Electrical Shock Injury Research Articles

Muskuloskelettale Rekonstruktion bei bilateraler Unterarmtransplantation

Improvement of motor function of the upper extremity was investigated in a patient following bilateral forearm transplantation. Following an electric shock injury with amputation of both forearms at the proximal level a bilateral allotransplantation was performed 2003 in a 41-year-old male patient. Missing and insufficient muscles were replaced by donor units. For use of myoprothesis in case of transplant failure remnants of BR, ECRL, ECRB and ECU remained at the recipient. 3.5 mm DCP plating was used without bone grafting to stabilize the forearm bones. PT, FCR, FDS, PL of the donor was fixed to the medial epicondyle of the humerus, ECU and EDC to the periosteum of the ulna. FCU, BR, ECRL; ECRB of the donor were sutured to the corresponding fascia of the recipient muscles. For motor function NIA; NIP and the motor branches of the median nerve for PT, FCR, FDS, PL were coapted. The ulnar nerve was coapted distally to the motor branch for the FCU. Following induction therapy today IS consist of tacrolimus (trough level 8 ng/ml), everolimus (trough level 6 ng/ml) und Prednisone (5 mg/day). Both grafts are vital at FU of 6 years and 1 month. During the first 3 years episodes of graft rejection, opportunistic infection and transient metabolic disorder occurred which could be treated successfully by systemic, topical agents and change of IS. Bone healing appeared normal. TRM of the upper extremity improved from 32.7% before surgery to 74.6% of normal, with gain of wrist motion/forearm rotation of 8.7% and finger motion of 33, and 2%. The moderate muscle power (M4/5) of the deep flexors, the extensors and the intrinsic muscles is considered to be due to the long distance of reinnervation, a pre-existing electric damage to the nerv and repeated rejection episodes. Range of motion of the upper extremity improved primarily by extrinsic muscle function. Muscle strength and grip are moderate. The patient described the following to be most beneficial: the better range of motion, the possibility to perform tasks without visual control, the availability of his range of motion 24 h a day and a new sense of body integrity.

Cataract and Retinal Detachment Following Electric Shock Injury in a 28-year-old Nigerian Male: A case report

Aim: To report a case of cataract and retinal detachment following an electrical injury in an adult Nigerian male. C a se report: A 28-year-old man presented with a history of progressive and painless loss of vision in the right eye, three years after an electric shock injury. There was no history of mechanical trauma. Examination and investigations revealed a mature cataract and retinal detachment in the right eye. He subsequently had an uneventful cataract surgery with expected poor prognosis, secondary to the retinal detachment. Conclusion: This case highlights two ocular complications (one common and one uncommon) following an electrical injury. A high index of suspicion and awareness of the likelihood of these complications may increase diagnostic accuracy, especially in cases of presenile cataracts with no apparent cause. Keywords: electrical injury, presenile cataract, retinal detachment Nigerian Journal of Ophthalmology Vol. 16 (1) 2008: pp. 23-25

Hepatic “split lesion” in a fatal electrocution case

The first recorded death caused by electrical current from an external source was reported in 1879, when a carpenter in Lyon, France, inadvertently contacted a 250 V alternating current generator [1]. Electrical injuries (excluding lightning) are responsible for >500 deaths per year in the USA. A little more than half of them occur in the workplace and constitute the fourth leading cause of work-related traumatic death (5–6% of all worker’s deaths) [2]. Medical literature typically categorizes electrocution according to the level of applied voltage: low voltage (less than 1000 V) and high voltage (greater than 1000 V); as reported from medical-legal practice, 14–40% of mortal electrocution are caused by high-voltage injuries [3,4]. It is well known that an electrical shock may cause death or any degree of damage to various organs and systems; the severity of electric shock injury is dependent upon many variables: type of current, level of applied voltage, duration of shock, body contact surface area, resistance of tissue involved, contact with water or metal conductor and current pathway through the body [5]. The electrical shock may strike the victim’s central nervous system, the cardiovascular apparatus, the skeletal muscular tissue, the lungs, the skin and other internal organs [6]. Severe abdominal visceral injuries by electricity are a rare entity; in particular, we rarely come across cases of hepatic lesions. In

