"HOT POTATO PATIENTS"
This percentage of total body surface area involvement requires burn center referral for burns greater than superficial.
What is greater than 10%?
Use the "rule of 9s" to estimate burn size quickly. Electrical burns often have more internal damage than surface appearance suggests.
This validated decision rule helps determine CT need in pediatric head injuries.
What is PECARN?
PECARN reduces unnecessary radiation exposure while maintaining sensitivity for clinically important brain injuries.
This essential test must be performed before discharge to assess lower extremity function.
What is an ambulatory trial?
Electrical current can cause spinal cord injury even without direct spinal contact. Never discharge a patient who can't walk normally.
The number of hours of cardiac telemetry monitoring needed for patients with mild symptoms and minor burns before discharge.
What is 4 to 6 hours?
This specific timeframe is evidence-based - shorter monitoring misses delayed arrhythmias, longer monitoring doesn't improve outcomes.
This voltage threshold separates low-voltage from high-voltage electrical injuries.
What is 600 volts?
Remember the 600V rule - it's different from the old 1000V threshold. This affects your entire management approach and disposition decisions.
These three body regions, when burned, require burn center referral regardless of size.
What are genitals, ocular region, and hands?
These are functional and cosmetically critical areas. Specialized burn care prevents contractures and preserves function.
This minimum height fall is considered a dangerous mechanism in head injury assessment.
What is 3 feet or 5 stairs?
Mechanism matters as much as symptoms. High-energy transfer can cause significant brain injury even with initially normal presentations.
This type of hearing loss can result from ear barotrauma in electrical injuries.
What is sensorineural hearing loss?
The acoustic nerve is particularly sensitive to electrical injury. Always test hearing and ask about tinnitus or vertigo before discharge.
These four criteria must ALL be met for immediate discharge of electrical injury patients.
What are low-voltage injury, no symptoms, no loss of consciousness, and no acute physical findings?
Missing even ONE criterion changes your management. When in doubt, monitor longer or transfer to ED.
This age group is most likely to sustain low-voltage electrical injuries.
Who are children 6 years old and younger?
Toddlers explore with their mouths - think oral burns and delayed labial artery bleeding up to 2 weeks post-injury.
This type of burn pattern around an extremity requires immediate burn center referral.
What are circumferential burns?
Circumferential burns act like tourniquets as they swell. Emergency escharotomy may be needed to prevent limb loss.
These four neurologic signs indicate possible basal skull fracture.
What are hemotympanum, "panda" eyes, CSF otorrhea, and Battle's sign?
Basal skull fractures indicate high-energy impact. These patients need CT imaging and neurosurgical evaluation even if GCS is normal.
Children with oral electrical burns are at risk for delayed hemorrhage from this artery up to 2 weeks post-injury.
What is the labial artery?
The labial artery runs right through the oral commissure. Parents must understand this delayed bleeding risk and know to seek immediate care.
This type of electrical injury device requires ECG plus 4-6 hours of telemetry monitoring.
What is a TASER?
TASER injuries are essentially high-voltage, short-duration electrical injuries. Have a low threshold for ED transfer if ANY symptoms persist.
This type of current has a higher "let-go threshold" and causes less tactile sensation.
What is direct current (DC)?
AC current causes tetanic contractions that prevent "letting go" of the source, leading to prolonged exposure and worse injuries.
The maximum time delay possible for severe hemorrhage in pediatric oral electrical burns.
What is 2 weeks?
The eschar (scab) falls off 7-14 days post-injury, potentially exposing the damaged labial artery. Parents need clear bleeding precautions.
This medication use requires CT imaging even with minor head injury mechanisms and normal exam.
What are anticoagulants or antiplatelet medications?
Anticoagulated patients can have delayed intracranial bleeding hours after injury. Even daily aspirin increases bleeding risk significantly.
This specialty follow-up is required in 2-3 days for pediatric patients with minor oral commissure burns.
What is ENT or plastic surgery?
Even "minor" oral burns can have significant cosmetic and functional consequences. Early specialist involvement improves outcomes.
The gestational age after which pregnant patients require ED evaluation regardless of voltage or symptoms.
What is 20 weeks?
Fetal cardiac conduction systems are extremely sensitive to electrical current. The 20-week cutoff relates to fetal cardiac development and viability.
This skin condition provides protection against voltage penetration to internal organs.
What is dry skin?
Wet skin drops resistance dramatically - a 110V shock in the bathtub can be fatal, while the same voltage with dry skin may cause minimal injury.
These five conditions mandate immediate EMS transfer to ED with continuous cardiac monitoring for 12-24 hours.
What are high-voltage injury, lightning strike, deep burns, loss of consciousness, and any arrhythmia or heart block?
These criteria are absolute. Don't let a stable-appearing patient fool you - high-voltage injuries can deteriorate suddenly hours later.
The time frame after which TBI patients should be referred to specialists if symptoms don't resolve as expected.
What is 2-4 weeks?
Most mild TBI symptoms resolve in days to weeks. Persistent symptoms beyond 2-4 weeks may indicate complications or need for specialized rehabilitation.
These three types of injuries should be assessed in all electrical injury patients due to secondary trauma from falls or muscle contractions.
What are spinal, orthopedic, and blunt trauma injuries?
Electrical injuries are often multi-trauma. The electrical injury may be obvious, but don't miss the cervical spine fracture from the fall.
The maximum time period that heart blocks from electrical injury may persist before resolving without treatment.
What is 3 weeks?
Document the specific type of heart block and arrange cardiology follow-up. Most resolve spontaneously, but serial ECGs are needed to confirm resolution.
Standard wall outlets in North America use this voltage, while utility outlets use 220 volts.
What is 110 volts?
Both are considered low-voltage (<600V), but 220V appliance injuries often cause more significant tissue damage than standard 110V outlets.