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Saturday, 10 March 2012



Electrical injuries often found in everyday practice and will come to the emergency . types of electrical injury: consists of threekinds of electric current injury, burns from the arcing currentelectrothermal, and burns caused by ignition of clothing fire.Sometimes, all three will be present in the same victim.
Flash or electrical burns are thermal injury to the skin caused byhigh voltage electric current reaches the skin of the conductor.Thermal injuries to skin an intense and deep, because the electric current has a temperature of about 2500 ° C (high enough to melt the bones). The fire burned clothes from the most frequent trigger ofserious injury. Wound care the same as for any thermal injury.
Due to damage of the electrical current is directly proportional to theintensity as stipulated by the law of Ohm. Thus, the electrical currentdepends on voltage and resistance are given by different parts of the body. Voltage above 40 V is considered dangerous.
After this time has entered the body, depending on the path it encounters resistance in various organs. The following are listed inorder of resistance: bone, fat, muscle, skin, muscle, blood, andnerves. Determining the current path of survival, for example, whengoing through the heart or brain stem death from ventricular fibrillation can be direct or apnea. Current passing through cancause muscle spasms severe enough to produce long-bonefractures or dislocations.
This type of current is also related to the severity of the injury. cyclealternating current that causes of the most severe injury.
INJURIES as more than just an electric shock burns. Focal burns occur at points of entry and exit through the skin. Once inside the body, this time traveling through the muscle, causing more injuries such as broken than thermal burns. Thrombosis often occurs at the far end of a ship, causing tissue necrosis depth greater than that seen on initial examination. Largest muscle injuries are usually closest to the bone, where the highest heat resistance is generated.Treatment of electrical injury depends on the extent of muscle and nerve destruction in more than any other factor.The occurrence of myoglobinuria may develop with the risk of acute tubular necrosis. Urine output should always be two to three times normal with intravenous fluids. Alkalinization of urine and osmotic diuretics may be indicated if there is myoglobinuria.The existence of rapid decrease in hematocrit suddenly sometimes following the destruction of red blood cells by electrical energy.Bleeding into the tissues may occur as a result of disruption of blood vessels and tissue planes. In some cases, destroyed thrombosed vessels and cause massive bleeding and interstitial.Wounds where skin burns at the entrance and exit normally depressed areas of gray or yellow eliminate the thickness of the dermis and surrounded by a zone of hyperemia sharply defined.Charring may be present if the arc burning side by side. Underlying lesion should didebridement to healthy tissue. Often there is not initially apparent in the destruction. Dead and devitalized tissue should also be excised.
 A repeated debridement typically show 24-48 hours after injury, due to extensive necrosis was found more than expected.Strategies to get the skin covering the burns depends on the breadth and depth of injuries. microvascular flaps are now used routinely to replace the loss of large networks.Handling In general, the treatment of electrical injury is complex at every step, and after initial resuscitation of these patients should be referred to specialized centers / burn center.

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