Thermal burn and electric shock injuries among electric utility workers

Electrical burns are devastating, posing development of multiple injuries with high morbidity and mortality. Electrical burn management benefits from a multidisciplinary, multispecialty collaborative approach to improve outcomes.To highlight the clinical spectrum of electrical burns in the developing world, including common etiologies, presentation, intervention, associated injuries, and complications.A prospective study was conducted from January 2010 to December 2015 that included 78 patients (75 men and 3 women), who presented with a history of electrical burns. Patients were interviewed for detailed clinical history and physical examination.The study comprised 78 patients (high-voltage group: 38.46% and low-voltage group: 61.54%). The most affected age group was the 21–40 year age group. High-voltage injuries were more devastating. The most common complication was septicemia in 24.4% of the patients, which included 43.3% from the high-voltage group.Electrical burns affecting young adult men can impose a significant burden in developing countries. Electrical burns, especially due to high voltage, involve multiple organs benefitting from multidisciplinary management and have significant residual sequelae. Public awareness and education and proper training of industry workers remain the best way to minimize the prevalence of electric burns in the developing world.

Thermal burn and electrical injuries among electric utility workers, 1995–2004

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.

ELECTRIC SHOCK INJURIES IN A HARRIS'S HAWK POPULATION

Electrocution may be an important agent of mortality in many raptor populations, and has been implicated as a contributing factor in the endangerment of some species. In Tucson, Arizona U.S.A. the electrocution of Harris's Hawks (Parabuteo unicinctus) was reported in both the 1980s and 1990s. The latter report also described Harris's Hawks that survived electric shock injuries. From February 2003–May 2004, I captured and examined wild Harris's Hawks in Tucson to investigate whether electric shock injuries might be present in individuals that appeared healthy from a distance. I trapped 85 birds; seven exhibited definite electric-shock injuries, and seven exhibited suspected electric-shock injuries. One individual exhibited injuries not consistent with electric shock. I captured an equal number of males and females, but only one of the injured birds was a male. Females were significantly more likely to have injuries. Whether this difference reflects patterns of initial incurrence of injury, or of higher probability of survival after electric shock remains unresolved. As medium- and large-bodied raptors colonize urban areas where overhead electric systems tend to occur in high densities, those species may also incur increased risk of electrocution.

Supramembrane potential-induced electroconformational changes in sodium channel proteins: A potential mechanism involved in electric injury

Effects of imposed large supraphysiological transmembrane potential (TP) pulses on channel proteins, particularly on the voltage-gated Na channels, were investigated. Voltage clamp techniques were used to deliver both shock and stimulation pulses, and to monitor changes in the channel functions. Our experimental results indicated that more than one 4 ms duration TP shock of −450 mV resulted in electroconformational denature of voltage-gated Na channels. This resulted in functional reductions in muscle cells’ excitability. We quantified the TP shock-induced decrease in the Na channel currents, compared the pre- and post-shocked Na channel currents’ voltage dependency, and studied the reversibility of the electroconformationally denatured ion channel proteins. These observations are particularly relevant to the problem of explaining the neuromuscular damage following high voltage electrical shock injuries despite no evidence of a thermal injury component.

Lightning Strike and Electric Shock Survivors, International

Prior to1989 no known support group existed for victims of lightning or electrical shock injury and their families. A lightning strike survivor of twenty years, Steve Marshburn, recognized the need both from his personal experience and after meeting two other survivors. With his wife and psychologist, he formed Lightning Strike and Electric Shock Survivors International. The organization has grown nearly one hundredfold from the thirteen who attended the first annual meeting. The support group serves people from around the world, has produced a number of publications, participated in research about these injuries and has become active in prevention activities. This paper will describe some of the factors that have led to such success for the organization.

