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Fonseca J, Garza J, García M, Aguirre K, Alotaibi H, Mortada H. Electrical burn-induced vocal cord injury: insights from a case report and literature review. Case Reports Plast Surg Hand Surg 2024; 11:2374549. [PMID: 38993354 PMCID: PMC11238649 DOI: 10.1080/23320885.2024.2374549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/24/2024] [Indexed: 07/13/2024]
Abstract
We report a rare case of vocal cord injury from an electrical burn, managed successfully with conservative, non-invasive treatment. This unique case illustrates potential complications of electrical trauma and underscores the need for vigilance and consideration of conservative management approaches.
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Affiliation(s)
- José Fonseca
- Plastic Surgery Department, Hospital Universitario “Dr José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Jorge Garza
- Plastic Surgery Department, Hospital Universitario “Dr José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Mauricio García
- Plastic Surgery Department, Hospital Universitario “Dr José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Karen Aguirre
- General Surgery department, centro médico nacional del noreste UMAE#25 del Instituto Mexicano del Seguro social, Monterrey, Nuevo León, México
| | - Haya Alotaibi
- Department of Surgery, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Division of Plastic Surgery, Department of Surgery, King Abdullah Bin Abdullaziz University Hospital, Riyadh, Saudi Arabia
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Plastic Surgery & Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
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2
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Sumer RW, Woods WA. Cardiac Arrest in Special Populations. Cardiol Clin 2024; 42:289-306. [PMID: 38631796 DOI: 10.1016/j.ccl.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Best practices in cardiac arrest depend on continuous high-quality chest compressions, appropriate ventilatory management, early defibrillation of shockable rhythms, and identification and treatment of reversible causes. Although most patients can be treated according to highly vetted treatment guidelines, some special situations in cardiac arrest arise where additional skills and preparation can improve outcomes. Situations covered in this section involve cardiac arrest in context of electrical injuries, asthma, allergic reactions, pregnancy, trauma, electrolyte imbalances, toxic exposures, hypothermia, drowning, pulmonary embolism, and left ventricular assist devices.
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Affiliation(s)
- Ravi W Sumer
- Department of Emergency Medicine, 4601 Dale Road, Modesto, CA 95356-8713, USA.
| | - William A Woods
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908-0699, USA
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Xu X, Ren P, Wang Y, Li J, Xiao S, Li J, Li X. An experimental model of peripheral nerve electrical injury in rats. Burns 2023; 49:1958-1968. [PMID: 37821288 DOI: 10.1016/j.burns.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Although several studies have investigated models of nerve electrical injury, only a few have focused on electrical injury to peripheral nerves, which is a common and intractable problem in clinical practice. Here, we describe an experimental rat model of peripheral nerve electrical injury and its assessment. METHODS A total of 120 animals were subjected to short-term corrective electrostimulation (50 Hz, 1-s duration) applied at varying voltages (control, 65, 75, 100, 125, and 150 V) to the exposed left sciatic nerve. Behavioural testing, electrophysiological measurements, and histopathological observation of the sciatic nerve were conducted at 1-, 2-, 4-, and 8-w follow-ups. RESULTS No functional defects were noted in the groups that received 65-V stimulation at any time point. Sciatic nerve functional defects were found after 2 w in animals that received 75-V stimulation, but function returned to normal after 4 w. In animals that received 100-V and 125-V stimulation, functional defects were observed at 4 w, but had partially recovered by 8 w. Conversely, animals that received 150-V stimulation did not show recovery after 8 w. CONCLUSION We presented a model of peripheral nerve electrical injury that avoided the interference of various external factors, such as current instability, compression of the surrounding tissues, and altered blood supply. The model allowed quantitation and ranking of the nerve injury into four degrees. It facilitated effective evaluation of nerve function impairment and repair after injury. It can be used post-surgically to evaluate peripheral nerve impairment and reconstruction and enables translational interpretation of results, which may improve understanding of the mechanisms underlying the progression of peripheral nerve electrical injury.
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Affiliation(s)
- Xiaoli Xu
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Pan Ren
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Yan Wang
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Jing Li
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Shuao Xiao
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Jinqing Li
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China
| | - Xueyong Li
- Department of Burn and Plastic Surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China.
