Burns Chemical & Electrical

 

History:

 

  • Exposure to heat/gas/chemical
  • Inhalation injury
  • Time of Injury
  • Past medical history
  • Medications
  • Other trauma
  • Loss of consciousness

 

Significant Findings:

 

  • Pain
  • Swelling
  • Dizziness
  • Loss of consciousness
  • Hypotension/shock
  • Airway compromise/distress
  • Singed facial or nasal hair
  • Hoarseness/wheezing

 

Differential:

 

  • Superficial (1st⁰) : red and painful (don't include in TBSA)
  • Partial thickness (2nd⁰) : blistering
  • Full thickness (3rd⁰) : painless, charred or leathery skin
  • Thermal
  • Chemical
  • Electrical
  • Radiation

 

 

 

 

  • Oxygen
  • Consider Spinal Immobilization
  • Fly critical and serious burns to a burn center if possible
  • If eye involvement flush with water or Normal Saline for 10-15 min
  • Remove rings, bracelets, and other constricting items
  • Protect burns/wounds with sterile dressing; do not attempt to remove clothing that is adhered to the burn area
  • Identify entry and exit sites; apply sterile dressings

 

 

  • Consider 12-Lead EKG

 

Chemical and Electrical Burn Patients MUST be Triaged using the Guidelines below and their care must conclude in the:

 

 

Critical or Hypotensive ?

 

  • No

 

    • Notify receiving facility or contact Medical Control

 

  • Yes

 

 

 

 

 

    • Notify receiving facility or contact Medical Control

 

Pearls Chemical:

 

  • Refer to Decontamination Standard Procedure (Skill) WMD Page
  • Certainly 0.9% NaCl Solution or Sterile Water is preferred, however if if it is not readily available, do not delay, use tap water for flushing the affected area or other immediate water sources. Flush the area as soon as possible with the cleanest readily available water or saline solution using copious amounts of fluids.

 

Pearls Electrical:

 

  • DO NOT contact the patient until you are certain the source of the electric shock has been disconnected.
  • Attempt to locate contact points, (entry wound where the AC source contacted the patient, an exit at the ground point) both sites will generally be full thickness.
  • Cardiac Monitor, anticipate ventricular or atrial irregularity, to include V-Tach, V-Fib, heart blocks, etc.
  • If able, identify the nature of the electrical source (AC vs. DC), the amount of voltage and the amperage the patient may have been exposed to during the electrical shock.

NREMR

National Registry Emergency Medical Responder

NREMT

National Registry Emergency Medical Technician

NREMT-I

National Registry EMT-Intermediate