management

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management

The first step is to turn off the electrical source safely in order to avoid further accidents. Once the patient is safe, manage according to the symptoms.

  • perform basic life support
    • prompt and sometimes  prolonged resuscitation attempt is warranted
      • immediate resuscitation is vital since it can result in long term survival in patients with cardiac arrest from electrocution
      • furthermore complete recovery has been reported even after prolonged life support
    • standard life support principles should be used
    • IV hydration is recommended to prevent kidney shut down even in the absence of low blood pressure
  • look for clinical signs to assess effects of electrical current on the patient’s body
    • if there is extensive burns - admit patient to burns unit
    • pregnant women should be admitted to obstetrics for fetal cardiac monitoring
    • identify the entry and exit points to determine which organs could be damaged
  • the following patients should be admitted to the hospital for continuous ECG monitoring and further management
    • with initial loss of consciousness
    • cardiac anomalies
    • high voltage injury

Discharging the patient:

  • low voltage accidents
    • in the absence of loss of consciousness or initial cardiac arrest - patient can be discharged since episodes of arrhythmia is unlikely if the ECG on admission was normal
  •  high voltage accidents
    • monitor ECG for at least 24 hour
      • patients should be educated about delayed cardiac arrhythmias which may rarely lead to sudden death
    • discharge if arrhythmia free for at least 24 hours (1)

Reference:

Last reviewed 01/2018