Electric injury, part I: treatment priorities, subtle diagnostic factors, and burns.

Patients with electric injury present a significant challenge. Possible mechanisms of injury include electrical disruption of cardiac rhythm and breathing, burns of several types, and inhalation of gases from fires. Mechanical trauma may come from electric arc blast, explosion of gases, falls, and strong muscle contractions. Additionally, the patient may have multiple co-existent injuries, comorbidities, an abnormal mental status, and a severely disrupted acid-base balance. These factors can make diagnosis and treatment difficult. In addition, electric injury can cause a number of slowly developing and subtle sequelae that may be difficult, if not impossible, to diagnose on initial examination.