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21 Cards in this Set
- Front
- Back
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pathognomonic for lightening injuries
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feathering (lichtenberg figures), punctate or linear burns
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can one treat a lightening injury the same as a high voltage electrical injury
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no...large volume resuscitation, fasciotomies and other aggressive treatments common in high voltage injuries are almost never necessary in lightening injuries
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lightening injured patients ar candidates for D/C only when
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they are asymptomatic with a normal ECG including those with feathering hoever f/u with neuro,optho and ent must be ensured as delayed sequelae are common
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lightening injured pregnant patients requireadmission for fetal
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U/S and 4 hours of tocodynometric monitoring if beyond 20 weeks
treatment for fetal demise is evacuation |
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cardiovascular care of lightening injuries
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is not different from treatment of primary cardiac causes ...dysrhythmias may not occur until 24 hours asystole and V fib are more common in the field than ED transient htn is the rule and does not usually require treatment
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most lightening burns are in fact
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superficial and do not require special treatment
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hypottension in the setting of lightening injury should
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should cause a prompt search for a bleeding source
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fixed dilated pupils in the setting of lightening injury may
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be the result of local eye injury not CNS damage...also paralyzed extremities that are cool mottled and pulsless may be observed but the limb usually returns to normal in a few hours once the vasospasm resolves
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pregant patients are not at increased risk for mortality in lightening strikes however
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fetal death occurs in about half of these patients as a result of high conductivity of amniotic fluid
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side flash is?
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not being struck directly but from nearby objects and such not exactly the same as contact injury
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common pressure injuries of lightening strikes
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TM rupture for one
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death from lightening is usually due to
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cardiac arrest...respiratory arres also occurs secondarily to paralysis of the respiratory center in the medulla which may also lead to cardiac arrest from hypoxia
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the temporary paralysis of the extremities that occurs comonly in lightening injuries is referred to as
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keraunoparalysis...it is due to an intense vasospasm and usually clears within hours...delaye injuries which are likely progressive inclyed sz, neuromusc d/os, ataxia, extremety weakness, paralysis and chronic pain
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half of lightening visctims will have eye injuries most commonly
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cataracts
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most direct burns from lightning are
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superficial from rapid flashover effect
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feathering is from what
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not burns but electron showering
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requiring rescusitation at the scene worsens prognsos
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just saying
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indicate sever injury
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burns to the head
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unreliable indicator of cranial nerve funcgtion in lightning victims
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pupillary findings
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most frequent rhythm abnormality scene with lightning injuries
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QT prolongation but ECG changes may be delayed for 24 hours
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who gets there head spun in a lightening strikepts with
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patients with ALOC, CXR should be obtained in errbody to rule out Pneumothorax or other pulmonary injury
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