Electrocution is death or serious injury caused by electric shock, electric current passing through the body.
Take full history of type of injury, ?self inflicted/ foul play/ abuse,
Look for entry/ exit wounds, associated injuries, fractures, burns, necrosis etc.
Use PARADOXICAL TRIAGE – i.e. Treat the apparently dead before the living.
1. ABC’s, resuscitate as indicated (Resuscitation might need to be long & “aggressive”),
2. Cervical spine protection as indicated,
3. IV access,
4. IV fluids as indicated,
5. FBC, U&E’s, CK,
6. Urinalysis for myoglobinuria,
8. Monitor as appropriate,
9. Treat arrhythmias as indicated,
11. Catheterise to monitor urine output (aim for 1 ml/kg/hr in face of potential myoglobinuria),
12. Tetanus prophylaxis as indicated,
13. Admit for observation/ monitoring if:
· High voltage/monitoring if:
· High voltage (>600V),
· Chest pain,
· ECG changes (ST changes, transient arrhythmias, BBB, Heart block, VF, Asystole),
· Loss of consciousness,
· Neurovascular injury or
14. Only discharge if brief, low voltage with no ECG changes & normal tests period of observation. Advise that arrhythmias may occur in the next 2/52.