electrical burn
Introduction
Introduction to electric burn There are two types of electrical injury in clinical practice. One is systemic injury, which is called electric injury. The skin damage is slight, and the current enters the body and spreads throughout the body, mainly damaging the heart, causing drastic changes in hemodynamics, thereby presenting heart palpitations, dizziness, disturbance of consciousness, etc., and electroconvulsive and even cardiac arrest can occur. First aid allows the patient to quickly get out of the power supply and perform resuscitation. The other type is local damage. The current generates heat in the tissue whose conduction is blocked, causing tissue protein coagulation or charring, thrombosis, etc., called electric burn, and the tissue cells of the current conduction path (such as vascular endothelium) can also be affected by electrolysis. Damaged, spoiled, and necrotic. Patients with electrical burns are not suffering from systemic injury, but because the latter procedure is mild, there is only one-time sexual symptoms, and local injury is the main problem after recovery. basic knowledge The proportion of illness: 0.03% Susceptible people: people who are inadvertently charged or equipped with electrical appliances, circuits, etc. Mode of infection: non-infectious Complications: cataract shock
Cause
Cause of electric burn
Cause:
Mainly lacks knowledge of safe electricity, installs and repairs electrical appliances, wires are not operated according to the regulations, clothes are hung on the wires, high temperature, high humidity and sweating cause the surface resistance of the skin to decrease, which is easy to cause electrical damage, and the wires are broken in accidents. The human body and lightning strikes under the trees under thunderstorms or lightning strikes with iron umbrellas can cause electrical damage. The human body acts as a conductor, which becomes part of the circuit when it contacts the current. The weight and voltage of the human body are damaged, the current is strong, the DC and AC power, the frequency is high, the power-on time, the contact area, the current direction and the environment of the environment. The conditions are closely related, and the relationship with the voltage is greater, the voltage of 40V is the risk of tissue damage, 220V can cause ventricular fibrillation, 1000V can paralyze the respiratory center, and the current can depolarize the muscle cell membrane.
Prevention
Electric burn prevention
Prevention: Pay attention to the safety of electricity. If there is electric shock, cut off the power immediately. And a full-body examination, pay attention to whether the internal organ damage is combined, if it should be treated accordingly.
Complication
Electrical burn complications Complications cataract shock
Susceptibility to severe myocardial damage or sudden cardiac arrest, severe infection, injury to the head and face can be complicated by cataract complications. Cataract is a disease that occurs in the lens of the eye. Any opacity of the lens can be called cataract, but when the lens is opaque, it does not significantly affect vision without being discovered or ignored and not included in the cataract. . According to the survey, cataract is the most common cause of blindness and visual disability.
Symptom
Symptoms of electric burns Common symptoms of toxemia burn wounds shallow coffee... Burn wounds dark gray or... Electrocardiogram abnormal oliguria burn wounds pale yellow... Boxing hand deformity burns after urine volume reduction Burns nausea and vomiting burn wounds Sweet suffocating...
Diagnosis is easier, but close observation of deep lesion progression and concurrent infection should also pay attention to hypovolemia, low urine output and abnormal urine components (protein, cast, red blood cells, etc.), ECG changes and anemia.
Electric burns have "inlet" (ie, electric shock), and generally "export". There is a III° burn at the entrance, the skin is browned or charred, and some form a crack or a cave. The burn may reach the muscle, tendon, bone, and exit. It is also a III° burn change, but to a lesser extent; the lesions at the individual exits are not obvious, and the deep damage of electrical burns often far exceeds the entrance to the skin, but it is difficult to determine early, 24 hours after the injury, around the entrance The swelling is red, the range is gradually enlarged, local skin or limbs are necrotic, and the swelling of the limbs spreads to the proximal or peripheral. The reason for the deep injury is that the current passes through the skin and then damages the subcutaneous tissue, muscles and tendons, and damages the blood vessels. The wall promotes thrombosis, which can cause ischemia and necrosis of blood supply tissue. The range of necrotic tissue can be determined within 1 to 2 weeks after injury. The depth of necrosis in the deep necrosis is still more than superficial necrosis, swelling site, in the process of necrosis after electric burn. Easy to concomitant infection, can occur wet gangrene, sepsis, or even gas gangrene, etc., after the shallow necrotic tissue is detached, the injured extravascular , Severe recurrent bleeding may occur.
Examine
Electric burn inspection
Pay close attention to blood volume, urine volume and urine routine, electrocardiogram and blood cell analysis. The basic examination of all electric shocks should include: electrocardiogram, myocardial enzymes, whole blood count, urine analysis, especially myosin determination. If there is any sign of myocardial damage, arrhythmia or chest pain, 12 hours of cardiac monitoring should be performed. Ordinary ECG can only be used to simply observe the short-lived ECG activity at the time of ECG. The ECG monitoring is a non-invasive monitoring method for continuously monitoring the electrical activity of the heart through the display screen. It can observe the condition in time, provide reliable and valuable indicators of ECG activity, and guide real-time processing. Patients with abnormal activities, such as acute myocardial infarction, various arrhythmias, etc. have important value in use.
Diagnosis
Electric burn diagnosis
Some patients have very weak heartbeat and breathing after being electrocuted, and even stop temporarily. They are in a "fake death state". Therefore, it is necessary to seriously identify and not give up the rescue of electric shock patients. Death is a gradual process, and its time is irreversible; it is difficult for a fake deceased to distinguish itself from the real one. If the fake deceased is rescued in time, the possibility of recovery is great. If the action is slow and the timing is delayed, then it is easy to "fake the truth into reality" and make the fake deceased lose the possibility of regeneration. Therefore, it is very important to determine the state of suspended animation in time. It can be said that life is a matter of life.
