The initial management of the electrically injured patient follows standard resuscitative measures. If cardiopulmonary arrest has occurred, basic and advanced life support techniques should be applied persistently and aggressively, given the young and often previously healthy state of the victim's myocardium. While resuscitation proceeds, efforts should be made to identify the voltage and the duration and site of contact, as well as the presence and condition of protective clothing. A history from the patient or witnesses of a fall should direct attention to the possibility of blunt trauma and bleeding from damaged internal organs (e.g. spleen). Examination should identify the presence of fractures and dislocations, particularly of vertebrae, and the area and depth of any cutaneous burn, and in particular should include a search for electrical contact points.
Once immediate resuscitation is completed, admission to a multidisciplinary intensive care unit should be expedited so that the administration of oxygen, respiratory support, intravenous fluid, and pain relief can be continued with the benefit of comprehensive ECG, invasive, and blood gas monitoring. L.e.e il994) has described a treatment strategy used in the care of the electrically injured patient (Table.,!).
Table 1 Basic clinical management principles
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