Cardiovascular | Sudden death (ventricular fibrillation, asystole), chest pain, dysrhythmias, ST-T segment abnormalities, bundle branch block, myocardial damage, myocardial infarction (rare), hypotension (volume depletion), hypertension (catecholamine release) |
Neurologic | Altered mental status, agitation, coma, seizures, cerebral edema, hypoxic encephalopathy, headache, aphasia, weakness, paraplegia, quadriplegia, spinal cord dysfunction (may be delayed), peripheral neuropathy, cognitive impairment, insomnia, emotional lability |
Cutaneous | Electrothermal contact injuries, noncontact arc and “flash” burns, secondary thermal burns (clothing ignition, heating of metal) |
Vascular | Thrombosis, coagulation necrosis, disseminated intravascular coagulation, delayed vessel rupture, aneurysm, compartment syndrome |
Pulmonary | Respiratory arrest (central or peripheral, eg, muscular tetany), aspiration pneumonia, pulmonary edema, pulmonary contusion, inhalation injury |
Renal/metabolic | Acute renal failure (due to heme pigment deposition and hypovolemia), myoglobinuria, metabolic (lactic) acidosis, hypokalemia, hypocalcemia, hyperglycemia |
Gastrointestinal | Perforation, stress ulcer (Curling ulcer), GI bleeding, GI tract dysfunction, various reports of lethal injuries at autopsy |
Muscular | Myonecrosis, compartment syndrome |
Skeletal | Vertebral compression fractures, long bone fractures, shoulder dislocations (anterior and posterior), scapular fractures |
Ophthalmologic | Corneal burns, delayed cataracts, intraocular hemorrhage or thrombosis, uveitis, retinal detachment, orbital fracture |
Auditory | Hearing loss, tinnitus, tympanic membrane perforation (rare), delayed mastoiditis or meningitis |
Oral burns | Delayed labial artery hemorrhage, scarring and facial deformity, delayed speech development, impaired mandibular/dentition development |
Obstetric | Spontaneous abortion, fetal death |