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Seyfrydova M, Rokyta R, Rajdl D, Huml M. Arrhythmias and laboratory abnormalities after an electrical accident: a single-center, retrospective study of 333 cases. Clin Res Cardiol 2023; 112:1835-1847. [PMID: 37526697 DOI: 10.1007/s00392-023-02274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Even though electrical injuries are common in the emergency room, guidelines, consensus, and general recommendations for the management of these patients do not exist in Europe. Documented cases of delayed arrhythmias are rare and their connection with electrical injury has not been fully confirmed. We also use cardio-specific markers for the risk stratification of myocardial injury, but there is no significant study referring to their utility in this clinical situation. These reasons led us to retrospectively analyze all cases of electrical injuries over 23 years to determine the prevalence of cardiac arrhythmias (mainly malignant arrhythmias and delayed arrhythmias). METHODS We retrospectively searched all patients admitted to the University Hospital in Pilsen, CZ, with a diagnosis of electric injury (ICD diagnostic code T754) from 1997 to 2020. The hospital´s information system was used to research the injury; data were drawn from patient medical records. RESULTS We identified 333 cases of electrical injury in our hospital. Men accounted for about two-thirds, and women one-third. Children accounted for about one-third of cases. Most were low-voltage injuries (< 1000 V, 91.6%). All participants had an initial ECG, and 77.5% of patients had continuous ECG monitoring, usually lasting 24 h. Cardiac arrhythmias were noticed in 39 patients (11.7%). The most frequent arrhythmias were: ventricular fibrillation, sinus tachycardia, bradycardia and arrhythmia, atrial fibrillation, and supraventricular tachycardia. The ECG showed cardiac conduction abnormalities in 28 patients (8.1%), and ten patients (3%) had supraventricular or ventricular extrasystoles. In ten cases (3%), we found changes in ST segments and T waves on the initial ECG. Thirty-one patients (9.3%) suffered a loss of consciousness and 50 patients (15.02%) reported paresthesia. The most frequent ion disbalances were hypokalemia (18%) and hypocalcemia (3.3%). Patients with an ion disbalance had significantly more arrhythmias and newly diagnosed cardiac conduction abnormalities. Troponin levels (cTnI or hs-cTnT) were measured in 258 cases (77.48%) and found to be elevated above the 99th percentile in 19 cases (5.7%). Almost one-third of patients had burns of various degrees of seriousness, and 41 patients (12.3%) had concomitant traumatic injuries. Eleven patients underwent pre-hospital resuscitation, three died in the hospital, and another died as result of intracranial hemorrhage. CONCLUSION All malignant arrhythmias occurred immediately after the electrical injury, delayed life-threatening arrhythmias were not observed, and no predictive factors of malignant arrhythmias were found. While elevations of cardiac troponins were observed sporadically, they did not appear helpful for risk stratification. In patients with arrhythmias, ion disbalance may be more critical. We concluded that asymptomatic, uninjured adult and pediatric patients with normal initial ECG findings do not need continuous ECG monitoring and may be discharged home. Recommendations for high-risk patients and patients with mild ECG abnormalities at admission are less obvious.
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Affiliation(s)
- Miroslava Seyfrydova
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic.
| | - Richard Rokyta
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic
| | - Daniel Rajdl
- Institute of Clinical Biochemistry and Laboratory Diagnostics, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic
| | - Michal Huml
- Department of Pediatrics, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic
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Tróchez-Sanchez JP, Garcia-Perdomo HA. Electrical Burn and Associated Factors That Prolong In-patient Stay in a Level Three Burn Unit. J Burn Care Res 2023; 44:1241-1248. [PMID: 36882105 DOI: 10.1093/jbcr/irad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Indexed: 03/09/2023]
Abstract
Electrical trauma is associated with significant morbidity and mortality, which have been reduced by improved medical care, as measured by the length of stay (LOS) as a marker for this population's quality of care. This paper will review the clinical and demographic characteristics, LOS in the hospital, and variables related to patients with electrical burns. A retrospective cohort study was conducted at a specialized burn unit in Southwest Colombia. Five hundred seventy-five electrical burn-related admissions from 2000 to 2016 were reviewed for the LOS and variables including patient-related (age, gender, marital status, education, and occupation), location of the accident (domestic vs labor-related), voltage, direct contact, arc, flash, flame, clinical presentation (burn surface area, depth, single or multiple organ injury, secondary infection, and abnormal labs), and treatment (surgical procedures and intensive care unit [ICU] admission). Univariate and bivariate analysis, with its 95% CI (confidence interval). We also performed a multiple logistic regression. LOS was correlated to males, age greater than 20 years, construction workers, high voltage injuries, severe burns by area and depth, infection, ICU admission, and multiple surgical procedures or extremity amputation. LOS due to electrical injury was observed to be significantly associated with the following variables, carpal tunnel release (OR [odds ratio]= 4.25, 95% CI [confidence interval] 1.70-5.20); amputation (OR = 2.81, 95% CI 1.60-5.10); infection (OR = 2.60, 95% CI 1.30-5.20); site of infection, mainly wound (OR = 1.30, 95% CI 1.10-1.44); associated injury (OR = 1.72, 95% CI 1.00-3.24); work or domestic accident (OR = 1.83, 95% CI 1.00-3.32); aged 20-40 years (OR = 1.41, 95% CI 1.00-2.10); CPK (OR = 1.40, 95% CI 1.00-2.00); and third-degree burns (OR = 1.55, 95% CI 1.00-2.80). Risk factors for LOS secondary to electrical injury should be appropriately addressed. Prevention at high-risk workplaces is imperative. Mitigating the injury with appropriate management of infection and timely surgical interventions play an essential role in the successful treatment of these patients.
