OVERVIEW

Electrical Injuries in the Emergency Department: An Evidence-Based Review (Trauma CME) is organized by EB Medicine.

Date of Original Release: November 01, 2018
Date of most recent review: October 15, 2018
Termination Date: November 01, 2021
CME Expiration Date: November 30, 2021

Target Audience:
This enduring material is designed for emergency medicine physicians, physician assistants, nurse practitioners, and residents.

CME:
This issue includes 4 AMA PRA Category 1 Credits™; 4 ACEP Category I credits; 4 AAFP Prescribed credits; and 4 AOA Category 2 A or 2B CME credits. Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval.

Description:
A patient presenting to the ED after an electric shock is a potential multisystem trauma patient. All body systems can be affected by electrical injury: musculoskeletal, cardiac, vascular, respiratory, and neurologic. History and physical examination will be the best indicators of the extent of injury.
• What are the cutaneous markers for deep tissue injury?
• How should you prioritize traumatic injury over burn injury?
• What do the entrance/exit points tell you about which body system may be injured?
• What are the chances for DVT following deep vascular burn?
• What are the chances for neurologic injury, including deafness, paresthesia, and delayed depression?
• All patients will need an ECG, but who requires cardiac monitoring? Who can be discharged?
• Should you use the Parkland formula for fluids?
• Should you give prophylactic antibiotics?
• How should patients with Taser injuries be managed?

Objectives:
Upon completion of this article, you should be able to:
• Describe the pathophysiology and epidemiology of electrical and lightning strike injuries, both obvious and occult.
• Determine the severity of injury based on the mechanism of the electric shock and the physical examination
• Disposition patients based on the severity of the injury and likelihood of delayed effects.