ICU SAQs · Burns
High-voltage electrical injury — the management
A CICM Second-Part SAQ on high-voltage electrical injury — delayed arrhythmia monitoring, rhabdomyolysis fluids to a urine-output end point, surgical decompression rather than escharotomy, and arc-blast trauma.
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Prompt
A worker touches an 11,000 V power line and presents with an entry wound on the hand, an exit wound on the foot, dark urine, and an initial VF arrest that was reversed. Outline the management.
Question
A worker touches an 11,000 V power line and presents with an entry wound on the hand, an exit wound on the foot, dark urine, and an initial VF arrest that was reversed. Outline the management.[1]
References5ShowHide
- [1]Culnan DM, Farner K, Bitz GH, et al. Volume Resuscitation in Patients With High-Voltage Electrical Injuries. Annals of plastic surgery, 2018.PMID 29461290
- [2]Waldmann V, Narayanan K, Combes N, et al. Electrical cardiac injuries: current concepts and management. European heart journal, 2018.PMID 28444167
- [3]Scharman EJ, Troutman WG Prevention of kidney injury following rhabdomyolysis: a systematic review. The Annals of pharmacotherapy, 2013.PMID 23324509
- [4]Burd A, Noronha FV, Ahmed K, et al. Decompression not escharotomy in acute burns. Burns : journal of the International Society for Burn Injuries, 2006.PMID 16527416
- [5]Fish RM, Geddes LA Conduction of electrical current to and through the human body: a review. Eplasty, 2009.PMID 19907637