The treatment challenges and limitation in high-voltage pediatric electrical burn at rural area: A case report

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The treatment challenges and limitation in high-voltage pediatric electrical burn at rural area: A case report


JournalInternational Journal of Surgery Case Reports
Article typeJournal research article – Case report / series
Publication date – Apr – 2021
Authors – Adi Basukia , Agustini Songb Nabila, Viera Yovitad Kevin , Leonard Suryadinatac Asian, Edward Sagala
Keywordscase report, Electrical burn, pediatric, Rural area
Open access – Yes
SpecialityEmergency surgery, Plastic surgery, Trauma surgery
World region South-eastern Asia
Country: Indonesia
Language – English
Submitted to the One Surgery Index on April 14, 2021 at 2:21 am
Abstract:

Introduction
Although rare, electrical injury in pediatrics is potentially life threatening and has significant and long-term impact in life. It is challenging to manage such cases in rural areas.

Presentation of case
A fully conscious 13-year-old boy was admitted to the emergency room after being electrocuted by high-voltage power cable, with superficial partial thickness burn over right arm, trunk, and left leg (26 % of total body surface area). Tachycardia and non-specific ST depression was found on ECG examination and was diagnosed with high-voltage electrical injury. Treatments were based on ANZBA algorithm with several modifications, i.e., administering lower concentration of oxygen with nasal cannula instead of non-rebreathing mask as well as Ketorolac and Antrain® for analgesic instead of morphine.

Discussion
Different choices of treatments were given due to limited resources. Despite possible cardiac and renal complication, further tests could not be done. Fortunately, after strict monitoring, no signs of abnormality were found. We used silver sulfadiazine, Sofratulle® and dry sterile gauze as a dressing of choice following immediate surgical debridement. The patient was observed daily through 7 days of hospitalization and followed-up for 1 year, achieving normal physiologic function of the affected area but unsatisfactory esthetic result.

Conclusion
Lack of infrastructure, drugs, and trained personnel are some of the challenges that still exist in most rural areas. Thus, implementation of available standardized guidelines such as ANZBA, and giving similar training to personnel as well as providing feasible equipment followed by strict monitoring for the patient are needed to achieve maximum results.

OSI Number – 21011

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