Electrical Injuries in Emergency Medicine Medication

Updated: May 16, 2017
  • Author: Tracy A Cushing, MD, MPH, FACEP, FAWM; Chief Editor: Joe Alcock, MD, MS  more...
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Medication

Medication Summary

Hydration is the key to reducing the morbidity of severe burns. If there is significant muscle damage with myoglobinuria, an osmotic diuretic and/or alkalinizing agent is indicated.

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Fluids

Class Summary

Extravascular pooling of fluids through damaged endothelium leads to vascular hypovolemia and hypotension. Patients require fluid resuscitation with normal saline or lactated ringer.

Lactated Ringer solution

Lactated Ringer solution is essentially isotonic and has volume-restorative properties.

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Osmotic diuretics

Class Summary

Osmotic diuretics assist the kidneys in excreting myoglobin if present. They can help avoid acute renal failure in patients with significant myoglobinuria.

Mannitol (Osmitrol)

Mannitol is an osmotic diuretic that is not metabolized significantly and that passes through glomerulus without being reabsorbed by the kidney.

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Loop diuretics

Class Summary

These agents decrease plasma volume and edema by causing diuresis.

Furosemide (Lasix)

The proposed mechanisms for furosemide in lowering intracranial pressure include (1) lowering cerebral sodium uptake, (2) affecting water transport into astroglial cells by inhibiting cellular membrane cation-chloride pump, and (3) decreasing CSF production by inhibiting carbonic anhydrase. The dose must be individualized to patient.

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