Recovering from prolonged cardiac arrest induced by electric shock: A case report

BACKGROUND

Cardiac arrest (CA) induced by electric shock is a rare occurrence, particularly in cases of prolonged CA. Currently, there is limited literature on similar incidents, and we present a relevant case report.

CASE SUMMARY

A 27-year-old Asian male man, experiencing respiratory CA due to electric shock, was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions. In the subsequent stages, the patient received multiple organ function protection measures, leading to a successful recovery and eventual discharge from the hospital.

CONCLUSION

Prolonging resuscitation time can enhance the chances of survival for patients, this study provide valuable insights into the management of electric shock-induced CA.

Effect of electrical stimulation amplitude on dynamic behavior of mice during evacuation

Profound examination of the dynamic behavior of pedestrians during evacuation can significantly reduce the number of associated accidents. Conducting experiments on animals can help obtain deep insight into the dynamic behavior of pedestrians. Previous experiments using insects, such as ants and woodlice, showed large differences between the dynamic behaviors of insects and humans. However, systematic studies on the behavioral characteristics (e.g., velocity) of mice under electrical stimulation conditions have not been reported. Therefore, this study was conducted to investigate changes in the dynamic behavior of mice during evacuation caused by electric shock. Electrical stimulation was supplied through their feet during evacuation. The average velocity, desired velocity (maximum instantaneous velocity), average velocity in the congestion zone, and escape time were measured and analyzed. According to the results, the desired velocity and escape time increased in proportion to the amplitude of the electrical stimulation; however, the average velocity decreased. Consequently, the level of emergency of mice is affected by both the amplitude of electrical stimulation and the number density in congestion area as in human experiments.

An experimental rat model of electric shock injury with isolated electric shock and water conduction: the histopathological changes on the skin and internal organs and the effect on biochemical parameters

It is difficult to determine the cause of death in electric shock injuries when no trace can be determined on the skin, and this is accepted as a reason for negative autopsy. We aimed to determine useful parameters in the definition of the cause of deaths associated with electric shock and particularly those formed with water conduction. This study used a total of 42 rats, applied with fatal electric shock formed of isolated electric shock at 220 V and with water conduction. The serum NT-ProBNP and H-FABP levels were examined together with histopathological changes in the brain, cerebellum, brainstem, heart, liver and skin and the Bax, caspase-3 and HSP-60 antibody status in these tissues. A statistically significant difference was determined between the groups in respect of the serum H-FABP values and the immunohistochemical staining of the samples taken from the organs. In conclusion, this study is the first in literature with an experimental model of electric shock with water conduction. Using immunohistochemical and biochemical markers in deaths associated with isolated electric shock and electric shock with water conduction, the results of this study can contribute to the clarification of one of the reasons for negative autopsy in forensic medicine.

Evaluation of the epidemiological characteristics of the patients admitted to our clinic as a result of electric shock

INTRODUCTION

Electric shocks (ES) are common traumas in burn units that require treatment by specialists due to high mortality and morbidity.

OBJECTIVE

This study aimed to investigate the demographic and clinical characteristics of patients of ES, complications, and injury-related mortality and morbidity rates.

MATERIALS AND METHODS

We retrospectively analyzed data of 432 ES patients treated at the Gazi Yaşargil Training and Research Hospital Burn Center, Turkey, between January 2010 and December 2020.

RESULTS

Of the 432 patients, 92 (21.3%) and 340 (78.7%) sustained high- and low-voltage injuries, respectively. While high-voltage burns were common in January and December, low-voltage burns peaked in September and July. Burn patients were mostly males and were between the ages of 19 and 59 years. The majority of the ES events occurred at home. All four patients who died had suffered high-voltage burns, with two of high-voltage burns (2.17%) requiring amputation. None of the patients with low-voltage burns underwent amputation. High-voltage injuries manifested with larger burn surfaces, longer hospitalization, and more complications.

CONCLUSION

Electrical injuries are largely preventable with simple safety precautions in daily life as well as serious consideration of workplace safety.

Efficient high-voltage protection in the electric catfish

For thousands of years, starting with detailed accounts from ancient Egypt, the African electric catfish (Malapteruridae) has been renowned for its ability to hunt and to defend itself with powerful electric shocks. Surprisingly, the degree to which electric catfish are protected against their own or external electric shocks, how specific any protection would be to the species-specific waveform and whether a discharging catfish has to actively prepare for the onset of its high-voltage discharges has never been analysed. Here, we used digital high-speed video to record catfish during their own discharges or as they were exposed to external discharges, employing goldfish to carefully calibrate the efficiency of all discharges. Electric catfish show a remarkable degree of protection against high voltages: both self-produced and external electric shocks that heavily affected control goldfish failed to evoke involuntary muscle contraction or to affect sensorimotor processing. Even a commercial electrofishing device, set to efficiently immobilise and narcotise fish, failed to have any effect on the electric catfish. Our findings rule out several protective mechanisms and demonstrate a highly efficient and versatile shielding whose nature is presently unclear.

Beneficial effect of task-irrelevant threat on response inhibition

It is widely accepted that task-irrelevant threats utilize processing resources, resulting in impaired cognitive processes. However, if some subcomponents of the cognitive processes are activated by a threat, these cognitive processes may be facilitated. In the present study, we investigated whether task-irrelevant threats enhance cognitive control if the threat and task-relevant processes commonly recruit a cognitive process, inhibitory process. To examine the impact of task-irrelevant threats on inhibitory control, we had participants perform a stop-signal task with mild electric shocks. They were at risk for receiving the shocks randomly in threat blocks while no such shock was administered in safe blocks. The results showed that the stop-signal reaction time decreased under threat compared to safe conditions, indicating that inhibitory control was enhanced under threat. This beneficial effect of threat on response inhibition was more evident in participants with high state anxiety. An additional measurement of motor execution indicated that the interaction between threat and response inhibition was not derived from general arousal under threat. Results suggest that emotion and cognition do not interact simply by sharing processing resources but are related more closely to each other than we have previously thought by engaging a common processing.

