What is the primary concern for an electrical burn patient?

Burn depth: The issues of electrical burn are the extent of the tissue injury that you cannot see. Many times there may be more injury following the path of the current than what can be appreciated at first glance. Suggest functional evaluation of the entire path of the current and then follow up in 3-5 days to determine best course.

Extent of injury: Electrical burn injuries cause coagulation of blood vessels around margins of wound, resulting in gradual loss of tissue. Conservative removal of devascularized tissue over several sessions is best. After extent of loss is known, repair of the defect can be performed. Scarring and loss of pigmentation of skin area is common.

Depends...: Electrical injuries are complex, especially high voltage injuries. These can cause cardiac abnormalities, nerve and muscle damage, and changes in behavior-- and often cause more deep tissue damage than is apparent from the outside. Any significant electrical injury should be evaluated at a regional burn center, because they have the potential to cause a great deal of damage.

Extent of damage : The primary concern is assessing the extent of damage which can be deeiving due to the "tip of the iceberg" effect. The surface damage may be misleading and not reveal the extent of muscle and nerve injury. Muscles should be assessed for tissue death and possible early compartment syndrome requiring release and debridement.