Electrocution (Responder) Scenario

What is your first priority when responding to an electrocution accident?

Prior to approaching the patient you must ensure that the electrical source is off for your safety?

You get confirmation that all electricity has been isolated by the electrician on site and it is safe to approach the patient. As you approach the patient, you note that there are burns marks by his hand, he is unconscious and doesn’t seem to be breathing. You quickly assess and find he has no pulse. What should you do?

You attach the AED and start CPR. The defibrillator assesses and states ‘shock advised’. You clear the patient and administered a shock. You start CPR, what ratio should you do for compressions to ventilations?

You come to the second assessment and the AED states ‘shock advised’. You deliver the shock and continue with CPR. You start to feel fatigue setting in and that your chest compressions are becoming less effective. What should you do?

Following the third shock, the patient suddenly takes in a gasp and starts to move their arms and legs. His colleagues share their joy of the successful resuscitation, but you continue to monitor his condition. You start moving down the primary survey assessment: there’s no catastrophic haemorrhage, he is making a snoring noise on breathing, his ventilations are slow and poor, his circulation seems poor with weak pulses and poor perfusion of the skin. What action do you manage first?

You work on managing the airway and attempt patient positioning, a head tilt chin lift, and a jaw thrust. Despite these manoeuvres, the airway still seems obstructed. What further devices can you utilise to help maintain the airway? 

On placing an OPA the airway now seems secure and is no longer noisy. You count the respirations at 6 breaths per minute. What is the normal respiratory rate in adults?

You realise the need for the patient to be ventilated and you attach your BVM and oxygen, and start ventilating the patient. As you support ventilations, you still note poor perfusion. Although limited, what can you do to try and assist circulation?

You continue to ventilate the patient and manage the airway, while the staff assist you where they can. You get a blanket around the patient to stop any hypothermia and continue to manage where you can. You can hear sirens in the distance, and back up isn’t far away. You note the electrical burn on the patients’ hand. Within a non-emergency setting, how long should you irrigate a thermal burn for?

When dealing with electrocution accidents, what should you be aware of when managing injuries and electrical damage?

You find an exit wound on the opposite shoulder and can see the electrical route went across the chest. The electrical route passing the chest is important information as it can determine the severity of injury and damage?

You are aware that the arc of the electricity across the chest can effect vital organs. Given the events of the scenario, what further issue could occur?

The patient starts to become more awake and is groaning in pain. You note that the muscles across his arm and chest are spasming. Following electrocution, severe muscle spasms can occur?

The Ambulance arrives at scene and the crew walk in and start assisting the patient. You give a detailed handover to the crew, how many shocks did the patient have altogether?