Most severe electrical injuries require urgent field treatment prior to hospital admission.

1. The first priority is to ensure that the source of the electrical injury is not a hazard to rescuers.

2. Management of cardiorespiratory arrest.

3. Prevention of further injury, e.g. spinal protection, removal of smouldering clothes

After hospital admission and restoration of the circulation management is directed towards the complications.

1. Maintain ventilatory support.

2. Management of hypovolaemia associated with burn injury. Fluid requirements are usually greater than for victims of thermal burns and require close monitoring.

3. Check cardiac enzymes for degree of myocardial injury. Treat heart failure and/or arrhythmias as indicated.

4. Management of rhabdomyolysis and covert compartment syndrome.

5. Surgical debridement of necrotic tissue and fixation of bony injury.

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