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Friday, June 12, 2020

MDM - Electrical Injury

[##]-year-old [male/female] presents with history and exam consistent with [low/high voltage] electrical injury [with dysrhythmia/superficial cutaneous burns/etc.].

Initial considerations in this patient included complications from electrical injury including dysrhythmias including ventricular and atrial arrhythmias, cutaneous burns, cardiovascular and central nervous system injuries, orthopedic injuries including fractures, dislocations and compartment syndrome, and rhabdomyolysis among others.

Patient presented with report of electrical injury from [household/industrial] source consistent with [low voltage (<1000 Volts)/high voltage (>1000 Volts) DC/AC current] exposure.  A 12-lead EKG was obtained with [no evidence of dysrhythmia, ischemia or infarction/notable for evidence of atrial fibrillation/frequent premature atrial/ventricular contractions/other specific abnormality].  Patient was noted to have [no evidence of significant cutaneous burns/first degree burns at the point of contact with electrical source with appropriate burn care provided in the ED].  Patient felt to have [no other concerning features with electrical exposure/high risk features including prolonged exposure/wet skin/loss of consciousness (LOC)].  Labs were [not obtained in patient felt to have no high risk features or findings on exam to suggest significant injury/obtained to include electrolytes/creatinine kinase/troponin/etc. and noted to be normal/notable for abnormality].  Patient noted to have [no focal deficits/subjective complaints of numbness/tingling with no significant focal deficits/describe abnormality] on neurological exam in the ED.

Prior to discharge, we discussed return precautions, specifically for evidence of significant electrical injury, symptomatic treatment, and recommended follow up with primary care provider in [1-2 weeks/2-3 days], and the patient demonstrated understanding and agreement with this plan.

https://www.ebmedicine.net/topics/burns/electric-shock-burns
http://www.emdocs.net/electrical-injury/

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