EMS Trauma—Electrocution

Learner arrives on-scene to find a 65-year-old male patient on the floor with decreased responsiveness. Learner should perform an initial assessment and identify that the patient just suffered an electrocution injury during a home repair and is now bradycardic secondary to pacemaker failure. The patient also has electric burn injuries to the left hand (entry wound) and the right foot (exit wound). A 12-lead ECG demonstrates complete heart block without pacer spikes and no evidence of ischemia. Patient should be placed on oxygen and immediately transported to the hospital. The Learner should report to the receiving team.

Advanced providers should start transcutaneous pacing en route to the hospital.

Learning Objectives

– Assesses scene, identifying any potential safety concerns, number of patients, presence of bystanders, and additional resources available

– Conducts primary survey and obtains vital signs with attention to the following:
a. Determines level of consciousness and identifies mental status impairment
b. Identifies any signs of airway obstruction, hypoxia, or any observable breathing difficulties
c. Identifies any profuse bleeding, signs of decreased or absent circulation, or any pulse deficits in extremities

– Performs immediate interventions to address concerns identified during the primary survey

– Determines priority of transport

– Conducts a secondary survey to gather additional pertinent HPI and PMH and conduct a focused physical exam

– Performs any necessary medical interventions to ensure patient stability and safety during transport

– Contacts Medical Direction when indicated

– Provides verbal report summarizing patient encounter

– Diagnoses presence of a third-degree (complete) heart block and initiates appropriate treatments