electric burn injuries among adults --muhammad saaiq
DESCRIPTION
Conference PresentationTRANSCRIPT
ELECTRICAL BURN INJURY AMONG ADULTS:EXPERIENCE AT PIMS, ISLAMABAD.
Presenter: Muhammad Saaiq Authors:
Muhammad Saaiq , Hameed-ud-din, M.Ibrahim Khan,DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, PIMS ,
ISLAMABAD, PAKISTANPIMS , ISLAMABAD.
Presented at:IBCAST 2009 (International Bhurban Conference on Applied
Sciences and Technology ) Held at Centres of Excellence in Sciencesand Applied Technologies ( CESAT ), Islamabad.
Jan 19, 2009.
ELECTRICAL BURN INJURY
TYPES
High Voltage Injuries
Low Voltage Injuries
Cloud to ground Lightning
ELECTRICAL BURN INJURY
PATHOPHYSIOLOGY
Direct tissue damage from electrical energy.
Conversion to thermal energy.
Mechanical injuries.
ELECTRICAL BURN INJURY
FACTORS INFLUENCING THE SEVERITY
ELECTRICAL BURN INJURY
Magnitude of Energy delivered
Type of Current
Pathway of the Current
Duration of Exposure
Others
CLINICAL PRESENTATION
• Skin burns• Cardiac arrhythmias• Renal failure• Limb Compartment syndrome• Others
ELECTRICAL BURN INJURY
MANAGEMENT OF THE VICTIM
• General Management i.e ABCDEs
• Specific measures: a) Medical measures
I.V Fluid resuscitation
IV Bicarbonate
IV Mannitol
b) Surgical measures:Debridements
Fasciotomies
Amputations
Various Reconstructive Procedures.
ELECTRICAL BURN INJURY
A) Magnitude of Energy delivered
FACTORS INFLUENCING SEVERITY Of EBI
FACTORS INFLUENCING SEVERITY Of EBI
(Cont’d)
B) Type of Current
FACTORS INFLUENCING SEVERITY Of EBI
(Cont’d)
C) Duration of Exposure
FACTORS INFLUENCING SEVERITY Of EBI
(Cont’d)
D) Resistance Offered by the Tissues
FACTORS INFLUENCING SEVERITY Of EBI
(Cont’d)
E) Pathway of the Current
CLINICAL PRESENTATION of
ELECTRICAL BURN INJURY
• Skin burns / tissue trauma• Cardiac arrhythmias• Renal failure• Limb Compartment syndrome• Others
INVESTIGATIONS OF EBI VICTIM
• Basic essential tests• ECG• Urine for Myoglobin• CK• Others
MANAGEMENT OF EBI VICTIM
• General Management
• EBI specific measures
MANAGEMENT OF EBI VICTIM(Cont’d)
GENERAL MEASURES INCLUDE:
• A• B• C• D• E
F ?
EBI Specific Measures
a) Medical measures:• I.V Fluid resuscitation• IV Bicarbonate• IV Mannitol
EBI Specific Measures(Cont’d)
b) Surgical measures:• Debridement• Fasciotomies• Amputations• Reconstructive Procedures.
ELECTRICAL BURN INJURY;EXPERIENCE AT PIMS, ISLAMABAD.
Duration of the Study:Jan 01 2005 to June 30, 2007
Objective: To document the presentation and outcome of Electrical burn Injury in our set up.
Study Design: Descriptive Study.Place of the Study : Department of Plastic &
Reconstructive Surgery, PIMS, Islamabad. Duration of the Study:Jan 01 2005 to June 30, 2007Subjects and Methods: All adult Electrical burn
Injury victims presenting to the Department and consenting to participate in the study.
Data Collection and Processing: Proforma
Distribution of Burn Injuries Overall (n=561)
263
172
81
32
13
0 50 100 150 200 250 300
Flame burns
Scalds
Chemical
Electrical
Miscellaneous
5.70% of the total Patients were of Electrical Burn Injuries
016
11
3
1
1
0 5 10 15 20
Household Accidents
Workplace accidents
Iatrogenic
Contact with E. pole
Contact with transformer
NUMBER OF PATIENTS
Causes of Electrical burn injury (n=32)
Gender Distribution (n=32)
Male59%
Female41%
Age Distribution (n=32)
1
6
910
5
10
2
4
6
8
10
Number of Patients
0-10 11 20 21 -30 31 -40 41 -50 51 -60
Age ( Years)
Voltage Distribution Of Electrical burn injury (n=32)
High41%
Low59%
PROCEDURE NUMBER1 Debridements 282 Amputations 153 STSGs 144 Flaps 75 Fasciotomies / Carpal
tunnel Release6
Surgical Procedures Undertaken among the Victims of Electrical burn injury ( n=70)
AMPUTATION NUMBER
1 Upper Limb:RightLeft
63
2 Hand 1
3 Finger(s) 5
Various Amputations Undertaken among the Victims of Electrical burn injury (n=15)
ASSOCIATED INJURIES
NUMBER
1 Long bone fracture 1
2 Spinal cord trauma 1
3 Mild head injury 2
4 Genital injury 1
Associated Injuries found (n=4)
COMPLICATIONS NUMBER
1 Wound infection 5
2 Cardiac dysrhythmia 1
3 Renal failure 1
4 Sepsis 1
Complications Encountered (n=8)
Rate of Hospitalization : 71.87%
Average Hospital stay: 17 days ( Range 3-63 days)
Inhospital mortality: 01
Conclusion & Message