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predictors of serious injury
- -rural area
- -construction environment
- -in mil: electrical equipment
- -*pathway of electricity that makes the difference, not amps and volts
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most important factor in electrocution
- heat causes coagulation necrosis
- victim will have burns, may be hidden
- joules law: small increase in amp can have large effect on heat
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AC vs DC current affect on heart
- AC: Vfib
- DC: Asystole
- lighting: Asystole
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what determines electricity's pathway of flow?
- type of tissue...path of least resistance. as things get wet, resistance goes down*.
- - nerve
- -blood
- -muscle
- -skin
- -tendon
- -fat
- -bone
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internal burns?
- electricity, yes (A/C), bouncing around inside
- lightning, no, flashover effect
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flashover effect
- from lightning injury, not electrical injury
- -feathering burns, punctate burns
- -skin intact
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electrical injury
- must enter and exit body, at least two wounds
- -deep, internal pathway
- -kissing burns - arc injury
- -lots of damage, fasciotomy common
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Initial Treatment applying to both Lightning & Electricity
- *secure scene, turn off power source
- reverse triage - treat dead first (those that look dead might be in Vfib and you can save)
- ABCs
- CPR/defib
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Treatment specific to Lightning
- -suspect hypothermia
- -dilated pupils do not mean death
- -spare IV fluids
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Treatment specific to Electricution
- -treatment for blunt injuries/trauma
- -generous IV fluids
- -high likelyhood of rhabdomyolysis and compartment syndrome
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when and where does lightning strike?
inland, afternoon, summer months
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