Page 24 - 2026 SMOG

BURNS/ELECTRICAL INJURY
Call the Burn Center:
DSN: 312-429-2876 (429-BURN)
Comm: 210-916-2876 or 210-222-2876
STOP the burning process/remove the patient from the electrical source. Ensure your safety first!
History Differential Diagnosis
• How long ago was the injury? • Cardiac arrest
• Any signs of airway involvement? • Environmental exposure
• How big/small of a space was the patient • Seizure
in during the incident? (inhalation/carbon • Burns (chemical, electrical, thermal,
monoxide/cyanide toxicity) radiation)
• Are there other traumatic injuries associated? • Multiple trauma
• Any spinal immobilization needed? (fall • Carbon monoxide toxicity
from height, blast etc.)
Treatment
• Assess for additional injuries and treat life threats first (DO NOT overlook TRAUMA),
IV/IO, O , and monitor (electrical injuries must have a 12-lead EKG completed to assess for
2
arrhythmias)
• Electrical: If arrhythmia is present, go to the appropriate cardiac protocol
• Remove any constricting items (i.e., rings and bracelets). Consider elevating burned extremities
if able.
• Assess airway; if suspected airway involvement, move to AIRWAY PROTOCOL.
˚ Indications for endotracheal intubation include a comatose patient, symptomatic inhalation
injury, deep facial burns, and burns over 40% Total Body Surface Area (TBSA). Requires
ETT (8.0min) in adults.
• Thermal/Electric Burn: If able, remove burning/charred clothing and cover with dry, sterile
sheets/dressings.
• Chemical Burn: Brush off dry chemicals, cut off contaminated clothing, flush the area with
saline for 10–15 minutes.
˚ Eyes: flush with saline for 30min
˚ Hydrofluoric acid: after thorough irrigation, apply a CaGlu gel (3:1 ratio of KY Jelly to
10% CaGlu) for 30min
˚ Tear Gas: rinse skin and eyes with NS
Alkali Burns to eye: 12L of NS each eye for 30min
˚
• Determine/start fluid replacement for burn fluid resuscitation
• Manage pain and prevent hypothermia. KEEP WARM!
• Monitor urinary output, if able.
Notes, Cautions, Warnings
• Urinary output is the MOST reliable guide for adequate resuscitation
˚ Adult: 30–50mL/hr (75–100mL/hr electrical burns)
Pediatrics <40kg: 0.5–1mL/kg/hr
˚
• Edema after burn injury causes most supraglottic airway devices to be inadequate.
• Ventricular fibrillation (in AC) and asystole (in DC) are the most common dysrhythmias seen
with electrical shock.
Reference: CPG ID #20 (Burn Care)

16 • TRAUMA