All patients with high-voltage exposure (more than 600 V) should be admitted for observation even if there is no apparent injury. Patients with serious high-voltage injuries (neurologic, cardiac, vascular, or muscle damage) should be admitted to a specialized burn center. Routine cardiac rhythm monitoring is not required for patients admitted with high-voltage injuries unless there is an initial abnormal ECG or arrhythmia. 12 Disposition of patients with a low-voltage injury is more problematic ( Table 196-9).

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