Diagnostic and treatment algorithm for patients with electrical injury

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Abstract

Determining the amount of tissue damage in electrical injury at an early stage is an extremely urgent task since the approach and therapeutic strategy depend on it to a great extent. We evaluated the informative value of various diagnostic methods, which enabled us to establish the degree and amount of tissue damage in the early stages after the electrical injury and to develop an algorithm for examining and treating the patients. The algorithm included studying the sensitive and motor function of the affected extremity and determining the creatine phosphokinase level, electroneuromyography, and stimulation neuromyography (preoperatively and intraoperatively). The algorithm allowed an accurate diagnosis of the damage and initiation of surgical treatment at an earlier stage.

About the authors

Aleksey V. Sachkov

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: SachkovAV@sklif.mos.ru

MD, PhD

Russian Federation, Moscow

Andrey A. Grin

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: Aagreen@yandex.ru
ORCID iD: 0000-0003-3515-8329

MD, PhD, DSc

Russian Federation, Moscow

Mikhail V. Sinkin

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: mvsinkin@gmail.com
ORCID iD: 0000-0001-5026-0060

MD, PhD

Russian Federation, Moscow

Mikhail A. Godkov

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: mgodkov@yandex.ru
ORCID iD: 0000-0001-9612-6705

MD, PhD, DSc

Russian Federation, Moscow

Tamara G. Spiridonova

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: SpiridonovaTG@sklif.mos.ru
ORCID iD: 0000-0001-7070-8512

MD, PhD, DSc

Russian Federation, Moscow

Elena A. Zhirkova

N.V. Sklifosovsky Research Institute for Emergency Medicine

Author for correspondence.
Email: ZhirkovaEA@sklif.mos.ru
ORCID iD: 0000-0002-9862-0229

MD, PhD

Russian Federation, Moscow

Kirill V. Svetlov

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: Svetloffkirill@yandex.ru
ORCID iD: 0000-0002-1538-0515

MD, PhD

Moscow

Irina B. Aleynikova

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: Alejnikova_irina@mail.ru
ORCID iD: 0000-0003-4937-0400

MD, PhD

Russian Federation, Moscow

Elena V. Klychnikova

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: klychnikovaev@mail.ru
ORCID iD: 0000-0002-3349-0451

MD, PhD

Russian Federation, Moscow

Mikhail A. Migunov

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: mihail_migunov@mail.ru
ORCID iD: 0000-0002-2713-3634
Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Damage to soft tissue caused by electric shock.

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3. Fig. 2. Patient Ch. After electrical injury.

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4. Fig. 3. Stimulation of the median nerve.

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5. Fig. 4. Assessment of activity m. abductor pollicis using a needle electrode. Spontaneous activity was not registered.

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6. Fig. 5. Block of conduction along the sensory fibers of the median (a), ulnar (b) and radial (c) nerves according to ENMG data.

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7. Fig. 6. The mixed nature of the neuropathy of the median nerve in the form of a decrease in the amplitude of the M-response and the speed of propagation of excitation along the motor fibers.

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8. Fig. 7. Algorithm for diagnosing the level and volume of tissue damage to the limb and treatment tactics.

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