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Affiliation(s)
| | - Herney Andres Garcia-Perdomo
- Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle. Cali, Colombia
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Sumer RW, Woods WA. Cardiac Arrest in Special Populations. Emerg Med Clin North Am 2023; 41:485-508. [PMID: 37391246 DOI: 10.1016/j.emc.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Best practices in cardiac arrest depend on continuous high-quality chest compressions, appropriate ventilatory management, early defibrillation of shockable rhythms, and identification and treatment of reversible causes. Although most patients can be treated according to highly vetted treatment guidelines, some special situations in cardiac arrest arise where additional skills and preparation can improve outcomes. Situations covered in this section involve cardiac arrest in context of electrical injuries, asthma, allergic reactions, pregnancy, trauma, electrolyte imbalances, toxic exposures, hypothermia, drowning, pulmonary embolism, and left ventricular assist devices.
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Affiliation(s)
- Ravi W Sumer
- Department of Emergency Medicine, 4601 Dale Road, Modesto, CA 95356-8713, USA.
| | - William A Woods
- Department of Emergency Medicine, University of Virginia Health System, PO Box 800699, Charlottesville, VA 22908-0699, USA
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IRMAK KAYA Z, BİLGİN Ç. Yanık Merkezinde Tedavisi Yapılan Elektrik Yanıklı Hastaların Kronik Yaraya Dönüşümünün Değerlendirilmesi. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1171855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Amaç: Yanık merkezi yoğun bakımında elektrik yanığı nedeniyle takip edilen hastaların yaralarının kronik yaraya dönüşümleri değerlendirilmiştir.
Gereç ve Yöntemler: Mayıs 2019 - Ekim 2021 tarihleri arasında XXX Yanık Merkezi yoğun bakımında elektrik akımına maruziyet ile takip edilen, elektrik akım giriş ve çıkış yerleri ekstremitelerde belirgin olan, 3.derece ve üzeri yanık oluşmuş hastalar retrospektif olarak incelenerek, hastaların elektrik akımı maruziyeti sonrası takipleri ile taburculuk sonrası poliklinik izlemlerinde yara yerleri değerlendirilmiştir.
Bulgular: Yanık merkezi yoğun bakımda takip edilen 121 hastanın %28,9’u elektrik yanığı (n=35) olup, çalışmaya 30 hasta dahil edilmiştir. Çalışma kapsamına alınan 30 hastanın tamamı erkek cinsiyet, ortanca yaş 31 yıl olup hastaların hiçbirinin kronik hastalığı yoktu. Hastaların %83,3’ü (n=25) iş kazası, %16,7’i (n=5) ev kazası olarak kayıtlara geçmiştir. Hastaların %53,3 ‘ü (n=16) şehir içi, %46,7’si (n=14) il dışından başvuru şeklindedir. Erken dönem başvuran 20 hastanın 7’sinin (%35), geç dönem başvuran 10 hastanın 8’inin (%80) kronik yaraya dönüşümü (p=0,02) saptanmış olup, yanık merkez yoğun bakımında takip edilen elektrik yanıklı hastaların %50’sinde (n=15) kronik yaraya dönüşüm olduğu belirlenmiştir.
