Electrical Injuries in the Emergency Department: An Evidence-Based Review - Trauma CME

<< Electrical Injuries in the Emergency Department: An Evidence-Based Review

Points and Pearls Digest

Points and Pearls Excerpt

During evaluation, consider multisystem injuries from thermal reactions, electrical damage, and mechanical trauma.
Thermal injury can lead to muscle breakdown, rhabdomyolysis, myonecrosis, edema, compartment syndrome, osteonecrosis, and periosteal burns.
Grasping an electrical source can cause tetanic muscle contractions and the inability to “let go,” which will increase the duration of contact and extent of injury.
Mechanical injury can result from forceful muscular contractions, and trauma can manifest as fractures and dislocations.
Electrical current tends to follow the path of least resistance. Deeper injuries may be found, despite relatively unaffected skin.

Most Important References

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Arnoldo BD, Purdue GF, Kowalske K, et al. Electrical injuries: a 20-year review. J Burn Care Rehabil. 2004;25(6):479-484. (Retrospective study; 700 patients) https://academic.oup.com/jbcr/article-abstract/25/6/479/4733 820?redirectedFrom=PDF
Blackwell N, Hayllar J. A three year prospective audit of 212 presentations to the emergency department after electrical injury with a management protocol. Postgrad Med J. 2002;78(919):283-285. (Prospective study; 212 patients) DOI: http://dx.doi.org/10.1136/pmj.78.919.283
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Bailey B, Gaudreault P, Thivierge RL. Neurologic and neuropsychological symptoms during the first year after an electric shock: results of a prospective multicenter study. Am J Emerg Med. 2008;26(4):413-418. (Prospective cohort study; 86 patients) DOI: https://doi.org/10.1016/j.ajem.2007.06.021
Avni T, Levcovich A, Ad-El DD, et al. Prophylactic antibiotics for burns patients: systematic review and meta-analysis. BMJ. 2010;340:c241. (Meta-analysis; 17 trials) DOI: https://doi.org/10.1136/bmj.c241
Zipes DP. TASER electronic control devices can cause cardiac arrest in humans. Circulation. 2014;129(1):101-111. (Case reports; 8 patients) https://www.ahajournals.org/doi/10.1161/ CIRCULATIONAHA.113.005504