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Institutional Experience Using a Treatment Algorithm for Electrical Injury.

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Implementing an electrical injury treatment algorithm reduced diagnostic testing and healthcare costs. This standardized approach improved patient triage without impacting mortality or readmission rates.

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Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Clinical Triage

Background:

  • Electrical injuries, though rare, present significant morbidity and mortality risks.
  • Inconsistent diagnostic and management practices can lead to excessive medical testing.
  • Standardized treatment protocols are needed to optimize care for electrical injury patients.

Purpose of the Study:

  • To evaluate the effectiveness of an electrical injury treatment algorithm in reducing diagnostic testing.
  • To compare patient outcomes before and after the implementation of a standardized electrical injury care pathway.
  • To assess the algorithm's impact on healthcare costs and patient safety.

Main Methods:

  • A retrospective cohort study comparing patients treated before and after algorithm implementation (July 2015).
  • Data collected included demographics, injury details, and diagnostic testing (creatine kinase, troponin, myoglobin).
  • Outcomes analyzed included length of stay, ICU admission, mortality, and readmission rates.

Main Results:

  • Post-algorithm implementation showed significant reductions in creatine kinase, troponin, and urinary myoglobin testing.
  • Fewer telemetry monitoring days and shorter intensive care unit (ICU) lengths of stay were observed after algorithm adoption.
  • No significant differences were found in overall hospital stay, ICU admissions, mortality, or 30-day readmissions.

Conclusions:

  • An electrical injury evaluation and treatment algorithm effectively guides triage for cardiac monitoring and hospital admission.
  • Algorithm use decreased unnecessary testing and associated healthcare costs.
  • The standardized approach maintained patient safety, with no increase in adverse outcomes.