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Trauma | Electrical & Radiation Burns

Specific Types of Burn Injuries

Electrical Burns: Three types:

  • Direct Contact burns – current to skin, Arc injuries – current jumps air to skin.
    • Source, voltage and type of current are invaluable to the attending physicians
    • Entrance Wound
    • Exit Wound
  • Flash burns (no electrical current passes through body)

If possible start two large bore IV lines for Lactated Ringer’s or normal saline

The human body is primarily water and makes a good conductor. 2 dangers of electrical burns:

  1. Large amount of deep tissue injury, always more than the entrance wound suggests.
  2. Patient might go into cardiac arrest from electrical shock. Prepare AED these patients have good chance of survival.

Lightning Injuries: 30% of those struck by lightning die. Pathway of tissue damage is often over rather than through the skin. Linear, feathery, pinpoint burns, patient may also suffer cardiac and respiratory arrest (most common causes of death).

Radiation Exposure: accidents usually involve sealed radioactive sources. Three types of radioactive particles:

  • Alpha: large, travel few mm, minimal penetrating capability, stopped by paper, clothing and skin, least dangerous external exposure, most dangerous internal exposure if inhaled, ingested or absorbed
  • Beta: 1/7000 the size of Alphas, more energy and penetration power. Usually enter via damaged skin, inhalation or ingestion
  • Gamma: most dangerous form of penetrating radiation. Only lead shields protect, internal and external hazard, localized skin burns and extensive internal damage

EMS Response: 200-300 feet upwind, PPE, SCBA. Contain the spread of contaminants, otherwise treat patient as usual.

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