TY  - BOOK
AU  - Johnson, Laura
AU  - Keyloun, John Wilkerson
AU  - Kolachana, Sindhura
AU  - McLawhorn, Melissa M
AU  - Moffatt, Lauren T
AU  - Nisar, Saira
AU  - Shupp, Jeffrey W
AU  - Travis, Taryn E
TI  - Institutional Experience Using a Treatment Algorithm for Electrical Injury
SN  - 1559-047X
PY  - 2021///
KW  - *Algorithms
KW  - *Burns, Electric/th [Therapy]
KW  - *Outcome Assessment, Health Care
KW  - Adult
KW  - Biomarkers/me [Metabolism]
KW  - Burn Units
KW  - Burns, Electric/mo [Mortality]
KW  - Female
KW  - Health Care Costs
KW  - Hospital Mortality
KW  - Humans
KW  - Intensive Care Units/sn [Statistics & Numerical Data]
KW  - Length of Stay/sn [Statistics & Numerical Data]
KW  - Male
KW  - Patient Readmission/sn [Statistics & Numerical Data]
KW  - Retrospective Studies
KW  - Telemetry
KW  - Triage
KW  - MedStar Health Research Institute
KW  - MedStar Washington Hospital Center
KW  - Firefighters' Burn and Surgical Research Laboratory
KW  - MedStar Health Research Institut
KW  - Surgery/Burn Services
KW  - Journal Article
N1  - Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
N2  - Electrical injury has low incidence but is associated with high morbidity and mortality. Variability in diagnosis and management among clinicians can lead to unnecessary testing. This study examines the utility of an electrical injury treatment algorithm by comparing the incidence of testing done on a cohort of patients before and after implementation. Demographics, injury characteristics, and treatment information were collected for patients arriving to a regional burn center with the diagnosis of electrical injury from January 2013 to September 2018. Results were compared for patients admitted before and after the implementation of an electrical injury treatment algorithm in July 2015. There were 56 patients in the pre-algorithm cohort and 38 in the post-algorithm cohort who were of similar demographics. The proportion of creatine kinase (82% vs. 47%, p<0.0006), troponin (79% vs. 34%, p<0.0001), and urinary myoglobin (80% vs. 45%, p<0.0007) testing in the pre-algorithm cohort was significantly higher compared to post-algorithm cohort. There were more days of telemetry monitoring (median (IQR), 1 (1-5) vs. 1 (1-1) days, p=0.009) and greater ICU length of stays (4 (1-5) vs. 1 (1-1) days, p=0.009), prior to algorithm implementation. There were no significant differences in total hospital lengths of stay, incidence of ICU admissions, in-hospital mortality, or 30-day readmissions. This study demonstrates an electrical injury evaluation and treatment algorithm suggests a mode of triage to cardiac monitoring and hospital admission where necessary. Use of this algorithm allowed for reduction in testing and health care costs without increasing mortality or readmission rates. Copyright (c) The Author(s) 2021. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
UR  - https://dx.doi.org/10.1093/jbcr/irab020
ER  -