›Ongoing IV fluids titrated to urine output target local protocol dependent
›Avoid potassium containing fluids if hyperkalemia
›Electrolyte management
›Potassium correction
›Calcium correction only if symptomatic
›Phosphate correction if severe
Pain control
›Analgesia
›Acetaminophen PO or IV
›Opioid IV for severe pain
›Avoid NSAIDs if acute kidney injury concern
Consultation and transfer
›Consultation plan
›Burn center criteria consideration
›Surgery or orthopedics if compartment concern
›Cardiology if persistent ECG changes
›Trauma team if multisystem trauma
Reassessment loop
›Reassessment cycle
›Repeat vitals every 15 to 30 minutes if high risk
›Repeat neurovascular checks every 30 to 60 minutes if limb injury
›Repeat pain and swelling assessment after analgesia
›Repeat ECG if symptoms change
17Disposition/dispo29
ICU and monitored bed criteria
›Higher level of care criteria
›Dysrhythmia
›Hemodynamic instability
›Abnormal ECG requiring monitoring
›Significant burns requiring resuscitation
›Severe rhabdomyolysis
›Hyperkalemia
›Compartment syndrome concern
Inpatient admission criteria
›Admission indications
›High voltage exposure with symptoms
›Elevated CK with renal injury risk
›Deep tissue injury concern
›Concomitant trauma requiring observation
Observation pathway criteria
›Observation candidates
›Low voltage exposure with transient symptoms
›Normal ECG
›Normal initial labs when obtained
›Reliable follow up
Discharge criteria
›Discharge requirements
›Low voltage exposure
›No syncope
›Normal ECG
›No significant burns
›No concerning trauma findings
›Normal neuro exam
Follow up timing
›Follow up plan
›Primary care within 24 to 72 hours if symptoms
›Burn clinic timing based on burn depth
›Ophthalmology if vision symptoms develop
18Discharge Instructions/di25
Copy discharge instructions
›Diagnosis summary
›Electrical shock injury with no dangerous heart rhythm found today
›Burns are superficial unless told otherwise
›Medications
›Pain control as directed
›Avoid NSAIDs if kidney concerns discussed
›Wound care
›Keep dressings clean and dry
›Return for increasing redness or drainage
›Activity
›Avoid strenuous activity for 24 hours
›No driving if fainted or had seizure like episode
›Return to ED now for
›Chest pain
›Palpitations
›Fainting
›Trouble breathing
›Worsening weakness
›New numbness
›Severe increasing limb pain
›Dark urine
›Fever
›Follow up
›Primary care follow up within 2 to 3 days
›Burn clinic follow up if instructed
19References/r6
Guidelines and core sources
›Core references
›American Burn Association burn referral criteria
›American Heart Association ACLS guidelines
›ATLS guidelines for trauma evaluation
›Emergency medicine review articles on electrical and lightning injuries
›Source file
Evidence & Review
Reviewed by SymptomDx Medical Team·Last reviewed
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