Management of the burn wound – electrical

The initial management of patients presenting with electrical burns is unchanged from that already described, however there are key differences to bear in mind.

In contrast to thermal burns, deeper tissue damage may be far more extensive than any superficial wounds may suggest and may involve whole compartments of the limbs. In patients with electrical burns to a limb, a high level of suspicion of compartment syndrome should be maintained. 

Tissue damage from electrical burns may also lead to renal failure due to the release of haemochromogens into the circulation. For this reason, if the urine is pigmented, urine output targets should be doubled (to 1ml/kg/hr in adults or 2ml/kg/hr in children).

An ECG should be obtained on admission for every patient presenting with an electrical burn. However, if the patient is asymptomatic and the ECG is normal, then there is no need for further cardiac monitoring or admission.23