Electric burns occur when electricity passes through the body and causes injury. They can result in internal or external burns as well as injuries to various organ systems. The pathophysiology involves direct tissue damage from electrical energy, thermal injury from heat generated, and mechanical trauma. Treatment depends on the severity and location of burns as well as any other injuries. It may include wound cleaning, skin grafting, surgery, or amputation for severe burns. The patient described suffered an electric shock that resulted in gangrene of the arm requiring debridement and antibiotic treatment with metronidazole, piperacillin, and paracetamol to prevent infection during recovery.

1. Electric Burn
Introduction
1) Definition
When electricity passes through the body and causes injury is called electric burn. It
may be
 Internal burn
 External burn
 Cardiovascular injury
 Respiratory injury
 Musculoskeletal injury
 Neurological injury
 Renal injury
a) Epidemiology
The Global Burden of Disease 2010 study estimates that the age-standardized
mortality rate for injury caused by fire, heat, and hot substances is 5.8 per 100,000
populations in Pakistan.
b) Pathophysiology
Three main mechanisms of electricity induced injury are
 Electrical energy causing direct tissue damage , altering cell membrane
and resting potential and eliciting tetany
 Conversion of electricity energy into thermal energy , causing massive
tissue destruction and coagulation necrosis
 Mechanical injury with direct trauma resulting from falls or violent muscle
contraction

2. c) Signs and symptoms
d) Diagnostic test
It includes
 CBC
 ECG
 X-Ray
 MRI etc

3. e) Treatment
Treatment of electric shock depends on the severity of the burns or the nature of
other injuries found.
Burns are treated according to severity.
 Minor burns may be treated with topical antibiotic ointment and dressings.
 More severe burns may require surgery to clean the wounds or even skin
grafting.
 Severe burns on the arms, legs, or hands may require surgery to remove
damaged muscle or even amputation.
Other injuries may require treatment.
 Eye injuries may require examination and treatment by an ophthalmologist,
 An eye specialist. Broken bones require splinting, casting, or surgery to
stabilize the bones. I
 Internal injuries may require observation or surgery.
Patientprofile and prescription
Patientdetails
Patient name: Muhammad Talha
Age: 8 years
Gender: Male
Date of admission: 03-03-19
PatientHistory
Case summary Electric Shock (Arm gangrene, forearm muscle non-viable, triceps also
non-viable, doubtful mortality of triceps all veins and arties thrombosed along their coarse,
good perfusion of skin of arm.
History of patient illness No
Social history No
Family history No
Past medical history No
New Rx Injection Flygel, Injection Zinacef, Injection procase

4. Medication list
Medication / strength Date
Injection Flaygel 45ml 8 hourly 05-04-19
Injection Tanzo 2.5g IV B.D
Normal saline D/W 700 ml IV 8 hourly
Injection Provas 30ml 8 hourly
Normal saline 750ml 22-04-19
Injection Provas 30ml TDS
Injection Flagyl 45ml TDS
Injection Tanzo 2.5 mg TDS
Injection Foradef 10mg
Injection Provas 30ml TDS 02-05-19
Injection Flagyl 45ml TDS
Injection Tanzo 2.5 mg TDS
Injection Foradef 10mg
Lab test
Test
10-4-19
Lab Value
25-04-19
Lab ValuesComplete Blood
Count
Hb 11.2g/dl 10.8 g/dl
WBC 10*103
g/dl 50.5*103
g/dl
PLT 490 g/dl 411g/dl
Discharge/ ongoing plan and follow up: No
Medicinedescription
1) Drug name : Flaygl
Generic name:Metronidazole
Class: Antibiotic
Mechanism of action: It inhibits nucleic acid synthesis by disrupting the
DNA of microbial cells.
Paediatricdose:
1-6 years 100mg B/D
6-12 years 200mg B/D
12-18years 400mg B/D
Side Effects: Loss of appetite, cramps, dry mouth, metallic taste in mouth

5. 2) Drug name : Tanzo
Generic name:Piperacilin
Class: B-lactum antibiotic
Mechanism of action: It inhibits the action of bacterial beta-lactamases.
Paediatricdose:
1-2months 7.5mg/kg 12hourly
2month-8years 7.5mg/kg 8 hourly
Side Effects: swelling, redness, pain, soreness or. Irritation, agitation,
3) Brand name: Provas
Generic name:Paracetamol
Class: NSAIDS
Mechanism of action: In vivo effects of paracetamol are similar to those of
the selective cyclooxygenase-2 (COX-2) inhibitors.
Paediatricdose:
<50kg weight 15mg/kg 4-6hourly
>50 kg weight 1g 4-6 hourly
Side effects: Jaundice, dark urine, clay colored stools
Medication Indicationsfor Electric Burn
Flygel: It is given to patient to avoid any type of infection. As patient wound
exposed during change of dressing. And metronidazole is used treat parasitic
infections.
Other infections for which it is used includes Giardia infections of the small
intestine, amoebic liver abscess, and amoebic dysentery (infection of the colon
causing bloody diarrhea), bacterial vaginosis, trichomonas vaginal infections, and
carriers of trichomonas (both sexual partners) who do not have symptoms.
Tanzon: It is also used to prevent infection.
It is used to treat many different infections caused by bacteria, such as urinary
tract infections, bone and joint infections, severe vaginal infections, stomach
infections, skin infections, and pneumonia.
Provas: It is used to relieve mild to moderate pain and to reduce fever.
Acetaminophen injection is also used in combination with opioid (narcotic)
medications to relieve moderate to severe pain.

6. Interaction: No
Pharmacist intervention:
 Give the appetite stimulant syrups or nutritional supplement.
 And suggest drink plenty of water if cannot than chew sugar and gum free
mints.
 Proper dressing of wound to avoid infection.
( Submitted By Meerab Tanveer )