An unusual presentation of inhalation injury in a patient with high voltage electrical injury: A case report.

John W Keyloun, Taryn E Travis, Laura S Johnson, Jeffrey W Shupp

Open access · goldAbstract readCase Reports

In one paragraph

Article in International journal of surgery case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

–field-weighted citation impact, top 82% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

John W KeylounFirefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA.

Taryn E TravisFirefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA.

Laura S JohnsonFirefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA.

Jeffrey W ShuppFirefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Departments of Surgery and Biochemistry, Georgetown University School of Medicine, Washington, DC, USA. Electronic address: jeffrey.w.shupp@medstar.net.

MedStar Washington Hospital Center · USMedStar Georgetown University Hospital · USMedStar Health · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElectrical injuries comprise a minority of burn center admissions but are associated with significant morbidity and mortality. This is a case of a patient who suffered high-voltage electrical injury who survived despite developing several sequalae, who had an unusual presentation of inhalation injury complicated by the aspiration of metal screws. CASE PRESENTATION: This is a 20-year-old male who suffered electrical contact injury, and 45.5% total body surface area (TBSA) burns from electrothermal discharge and subsequent ignition of clothing, whose hospital course was complicated by rhabdomyolysis, compartment syndrome, renal failure, and inhalation injury. After cardiac arrest with successful defibrillation and intubation in the field, he was found to have metallic foreign bodies in his airway. Metal screws were retrieved using rigid bronchoscopy and lower extremity escharotomy was performed for compartment syndrome. He was placed on renal replacement therapy for persistent acidosis and severe rhabdomyolysis. On post-burn day (PBD) 3 he developed severe hypoxia and bronchoscopy showed evidence of inhalation injury. This was treated with protocolized nebulizer treatments, prone-positioning, early tracheostomy, and frequent bronchoscopy. Over his hospital course he required lower extremity amputation and numerous excision and grafting procedures. Ultimately, he exhibited renal and respiratory recovery. He was discharged on PBD 75 to a rehabilitation hospital.

conclusionsThis case highlights that electrical injuries are associated with serious sequelae that can be overt or occult. Clinicians must maintain a high index of suspicion for comorbid conditions with electrically injured patients given variable presentations and the need for prompt, aggressive, and complex management.

Indexed as

BurnsCase reportCompartment syndromeElectrical injuryForeign body aspirationInhalation injury

Identifiers

PMID33217653

DOI10.1016/j.ijscr.2020.10.139

PMCPMC7683282

OpenAlexW3096322111

What OpenQuestion holds

Textmetadata

LicenceCC BY-NC-ND

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.