Electrical injuries can have serious multisystemic consequences and have to be evaluated regardless of the extent of skin injuries. Emergency department treatment is complex with simultaneous use of ACLS (Advanced Cardiac Life Support) and ATLS (Advanced Trauma Life Support) algorithms, and with particular attention given to fluid resuscitation and musculoskeletal damage management. Beyond the recognized intensive care admission criteria like polytrauma or severe bums, documented arrhythmia or abnormal ECG on initial evaluation, loss of consciousness and high voltage electrical injuries (> 1000 V) each prompt a minimum of 24 hours cardiac monitoring. In addition, severely burned patients should be promptly transferred to specialized facilities.