Sonuç: Elektrik yanıkları her yaş grubundan sağlıklı insanın maruz kalabileceği, hayati riski olan yaralanmalar grubunu oluşturmaktadır. 4- 6 haftadan uzun süren, iyileşmeyen yaralar kronik yara olarak kabul edilmektedir. Çalışmamızda elektrik yanığından 4 hafta sonrasında yarası iyileşmeyenler kronik yara olarak kabul edilmiştir. Çalışmamızda erken dönemde başvuran hastalarda geç başvurulara göre daha düşük oranda kronik yaraya dönüşüm gözlenmiş olup, elektrik yanıklarında erken başvuru ve müdahale ile kronik yaraya dönüşümünün azaltılmasının önemine dikkat çekilmek istenmiştir.
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Electrocution: Direct-Current Dogma Dies Hard. Am J Forensic Med Pathol 2021; 42:405-406. [PMID: 34483234 DOI: 10.1097/paf.0000000000000712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oruç M, Dündar AS, Okumuş H, Dengeşik Ö, Altın İ, Şamdancı ET, Celbiş O. Autopsy findings and scene of incident examination in deaths resulting from electrical injury. AUST J FORENSIC SCI 2021. [DOI: 10.1080/00450618.2021.1973098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mucahit Oruç
- Department of Forensic Medicine, Inonu University Faculty of Medicine, Malatya, Turkey
| | | | - Hasan Okumuş
- Council of Forensic Medicine, Gebze-Kocaeli, Turkey
| | - Ömer Dengeşik
- Department of Forensic Medicine, Inonu University Faculty of Medicine, Malatya, Turkey
| | | | | | - Osman Celbiş
- Department of Forensic Medicine, Inonu University Faculty of Medicine, Malatya, Turkey
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Chauveau N, Renard A, Gasperini G, Cazes N. Long-term consequences of electrical injury without initial signs of severity: The AFTER-ELEC study. Am J Emerg Med 2021; 50:518-525. [PMID: 34543835 DOI: 10.1016/j.ajem.2021.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND There is no specificity of emergency or long-term management of benign electrical injuries (EI). The main objective of our work was to describe the occurrence of long-term complications of EI considered as benign. METHODS Single-center retrospective study of a cohort of adult patients who consulted for EI without initials signs of severity in an emergency department between 2012 and 2019. All included patients were secondarily contacted by telephone at least one year after their EI to complete a questionnaire. RESULTS 76 adult patients visited the emergency department and 48 of them could be contacted by phone. 82% of the recalled patients had at least one complication following their EI. The main long-term complications were neurological (65%), psychological (58%) and cardiological (31%). Patients recalled eight years after EI had higher rates of neuropsychological complications than those recalled one year after EI. Only the time spent in the emergency department was statistically longer in patients who developed long-term complications compared to those who did not. DISCUSSION The occurrence of long-term neuropsychological complications predominates. The knowledge and management of these long-term consequences must be particularly well known by emergency physicians because they are often the first medical contact of the patient. Our results also seem to show a crescendo in time of the occurrence of long-term complications. CONCLUSION all health professionals involved in the care of victims of a EI must be made widely aware of the occurrence of these long-term complications, particularly neuropsychological ones, in order to improve the long-term patient care.
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Affiliation(s)
- Nathan Chauveau
- Service des urgences, Hôpital d'Instruction des Armées Sainte-Anne, 83000 Toulon, France
| | - Aurélien Renard
- Groupement Santé, Service médical d'urgence, Bataillon de marins-pompiers de Marseille, 13233 Marseille cedex 20, France
| | - Guillaume Gasperini
- Service des urgences, Hôpital d'Instruction des Armées Sainte-Anne, 83000 Toulon, France
| | - Nicolas Cazes
- Groupement Santé, Service médical d'urgence, Bataillon de marins-pompiers de Marseille, 13233 Marseille cedex 20, France.
