury due to electrical exposure (disorder)

  • 269431000 Non-fatal el...

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