RETROSPECTIVE EVALUATION OF ADMISSION CRITERIA FOR PEDIATRIC ELECTRICAL INJURIES

In the medical community, the practice of admitting all electrical bur ns for 24-48 h of observation, monitoring and laboratory evaluation is widespread. This retrospective review of paediatric electrical burns was conducted to determine which patients may safely be treated as out patients. Retrospective analysis of all paediatric burns admitted betw een 1980 and 1991 identified 35 patients with electrical injuries. Pat ients were divided into two groups for analysis: those burned by expos ure to household voltages (120-240 V; n = 26) and those exposed to hig h voltages, in excess of 7000 V (n = 9). The majority of household ele ctrical injuries occurred secondary to contact with the household 120 V (21/26). Contact with an extremity accounted for the largest number of these injuries (7/26). The mouth was the second most frequent site of injury (7/26). Most of these patients (20/26) had <1 per cent BSA b urn. No patient in the household-voltage group had an arrythmia that r equired treatment, nor were there any identified examples of compartme nt syndrome or other vascular complications. Seven patients did requir e minimal skin grafting. No deaths occurred in either group. The patie nts in the household-voltage group were significantly younger. High-vo ltage electrical injuries occurred in an older patient population and required more aggressive care and surgical intervention. This was evid ent at the lime of initial evaluation. Based an these darn, healthy ch ildren with small partial-thickness electrical bums and no initial evi dence of cardiac or neurovascular injury do not appear to need hospita l admission.