Red flags
- Cardiac arrhythmia (VF from AC current)
- Rhabdomyolysis + AKI
- Deep tissue injury > visible
- Compartment syndrome
First steps
- ABCDE + spinal precautions (fall)
- Continuous ECG monitoring ≥24 h if LOC/arrhythmia/high voltage
- Fluid resus (aim urine output 1-2 mL/kg/h)
Key investigations
- 12-lead ECG, troponin
- CK, myoglobin, U&E, urinalysis
- CT if head injury
Differentials
- Lightning strike (asystole, unique pattern)
Initial management
- Aggressive fluid + urinary alkalinisation for rhabdo
- Fasciotomy for compartment syndrome
- Cardiology if arrhythmia
- Burns team for skin injury
Referral
- Burns / plastic surgery / cardiology
AI clinical assessment
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