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Ahmed J, Stenkula C, Omar S, Ghanima J, Bremtun FF, Bergan J, Raouf N, Ghanima W. Patient outcomes after electrical injury - a retrospective study. Scand J Trauma Resusc Emerg Med 2021; 29:114. [PMID: 34362435 PMCID: PMC8344194 DOI: 10.1186/s13049-021-00920-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/14/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION People exposed to electrical injuries are often admitted to hospital for observation. Current evidence suggests that patients who have a normal ECG on admission after a low-voltage injury, with no loss of consciousness or initial cardiac arrest may be discharged home after a short observation time. Currently, there are no established standards for the duration of monitoring after electric shock, but 24 h of observation is the most commonly adopted approach. We carried out a retrospective study of patients admitted after electrical injuries to determine the in-hospital outcomes and 30-day mortality in these patients. METHODS We performed a chart review of all patients with electrical injuries admitted to Østfold Hospital, Norway between the years 2001 and 2019, to determine in-hospital and 30-day mortality and the frequency of various cardiac and non-cardiac complications. RESULTS Mean age of 465 included patients (88% males) was 31 years. Of all injuries, 329 (71%) were work-related, 17 (3.7%) involved loss of consciousness. Furthermore, 29/437 (6.6%) were high voltage (> 1000 V), and 243/401 (60.6%) were transthoracic injuries. 369 (79.4%) were discharged same day. None of the admitted patients died in hospital nor did any die within 30 days of admission, yielding a 30-day mortality of 0% (95% CI 0-0.8). At admission troponin was elevated in three (0.6%) patients, creatinine kinase (CK) in 30 (6.5%) and creatinine in six (1.3%). Electrocardiogram (ECG) abnormalities were described in 85 (18%) patients. No serious arrhythmias were detected. When comparing high- vs low-voltage or transthoracic vs other injuries, there were no significant differences between most of the outcomes, except for more ECG abnormalities in the transthoracic group, whereas more patients had elevated CK, and fewer discharged the same day in high-voltage injuries. CONCLUSION No in-hospital nor 30-day mortality or serious arrhythmias were encountered in those who were assessed, regardless of the type of injury. Troponin and creatinine were rarely elevated. It seems that conscious patients admitted with a normal ECG following a low-voltage injury may safely be discharged home after a quick clinical assessment including ECG.
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Affiliation(s)
- Jamal Ahmed
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway.
| | - Charlotte Stenkula
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway
| | - Sherwan Omar
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway
| | - Josef Ghanima
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway
| | | | - Jonas Bergan
- Department of Research Østfold Hospital Trust, Gralum, Norway
| | - Nezar Raouf
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway
| | - Waleed Ghanima
- Department of Emergency Medicine, Østfold Hospital Trust, Gralum, Norway
- Department of Research Østfold Hospital Trust, Gralum, Norway
- Department of Hematology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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12
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Guimarães F, Camões J, Mesquita A, Gomes E, Araujo R. A Case Report: Low Voltage Electric Injuries Culminating in Cardiac Arrest and Direct Lung Injury. Cureus 2020; 12:e11261. [PMID: 33274138 PMCID: PMC7707888 DOI: 10.7759/cureus.11261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Serious electrical injuries are rare but may have life-threatening consequences. Voltage exposure injuries are divided into low voltage injury (LVI) or high voltage injury (HVI). An LVI current can result in severe injury, depending on the length of exposure, the size of the individual, the cross-sectional area in contact with the electrical source, and environmental humidity. The authors present a 31-year-old male with accidental electrocution with low voltage current and cardiopulmonary arrest. A detailed revision by organs and systems is presented. LVI is uncommon and can occur with a variety of clinical presentations, rarely presenting with direct lung injury. Early recognition and support are the cornerstones of treatment.
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Affiliation(s)
- Filipa Guimarães
- Internal Medicine Department, Unidade Local de Saúde de Matosinhos (ULSM) - Hospital Pedro Hispano, Porto, PRT
| | - João Camões
- Intensive Care Unit, Unidade Local de Saúde de Matosinhos (ULSM) - Hospital Pedro Hispano, Porto, PRT
| | - Ana Mesquita
- Intensive Care Unit, Unidade Local de Saúde de Matosinhos (ULSM) - Hospital Pedro Hispano, Porto, PRT
| | - Ernestina Gomes
- Intensive Care Unit, Unidade Local de Saúde de Matosinhos (ULSM) - Hospital Pedro Hispano, Porto, PRT
| | - Rui Araujo
- Intensive Care Unit, Unidade Local de Saúde de Matosinhos (ULSM) - Hospital Pedro Hispano, Porto, PRT
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Buckley CT, Velamuri SR, Sultan-Ali I, Arif F, Hickerson WL, Hill DM. Early initiation of high-volume hemofiltration may reduce complications of high-voltage electrical injuries: A case report. BURNS OPEN 2020. [DOI: 10.1016/j.burnso.2020.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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14
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Babu VS, Sharma S, Manas RK, Kaur C, R R. Study of serum creatine kinase and lactate dehydrogenase levels and their correlation in high-voltage electric contact burns. EUROPEAN JOURNAL OF PLASTIC SURGERY 2020. [DOI: 10.1007/s00238-020-01695-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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15
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Jingo K, Kondo Y, Hirano Y, Inoue J, Kawasaki T, Miyoshi Y, Ishihara T, Okamoto K, Tanaka H. Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs. SAGE Open Med Case Rep 2020; 8:2050313X20920421. [PMID: 32477561 PMCID: PMC7234342 DOI: 10.1177/2050313x20920421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/26/2020] [Indexed: 11/30/2022] Open
Abstract
Electrical injuries induce ventricular arrhythmias, which are lethal. Therefore, it is important to evaluate the risk of arrhythmias at initial presentation to the emergency department in cases of electrical injuries. Here, we report two cases with electrical injuries, where current flowed between the upper limbs, requiring 24-h hospitalization for arrhythmia monitoring. The patients were 57- and 30-year-old men, who sustained separate electrical injuries (6600 V, line voltage), with current flow from one hand to the other. They did not develop any ventricular arrhythmias during hospitalization and were discharged. The risk for ventricular arrhythmias is lower for electrical injuries occurring between the upper limbs than for those occurring between the upper and lower limbs. We conclude that 24-h hospitalization for monitoring of patients with electrical injuries of the upper limbs may be sufficient.
