Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presented following high-voltage electrical contact (>1000V). Mechanism involves [entry/exit point description]. Patient reports [loss of consciousness/tetanic muscle contractions/cardiac palpitations/dyspnea]. Assessment focuses on deep tissue necrosis, compartment syndrome risk, and systemic sequelae including rhabdomyolysis and potential cardiac arrhythmias.
Clinical Examination Findings
Physical exam reveals characteristic "kissing" burns at flexor surfaces. Entry/exit wounds assessed for depth, eschar formation, and neurovascular integrity. Distal pulses [present/absent/diminished]. Compartment pressures measured in [affected limb]. Neurological exam shows [intact/impaired] sensation and motor function. Cardiac monitoring confirms [normal sinus rhythm/arrhythmia].
Treatment Protocol
Immediate management includes aggressive fluid resuscitation (Parkland/modified formula) to maintain urine output >1ml/kg/hr. Surgical intervention: early escharotomy/fasciotomy for compartment syndrome, serial debridement of necrotic muscle/fascia, and wound coverage via [split-thickness skin graft/local flap/free flap]. Prophylaxis for tetanus and secondary infection initiated.