Electricity
Electricity
Electricity
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orespiratory status. Immediately after electrocution, respiration or circulation or both may fail. The patient may be
apneic, mottled, unconscious, and in circulatory collapse
with VF or asystole.
Vigorous resuscitative measures are indicated, even for
those who appear dead on initial evaluation. The prognosis
for recovery from electric shock or lightning strike is not
readily predictable because the amplitude and duration of
the charge usually are unknown. However, because many
victims are young and without preexisting cardiopulmonary
disease, they have a reasonable chance for survival if
immediate support of cardiopulmonary function is
provided.
If spontaneous respiration or circulation is absent, initiate
the ABCD techniques outlined in parts 3 and 4 of these
guidelines, including EMS system activation, prompt
CPR, and use of the AED. The presenting cardiac ECG
rhythm may be asystole or VF [23].
As soon as possible, secure the airway and provide ventilation and supplemental oxygen. When electric shock
occurs in a location not readily accessible, such as on a
utility pole, rescuers must lower the victim to the ground
as quickly as possible. Note: Actions that involve rescuer
proximity to live current must be performed only by
specially trained rescuers who know how to execute this
task. If the victim remains unresponsive, rescuers should
start the standard ABCD protocols, including AED use by
lay responders.
If the victim has no signs of circulation, start chest
compressions as soon as feasible. In addition, use the
AED to identify and treat VT or VF.
Maintain spinal protection and immobilization during
extrication and treatment if there is any likelihood of head
or neck trauma [23,24]. Electrical injuries often cause
related trauma, including injury to the spine [24] and
muscular strains and fractures due to the tetanic response
of skeletal muscles. Remove smoldering clothing, shoes,
and belts to prevent further thermal damage.
Modication of ACLS Support for Arrest Caused by
Electric Shock or Lightning Strike
Treat VF, asystole, and other serious arrhythmias with
ACLS techniques outlined in these guidelines. Quickly
attempt debrillation, if needed, at the scene.
Establishing an airway may be difcult for patients with
electric burns of the face, mouth, or anterior neck. Extensive
soft-tissue swelling may develop rapidly and complicate
airway control measures, such as endotracheal intubation.
For these reasons, intubation should be accomplished on an
elective basis before signs of airway obstruction become
severe.
For victims with hypovolemic shock or signicant tissue
destruction, rapid intravenous uid administration is indicated to counteract shock and correct ongoing uid losses.
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