Back to Annual Meeting Program

1. Objective. We present the singular case of a patient who suffered devastating electrical injuries to illustrate the complexities faced in the treatment of this dramatic insult.
2. Design. Case report.
3. Setting. Hospital care.
4. Patients or other participants. A 25 year-old male found hanging from high-voltage wires and transported to the hospital after a 45 minutes prolonged extrication by rescue workers. The patient is transferred to a burn center after initial resuscitation, treatment of severe hyperkalemia and cardiac arrest.
5. Results. On admission to the burn center the patient is noted to have fourth degree burns of the back and bilateral lower extremities. Fasciotomies are performed and management of rhabdomyolysis is instituted. Multiorgan failure ensues prompting institution of critical care measures by a multispecialty team. Bilateral above-the-knee amputations are eventually required and a combination of serial debridement and vacuum assisted therapy is necessary for stump closure. Excision of the back leaves spinous processes exposed, but serial surgical interventions and grafting result in wound closure. After several months of hospitalization the patient begins rehabilitation and is subsequently discharged, reintegrating into the community.
6. Conclusions. Severe electrical injuries present multiple clinical challenges. Destructive high voltage injuries are best managed in a burn center and require the participation of a multidisciplinary specialized team.