15. Electrocution/Lightning - CDE

Question 1

Extreme Fall

Answer 1

Patient fallen from distance of 30ft/10m (3 stories) or higher

Question 2

Long Fall

Answer 2

Patient has fallen from distance of:
* Adult/Child 10-29ft (3-9m)
* Infant 6-29ft (2-9m)

Question 3

Problem Suffixes

Answer 3

E: Electrocution
L: Lightning

Question 4

Lightning Strike Arrest Theory

Answer 4

Current theory connecting lightning and cardiac injury is that lightning acts as a cosmic countershock, sending the heart into asystole (absence of heart contractions). The heart will often resume its rhythm due to the heart’s property of automaticity, but the accompanying respiratory arrest is more lasting, leading to secondary cardiac arrest and arrhythmias due to hypoxia.

Question 5

Rule 1

Answer 5

All electrocution and lightning strike patients are assumed to be in cardiac arrest until effective breathing is physically verified. Stay of line with caller until breathing can be safely verified

Question 6

Rule 2

Answer 6

If cardiac arrest in an unconscious lightning strike patient is confirmed, the CPR Ventilations 1st pathway should be selected for care

Question 7

Rule 3

Answer 7

Advise the caller to beware of electrical risks and electrified water. Do not advise any treatment unless it is safe to do so.

Question 8

Rule 4

Answer 8

The airway of an unconscious patient must be constantly maintained

Question 9

Rule 5

Answer 9

All electrical burns are considered to be worse than they look externally

Question 10

EMD First, Second, Third Law of Safety

Question 11

Axiom 1

Answer 11

Hidden exit wounds and internal injuries may complicate the patient’s status

Question 12

Axiom 2

Answer 12

Electrocutions and lightning strikes occurring above the ground may result in significant falls, causing injuries that may be more serious than those incurred from the electrocution or lightning. Answering all KQ should ensure this is not overlooked.

Question 13

Axiom 3

Answer 13

Each year many potential rescuers are injured attempting to help. The caller should be advised to attempt rescue only if it is safe to do so

Question 14

Axiom 4

Answer 14

A bystander can be electrocuted just by getting close to the patient, without even touching her/him, when high voltage is involved or the ground is wet

Question 15

Axiom 5

Answer 15

Lightning accounts for about 200 deaths in the US per year and strikes the ground somewhere in the world 100 times a second