SAQ 175 – Burns – high-voltage electrical injury

Question 9. high-voltage electrical injury.

a. Significant injury features

• Finger involvement.
• Tissue loss and deep tissue involvement.
• White or black discolouration suggesting full-thickness burn.
• Mottling suggesting vascular thrombosis.

b. Systemic complications

• Colonic or small-bowel ischaemia.
• Pancreatitis.
• Bone ischaemia.
• Gallbladder inflammation.
• Vascular spasm and thrombosis.
• Rhabdomyolysis.
• Death.

c. Presenting ECG

• Patients without ECG changes are unlikely to develop life-threatening arrhythmias after household-voltage exposure.
• Any ECG change mandates further monitoring.

d. Ongoing monitoring indications

• ECG changes.
• Documented arrhythmia.
• High-voltage exposure above 1000 V.
• Loss of consciousness.
• Seizure.
• Previous cardiac disease, especially arrhythmia.
• Troponin elevation.