Electric shock induced Purtscher-like retinopathy

The most common ocular manifestation following electric shock injury is the development of cataract. Retinal manifestations can vary from development of macular holes to retinal detachments. Purtscher-like retinopathy following electrical injury has not been reported till date. We hereby present a case of a 19-year-old electrician who presented with grossly reduced vision in the right eye of 2 months following an electric shock. The fundus of the right eye showed macular ischemic degeneration, occluded vessels, cotton-wool spots, and hemorrhages. Optical coherence tomography angiography revealed presence of capillary drop-out in the para-foveal region, which was more pronounced in the deep capillary plexus. Electric shock injury can lead to a clinical picture simulating Purtscher's retinopathy. The electrical injury leads to a more extensive damage to the deep capillary plexus as compared with the superficial plexus.

Put Your Lights On: Electrocution As a Cause of an Unexplained Fall and Loss of Consciousness

Electrical accidents are not reported very frequently, and may occur undetected as the signs are often manifold and not very specific. We report the case of a 43-year-old woman admitted to hospital due to a fall of unclear cause, with loss of consciousness, partial amnesia, paresis of both legs and crush syndrome. Only by thorough and repeated history-taking, and a careful physical examination that revealed burns typical of electrical current injuries, was the case resolved. With this case presentation, we would like to make the reader aware of electrocution as a possible cause of bruises and unconsciousness of unclear origin.

Different Types of Maculopathy in Eyes after a High-Voltage Electrical Shock Injury

Background

We report a case of different types of maculopathy in eyes after a high-voltage electrical shock injury.

Case Report

A 43-year-old male suffered high-voltage electrical injury through his left arm. He underwent cataract surgery in both eyes 3 months after the injury, but there was no vision improvement. Ocular examination, including spectral domain optical coherence tomography, revealed diffuse retinal atrophy in the left eye which did not change until the final visit. In the right eye, an impending macular hole was observed but regressed spontaneously 9 months after the injury, and the visual acuity improved to 20/32 at the final visit.

Conclusion

Two different types of maculopathy can occur in each eye after high-voltage electrical shock injury, and this might be due to asymmetric pathogenesis of the eyes according to the proximity to the route of electrical current.

A Rare Case of Neurogenic Pulmonary Edema Following High-voltage Electrical Injury

Electrical injuries though infrequent, are potentially devastating form of injuries which are associated with high morbidity and mortality. The severity of the injury depends upon intensity of the electrical current which is determined by the voltage and the resistance offered by the victim. These injuries vary from trivial burns to death. There have been few reports about pulmonary injuries due to electrical current but none mentioning neurogenic pulmonary edema (NPE). Here we report a young boy who when exposed to high-voltage current developed neurogenic pulmonary edema and was successfully managed. Though there is no specific protocol for electrical injury but identifying the organs involved along with type of disease facilitates the management.

No discrimination shock avoidance with sequential presentation of stimuli but shore crabs still reduce shock exposure

Insights into the potential for pain may be obtained from examination of behavioural responses to noxious stimuli. In particular, prolonged responses coupled with long-term motivational change and avoidance learning cannot be explained by nociceptive reflex but are consistent with the idea of pain. Here, we placed shore crabs alternately in two halves of a test area divided by an opaque partition. Each area had a dark shelter and in one repeated small electric shocks were delivered in an experimental but not in a control group. Crabs showed no specific avoidance of the shock shelter either during these trials or in a subsequent test in which both were offered simultaneously; however they often emerged from the shock shelter during a trial and thus avoided further shock. More crabs emerged in later trials and took less time to emerge than in early trials. Thus, despite the lack of discrimination learning between the two shelters they used other tactics to markedly reduce the amount of shock received. We note that a previous experiment using simultaneous presentation of two shelters demonstrated rapid discrimination and avoidance learning but the paradigm of sequential presentation appears to prevent this. Nevertheless, the data show clearly that the shock is aversive and tactics, other than discrimination learning, are used to avoid it. Thus, the behaviour is only partially consistent with the idea of pain.

Summary: There was no discrimination shock avoidance with sequential presentation of stimuli but, consistent with pain, shore crabs used other tactics to reduce shock exposure.

A pragmatic comparison of noise burst and electric shock unconditioned stimuli for fear conditioning research with many trials

Several methods that are promising for studying the neurophysiology of fear conditioning (e.g., EEG, MEG) require a high number of trials to achieve an adequate signal-to-noise ratio. While electric shock and white noise burst are among the most commonly used unconditioned stimuli (US) in conventional fear conditioning studies with few trials, it is unknown whether these stimuli are equally well suited for paradigms with many trials. Here, N = 32 participants underwent a 260-trial differential fear conditioning and extinction paradigm with a 240-trial recall test 24 h later and neutral faces as conditioned stimuli. In a between-subjects design, either white noise bursts (n = 16) or electric shocks (n = 16) served as US, and intensities were determined using the most common procedure for each US (i.e., a fixed 95 dB noise burst and a work-up procedure for electric shocks, respectively). In addition to differing US types, groups also differed in closely linked US-associated characteristics (e.g., calibration methods, stimulus intensities, timing). Subjective ratings (arousal/valence), skin conductance, and evoked heart period changes (i.e., fear bradycardia) indicated more reliable, extinction-resistant, and stable conditioning in the white noise burst versus electric shock group. In fear conditioning experiments where many trials are presented, white noise burst should serve as US.