Burns (Adult) - Electrical

Developed by Prof H Rhode, Dr Albie van der Merwe, Dr Stephan Fourie & Prof A Millar & released as Circular H62 of 2011

(updated 2016 by Dr S Cox, Dr R Martinez & Prof H Rhode)

Special considerations with electrical injuries

• Differentiate between low-voltage (< 1 000 v) and high-voltage (> 1 000 v) injuries
• Attach a cardiac monitor; treat life-threatening dysrhythmias as needed.
• Assess for associated trauma; assess central and peripheral neurological function.
• Special investigations to assess fractures and serious soft tissue trauma/explosion in high voltage injury are necessary.
• High Voltage Electrical Injuries: suspect myoglobinuria. Keep urine output at 1- 1.5ml/kg/hr, administer Ringer’s lactate; titrate fluids to maintain adequate urine output or to flush pigments through the urinary tract (see urine output above).
• Useful laboratory test: arterial blood gas levels with acid/base balance.
• Using pillows, elevate burned extremities above the level of the heart. Monitor distal pulses.
• Suspect compartmental syndrome, consider escharotomies.
• Contact the regional burn centre for further instructions.