Electrical Burns In Adults

WHAT YOU SHOULD KNOW:

• Electrical burns are injuries that happen when an electric current (electricity) goes near or passes through your body. If you touch electric currents, parts of your body may be burned. The current may enter your body at one point and exit at another, causing damage wherever it passes. You may also get electrical burns even if the current does not go through your body. If you are near enough, electricity may jump from an electrical source to you. This creates an arc or flash with enough heat to burn your clothing or body. The current causes the most damage where the electricity enters and exits your body.
  
  
• You may get a low-voltage electrical burn from batteries or small machines. Voltage is a way to measure electricity. If you get burned by lightning or a machine with high voltage, then your burn may be worse. When you are burned, your tissue gets damaged and begins to die. Your muscles, tendons, blood vessels, nerves, and bones may also get damaged. You may have a fast heartbeat, reddish urine, or be dizzy and confused. With treatment, you may have less pain, tissue damage, or infections caused by germs called bacteria. You may be able to return to work or your normal daily activities sooner than without treatment.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• It may hurt when your caregiver changes your bandages. Your scars may itch or become thick and raised. You may get too much fluid in your body from fluids. Surgery to remove dead tissue may cause you to have pain or an infection. You may have bleeding that does not stop or you may need a blood transfusion. If you had a skin graft, your grafts may fail, leaving you with dead or infected tissue. You may need an amputation if your limb has too much dead tissue.
  
  
• With or without treatment, your burned skin may be painful or become infected. Your muscles may twitch or become smaller, making it hard to move parts of your body. Your brain may be damaged. Your organs and tissue may be damaged by compartment syndrome, which is too much pressure in your body. You may have eyesight or hearing problems. Your heart may stop beating and your lungs may stop working. You may die. Call your caregiver if you have concerns or questions about your surgery, condition, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Tubes:

• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• CVP line: A CVP line is also called a central line. It is an IV catheter or tube. It is put into a large blood vessel near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. The CVP line may be used to give medicines or IV fluids. It may also be hooked up to a monitor to take pressure readings. This information helps caregivers check your heart.
  
  
• Foley catheter: A Foley catheter is a tube that is put into your bladder to drain your urine into a bag. The bladder is an organ where urine is kept. Keep the bag of urine well below your waist. Lifting the urine bag higher will make the urine flow back into your bladder, which can cause an infection. Avoid pulling on the catheter because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink because this will block the flow of urine.
  
  
• Nasogastric (NG) tube: A nasogastric tube is put into your nose and down into your stomach. The tube may be attached to suction (vacuum) to keep your stomach empty. You may need a NG tube if your stomach gets too full or if you throw up a lot after surgery. You may also need it if you cannot use your mouth to eat. An NG tube may also be used to help get your bowels working. Food or medicine may be given through your NG tube.

Medicines: Your caregiver may give you the following kinds of medicines:

• Antibiotics: This medicine may be given to help treat or prevent an infection caused by germs called bacteria. This medicine may be put on your skin before your burn is bandaged. You may also get antibiotics as a pill, shot, or in your IV.
  
  
• Silver medicine: You may get medicine with silver in it to help fight infection. It may also help your burn heal faster. The silver may be placed on your skin as an ointment or may be part of your dressing.
  
  
• Heart medicine: This medicine may be given to make your heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with your caregiver to find out what your medicine is and why you are taking it.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Steroid medicine: Steroid medicine may be given to decrease inflammation. Steroid medicine may help your body heal after an electrical burn injury. It may help your muscles become stronger. Your caregiver may put steroids on your skin. He may also give it to you as a pill, shot, or in your IV. This medicine can help a lot but may also have side effects. Be sure you understand why you need steroids. Do not stop taking this medicine without your caregivers OK. Stopping on your own can cause problems.
  
  
• Diuretics: This medicine is often called "water pills". Diuretics help your body get rid of extra fluid (edema) in your legs and ankles. This medicine may also help get rid of extra fluid in your lungs or around your heart. It may also decrease your blood pressure. You may urinate more often when taking diuretics.
  
  
• Tetanus shot: This is medicine to keep you from getting tetanus. It is given as a shot. You should have a tetanus shot if you have not had one in the past 5 to 10 years. Your arm can get red, swollen, and sore after getting this shot.

