High-voltage electrical burn, polytrauma, and secondary humeral amputation in an elderly adult: A case presentation

Abstract

Injuries from high-voltage electric shocks are critical medical emergencies associated with high systemic morbidity and mortality, these deep burns massively destroy the internal cell compartments following the path of least tissue resistance, manifesting clinically with destructive coagulative necrosis that underestimates the skin damage visible externally, requiring immediate drastic ablative surgeries. Objective: To apply the structured Nursing Care Process (PAE) in a geriatric patient with a high-tension burn of 21% of the body surface, total necrosis and humeral amputation of the right upper limb and multisystem polytrauma, a descriptive, retrospective and analytical clinical study methodology was applied based on the standardized taxonomies NANDA-I, NOC and NIC. Results: Key diagnoses such as structural deterioration of chronic tissue integrity, imminent risk of shock due to electrolyte imbalances, acute neurogenic pain, and limitation in general physical mobility were identified and prioritized. The plan implemented targeted interventions of advanced sterile healing, exact dosing, and surveillance of critical antimicrobials, for multidrug-resistant bacteria, strict fluid replenishment, and endocrine metabolic stabilization, evidencing a favorable tissue response in surgical stump healing, total remission of severe pain, absence of distributive refractory shock, and gradual integration into targeted functional physical rehabilitation maneuvers. Concluding that the PAE allowed the organized, individualized, and safe structuring of transoperative and critical nursing care, resulting in the remission of severe infectious complications and significantly optimizing the patient's quality of life and biopsychosocial adaptation.