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Affiliation(s)
| | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Yohei Hirano
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Juri Inoue
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Takaaki Kawasaki
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Yukari Miyoshi
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Tadashi Ishihara
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Ken Okamoto
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hiroshi Tanaka
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
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Stockly O, Wolfe A, Espinoza L, Simko L, Kowalske K, Carrougher G, Gibran N, Bamer A, Meyer W, Rosenberg M, Rosenberg L, Kazis L, Ryan C, Schneider J. The impact of electrical injuries on long-term outcomes: A Burn Model System National Database study. Burns 2020; 46:352-359. [DOI: 10.1016/j.burns.2019.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/17/2019] [Accepted: 07/24/2019] [Indexed: 12/21/2022]
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Abstract
The analysis of domestic and foreign literature sources showed that the problem of diagnosing and treating electrical injuries remained relevant as in the early 20th century. Over the past century, the mechanisms of the effects of electric current on organs and tissues have been well studied. However, the search for methods for diagnosing the volume of tissue damage has not been completed, and such methods are necessary, since they are designed to help determine the volume of surgical intervention. Many patients still require repeated surgical interventions to completely excise necrotic tissue. In most patients with severe electrical trauma, reconstructive surgery takes place in several stages. Today, most clinical data and practical recommendations are based on the opinions of individual experts and limited clinical studies.Authors declare lack of the conflicts of interests.
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Affiliation(s)
- E. A. Zhirkova
- N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow health Department
| | - T. G. Spiridonova
- N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow health Department
| | - A. V. Sachkov
- N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow health Department
| | - K. V. Svetlov
- N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow health Department
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18
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Tolouie M, Farzan R. A Six-Year Study on Epidemiology of Electrical Burns in Northern Iran: Is It Time to Pay Attention? World J Plast Surg 2019; 8:365-371. [PMID: 31620340 PMCID: PMC6790258 DOI: 10.29252/wjps.8.3.365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Although electrical burns are less prevalent than other types, they put socioeconomic burden on communities, yielding higher mortalities. Therefore, the frequency and causes of electrical burns in the largest burn center in northern Iran were studied. METHODS All patients with electrical burn injuries admitted to Velayat Hospital, Rasht, Iran participated in this descriptive cross-sectional study. The data collection tool was a checklist including demographic data, damage mechanism, voltage classification (high or low), injured organ, ICU need, length of stay (LOC), electrical burn severity (degree and area of burns based on TBSA), surgical interventions, and return to work. All data were gathered through HIS system and analyzed. RESULTS Most electrical burns occurred in men (99.4%) and most of whom had electricity-related jobs (26%). The majority of victims had third-degree burns (63%), and electrical current-induced burns in entry points occurred in the upper and lower extremities, head and other organs ranked the first to fourth, respectively. Most burns happened due to abrupt contact with electrical current (83.33%) in routine home activities (52.78%). The mean LOC was 8.73 days, suggesting that LOC increased significantly, if the electrical current entered the body through lower extremities, while it decreased significantly, if the electrical current exited through lower extremities. CONCLUSION The majority of electrical burn victims were men. Most burns occurred in urban communities in summer. Most people were affected by high voltage electricity.
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Affiliation(s)
- Mohammad Tolouie
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ramyar Farzan
- Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
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