Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents following a lightning strike event. History of loss of consciousness, cardiac arrest, or respiratory distress noted. Chief complaints include cutaneous burns, neurological deficits, paresthesia, or auditory/visual disturbances. Time since injury: [Time]. Mechanism: Direct strike/Side flash/Ground current.
Clinical Examination Findings
Physical exam reveals characteristic Lichtenberg figures (ferning pattern) on skin. Assessment for full-thickness burns, blast injuries (tympanic membrane rupture), and neurological status (GCS, motor/sensory). Cardiac monitoring shows [Rhythm]. Musculoskeletal exam for fractures or compartment syndrome.
Treatment Protocol
Immediate stabilization: ACLS protocols if indicated. Wound care: Debridement of necrotic tissue, topical antimicrobial dressings (e.g., silver sulfadiazine), and tetanus prophylaxis. Surgical intervention: Fasciotomy if compartment syndrome is suspected; serial debridement for deep thermal/electrical burns. Fluid resuscitation per Parkland formula adjusted for electrical injury.