Monitoring:

• Intake and output: Your caregivers may need to know the amount of liquid you are getting. They may also need to know how much you are urinating. Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Certain foods also contain liquid. You may need more or less liquid each day. Ask your caregiver how much liquid you should have each day. Ask caregivers if they need to measure or collect your urine before you dispose of it.
  
  
• Neurologic signs: Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your eyes, your memory, and how easily you wake up. Your hand grasp and balance may also be tested. This helps tell caregivers how your brain is working after an injury or illness. You may need to have your neuro signs checked often. Your caregiver may even have to wake you up to check your neuro signs.
  
  
• Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Tests:

• Blood and urine tests: You may need blood or urine tests to check for damage to your muscles, heart, and other organs. You may need to have these tests more than once.
  
  
• Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Sticky pads are placed on your chest or different parts of your body. Each pad has a wire leading to a small portable box (telemetry unit), or to a TV-type screen. This lets caregivers see a tracing of the electrical activity of your heart. The heart monitor may help caregivers see problems with the way your heart is beating. Do not remove any wires or sticky pads without asking your caregiver first.
  
  
• Imaging tests: These tests help your caregiver see images (pictures) that show how your body is doing. You may need any of the following:
  
  
  • Computed tomography scan: This is also called a CT scan. A special x-ray machine uses a computer to take pictures of your brain. Your caregiver may do this test to check for signs of brain injury after you have electrical burns. This may help your caregiver see if you have swelling, bleeding, or damage in your brain.
    
    
  • Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your head or other body parts. An MRI may be used to look at your brain, muscles, joints, bones, or blood vessels. An MRI may show if you have swollen muscles that may cause too much pressure in your body. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
    
    
  • Scintigraphy: Scintigraphy is a test that takes pictures of your body. Scintigraphy may help your caregiver find dead tissue in your body. Scintigraphy may also help your caregiver figure out how much dead tissue needs to be removed during surgery.
    
    
  • Ultrasound: An ultrasound is a simple test that looks inside of your body. Sound waves are used to show pictures of your organs and tissues on a TV-like screen.

Treatment options: You may need to go to a special treatment center for people with burns. Areas of your body with burns will be bandaged to keep the area moist and clean. Caregivers will monitor your condition to see if you are improving or need other treatments. Your may need any of the following:

• Fluids: If you need more fluid in your body, your caregiver may give you intravenous (IV) fluids. These fluids may contain protein, salt water, minerals, or glucose (sugar). An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and the liquid.
  
  
• Surgery: Ask your caregiver for more information about the following:
  
  
  • Debridement: This is surgery to remove damaged tissue from your body. Your caregiver will remove enough tissue until he can see your healthy tissue. Caregivers may do this to avoid infection, decrease inflammation (pain and swelling), and improve healing. Your caregiver may do this surgery more than once. Your caregiver may cover the surgery spot with a skin graft or flap.
    
    
  • Skin grafts and flaps: Your caregiver may place grafts to cover or replace the skin or tissue you lost from electrical burns. Grafts may come from other healthy tissue in your body. It may also be natural or man-made material. A graft can help close your wounds, prevent an infection, or decrease scarring. Skin flap surgery is done to fix large wounds that cannot be covered by skin grafting. A skin flap is skin and tissue near the wound that is used to cover the wound area. Skin flaps may improve the appearance of your skin.
    
    
  • Escharotomy: In an escharotomy, your caregiver will remove dead tissue from your body. An escharotomy may decrease your chance of infection and more damage to your skin.
    
    
  • Fasciotomy: Fasciotomy is surgery to cut into your fascia. Fascia is strong tissue that divides your body into sections. Cutting into your fascia will release pressure that is caused by swollen muscles. With fasciotomy, you may be less likely to have more damage to your nerves, tissue, or organs.
    
    
  • Nerve release: You may need to have a nerve release if a nerve in your body is compressed (pressed down) after your burn. Surgery is done to release the pressure on the nerve. This may help prevent your injury from getting worse.
    
    
  • Arthroplasty: This is surgery to fix damaged joints. Joints are areas in your body where two bones meet.
    
    
  • Amputation: Amputation is surgery to remove one of your body limbs, such as a finger, arm, or leg. You may need an amputation if there is too much dead tissue in your limb.
  
  
• Blood transfusion: A blood transfusion may be needed if you lose too much blood. Whole blood or parts of blood will be given through a small tube placed in your vein. Ask your caregiver for more information on receiving blood products.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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