Overview
What are electrical injuries and how do they occur?
How should occupational electrical injuries be documented?
What is the pathophysiology of electrical injuries?
What is the role of voltage in the pathogenesis of electrical injuries?
What is the role of current in the pathogenesis of electrical injuries?
What is the role of resistance in the pathogenesis of electrical injuries?
What is the role of the circuit type in the pathogenesis of electrical injuries?
What are the types of electrical burns?
What is the pathophysiology of electrical injuries from direct contact?
What is the pathophysiology of electrical injuries from electrical arcs?
What is the pathophysiology of electrical injuries from flame?
What is the pathophysiology of electrical flash burns?
How do electrical injuries occur?
How does high-voltage alternating current cause electrical injuries?
How does low-voltage alternating current cause electrical injuries?
How does direct current cause electrical injuries?
What is the prevalence of electrical injuries in the US?
What are the racial predilections of electrical injuries?
What are the sexual predilections of electrical injuries?
How does the incidence of electrical injuries vary by age?
What is the prognosis of electrical injuries?
Presentation
What are the signs and symptoms of electrical injuries?
Which clinical history findings are characteristics of low-voltage alternating current (AC) injury?
Which clinical history findings are characteristics of high-voltage alternating current (AC) injury?
Which clinical history findings are characteristics of direct current (DC) injury?
What is the role of conducted electrical devices in the pathogenesis of electrical injuries?
Which physical findings are characteristic of electrical flash burns?
Which physical findings are characteristic of electrical contact burns?
Which physical findings are characteristic of electrical injuries?
Which cardiovascular findings are characteristic of electrical injuries?
Which respiratory findings are characteristic of electrical injuries?
How are the cutaneous findings of electrical injuries characterized?
Which physical findings are characteristic of high-voltage electrothermal burns?
Which physical findings are characteristic of electrical arc burns?
Which physical findings are characteristic of electrical flame burns?
Which physical findings are characteristic of low-voltage electrical injuries?
Which physical findings are characteristic of pediatric oral electrical injuries?
Which neurologic findings are characteristic of electrical injuries?
Which musculoskeletal findings are characteristic of electrical injuries?
Which physical findings on the head are characteristic of electrical injuries?
What are the possible complications of low-voltage electrical injuries?
What are the possible complications of high-voltage electrical injuries?
DDX
What are the differential diagnoses for Electrical Injuries in Emergency Medicine?
Workup
What is the role of lab studies in the diagnosis of electrical injuries?
What is the role of imaging studies in the diagnosis of electrical injuries?
What is the role of ECG and cardiac monitoring in the evaluation of electrical injuries?
When is central venous access indicated in the management of electrical injuries?
What is the role of fasciotomy in the evaluation of electrical injuries?
Treatment
What is included in prehospital care for electrical injuries?
How are electrical injuries treated in the emergency department (ED)?
When is inpatient care indicated for the treatment of electrical injuries?
When is patient transfer indicated for the treatment of electrical injuries?
Which specialist consultations are beneficial to patients with electrical injuries?
How are electrical injuries prevented?
What is included in the long-term monitoring of electrical injuries?
Medications
Which medications are used in the treatment of electrical injuries?
-
Arcing electrical burns through the shoe around the rubber sole. High-voltage (7600 V) alternating current nominal. Note cratering.
-
Contact electrical burn. This was the ground of a 120-V alternating current nominal circuit. Note vesicle with surrounding erythema. Note thermal and contact electrical burns cannot be distinguished easily.
-
Contact electrical burns, 120-V alternating current nominal. The right knee was the energized side, and the left was ground. These are contact burns and are difficult to distinguish from thermal burns. Note entrance and exit are not viable concepts in alternating current.
-
Electrical burns to the hand.
-
Electrical burns to the foot.
-
High-voltage electrical burns to the chest.
-
Superficial electrical burns to the knees (flash/ferning).
-
Energized site of low-voltage electrical burn in a 50-year-old electrician.
-
Grounded sites of high-voltage injury on the chest of a 16-year-old boy who climbed up an electric pole.
-
Energized site of the high-voltage injury depicted in Media File 9 (16-year-old boy who climbed up an electric pole).
-
Entrance site of a low-voltage injury.
-
Grounded sites of a low-voltage injury in a 33-year-old male suicide patient.
-
Grounded site of a low-voltage injury in the same 33-year-old male patient depicted in Media File 12.
-
Grounded sites of low-voltage injury on the feet.
-
A histologic picture of an electrical burn showing elongated pyknotic keratinocyte nuclei with vertical streaming and homogenization of the dermal collagen (40X). Courtesy of Elizabeth Satter, MD.