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  • Finger
  • Mouth
    • Electrical cord bite
    • Usually arc burns that may involve the orbicularis oris muscle, the oropharynx, and damage to the developing dentition
  • Extremities
    • Kissing burn: occurs at the flexor creases of the extremities due to current flowing across opposing skin surfaces as the extremity is forced into flexion by an electric shock
  • Lightning injuries
  • Power Lines

End Organ Effects

  • Brain: lack of concentration
  • Eyes: cataracts
  • Ears: Ruptured TMs
  • Cardiac: Arrhythmia
  • Renal: ARI
  • Rhabdomyolysis
  • Mouth/Lip
    • Usually a child who bites an electrical cord
    • Significant risk of delayed bleeding from the labial artery exists when the eschar separates
    • occurs 3 to 14 days post injury


  • Burned tissue should not be debrided
  • Cleansed and a petroleum-based antibiotic ointment applied to exposed skin areas

Cardiac Monitoring Indications

  1. Cardiac Arrest
  2. loss of consciousness
  3. abnormal ECG
  4. dysrhythmias (prehospital or ED)
  5. suspicion of conductive injury
  6. hypoxia
  7. chest pain