Pediatric emergency medicine trisk 1967 1967
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within a short time or shows signs of neurologic deterioration, a computed
tomography scan will help exclude intracranial hemorrhage.
Cardiopulmonary support is nonspecific. Most patients resume circulatory
stability unless severe hypoxia and ischemia have weakened the myocardium.
Arrhythmias should be treated along usual lines (see Chapter 86 Cardiac
Emergencies ).
Patients struck by lightning require only maintenance fluids. Patients with
ordinary thermal burns should be treated according to standard recommendations
(see Chapter 104 Burns ), although body surface area calculations may seriously
underestimate fluid requirements. It has been noted that burns caused by lightning
do not usually require special care. Extensive vascular and deep tissue destruction
may lead to extensive fluid sequestration. Isotonic fluid should be given in
amounts to maintain normal pulse and BP. In all cases, fluids should be given
with attention to possible CNS complications.
