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Case of Electrical Burn

Case of Electrical Burn. Gaddi.Tagomata.Talan.Toledo.Tolibas . Wi. General Data. WB 25M Married Construction worker from Manila. Chief Complaint. Electrical burn. History of Present Illness. DOI: December 22, 2013 TOI: 11:30 NN POI: Singalong , Manila MOI: electrical injury.

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Case of Electrical Burn

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  1. Case of Electrical Burn Gaddi.Tagomata.Talan.Toledo.Tolibas.Wi

  2. General Data WB 25M Married Construction worker from Manila

  3. Chief Complaint Electrical burn

  4. History of Present Illness DOI: December 22, 2013 TOI: 11:30 NN POI: Singalong, Manila MOI: electrical injury

  5. History of Present Illness 30 mins post-injury raising a metal rod from third floor to fourth floor ↓ rod hit a nearby electrical wire ↓ electrocuted and fell (+) LOC (-) vomiting ↓ PGH ER

  6. Primary Survey • Airway • Breathing • Circulation • Deficit • Exposure

  7. Initial Assessment • Electrical burn 31% TBSA With cutaneous burn With fall component

  8. Secondary Survey • Past Medical History (-) DM, HPN, BA, allergy, bleeding disorder • Family Medical History (-) DM, HPN, BA, allergy, bleeding disorder • Personal and Social History smoker, 0-2 sticks/day occasional alcoholic drinker denies illicit drug use

  9. Review of Systems (-) headache, nausea, vomiting (-) cough and colds (-) chest pain, palpitations (-) difficulty of breathing (-) abdominal pain (-) changes in bowel movement (-) urinary changes

  10. Physical Examination

  11. Course at the ER NPO for now IVF: R: PLR 1L @ 240cc/hr x 8 hrs L: PLR 1L @ 240cc/hr x 8 hrs Then 120 cc/hr on R and L X 16 hrs

  12. Diagnostics: CBC, BT, PT/PTT, BUN, crea, Na, K, Cl, UA with myoglobin, 12 L ECG, CXR PA, pelvis AP, Towne’s, Water’s, SMV plain cranial CT with BW

  13. Therapeutics ATS 3000 u TeAna 0.5 cc Omeprazole40mg IV OD Tramadol50 mg IV q 8

  14. Course in the ICU • 1st PBD • Start NGT feeding • Dressing: SSD • For application of MEBO + Duoderm • 2nd PBD • MV + Zinc 1 tab OD OD • Vitamin C 1 tab OD OD

  15. 3rd PBD • DAT with SAP, increase OFI • 4th • Give 50 mg NaHCO3 SIVP • IVF D5NR 1L @ 115 cc/hr + SD Plr 1 L + 50 mg NaHCO3 @ 125 cc/hr

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