Hair transplantation in scalp scars: an analysis of 782 cases

目的 运用自体毛发移植术将头发毛胚在头部瘢痕上进行移植.观察在瘢痕上头发移植的特点及移植后的效果.方法 1998～2002年对782例因不同原因引起头部瘢痕的患者运用自体毛发移植术进行修复.结果移植的头发均生长良好.但因形成瘢痕原因的不同,所造成的瘢痕深度的不同和血运状态的不同,引起头发生长的速度及状态亦不同.结论自体毛发移植术可以应用于头部瘢痕性脱发的修复,对感染、烫伤及火轻中度烧伤而引起的瘢痕均可实施手术,且术后效果均较理想;对于头皮撕脱伤、电击伤及火深度烧伤者,手术后,头发生长速度较慢。

Occupational electrical injuries in the United States, 1992–1998, and recommendations for safety research

Problem: CFOI and SOII data show that 2,287 U.S. workers died and 32,807 workers sustained days away from work due to electrical shock or electrical burn injuries between 1992 and 1998. Method: The narrative, work activity, job title, source of injury, location, and industry for each fatal electrical accident were examined. A primary causal factor was identified for each fatality. Results: Electrical fatalities were categorized into five major groups. Overall, 44% of electrical fatalities occurred in the construction industry. Contact with overhead power lines caused 41% of all electrical fatalities. Discussion: Electrical shock caused 99% of fatal and 62% of nonfatal electrical accidents. Comprising about 7% of the U.S. workforce, construction workers sustain 44% of electrical fatalities. Power line contact by mobile equipment occurs in many industries and should be the subject of focused research. Other problem areas are identified and opportunities for research are proposed. Impact on Industry: Improvements in electrical safety in one industry often have application in other industries.

Forensic Engineering Analysis Of Electric Shock From Ground Fault Circuit Interrupter (GFCI)

Many Electrical Wiring Systems Include Ground Fault Circuit Interrupters (Gfci) As Protective Elements. The Application Is For Avoidance Of Electric Shock Injuries To A Person In The Event That Their Body Becomes Part Of An Electrical Circuit Path From A Live Wire And Ground. The Theory Behind The Device Is That If There Is A Difference In Electrical Current Flowing Through The Live (120 Volt Ac) Wire And The Neutral Wire, Then The Difference Current Is Flowing To Ground And Is Potentially Hazardous To A Person. Functionally, The Gfci Should Automatically Open The Electrical Circuit Above A Certain Ground Current Value. This Paper Explores How The Circuit May Fail To Provide The Protection For Which It Is Intended, And Result In An Electric Shock.

Bilateral posterior fracture-dislocation of the shoulder revealing unsuspected brain tumor: Case presentation

Posterior dislocation of the shoulder is an uncommon injury, constituting 2% to 4% of all shoulder dislocations, whereas fracture-dislocations are even more rarely encountered.1 Posterior fracture-dislocations are usually caused by a massive contraction of shoulder girdle muscles; however, when bilateral, they are pathognomonic for either a convulsive disorder or an electric shock injury.2,5,6,8

Alteration in gastrointestinal and neurological function after electrical injury: a review of four cases

OBJECTIVE: Individuals exposed to an electrical injury develop a variety of complications, several of which are recognized years after the initial electrical shock. Alteration in gastrointestinal and nervous system function has been described in these patients, yet the frequency and character of these abnormalities are poorly understood. We reviewed records of 40 individuals with a history of electrical injury to identify evidence of delayed onset of complications. METHODS: Forty consecutive patients with electrical shock injuries were monitored for up to 5 yr after their traumatic event using a comprehensive systems review. Of the eight patients who described an alteration in their gastrointestinal and neurological functions, four agreed to undergo further testing. Investigations included a flexible sigmoidoscopy, anorectal manometry, stool evaluation, serological and biochemical serum analysis, and a psychological examination. RESULTS: Each of the four patients described an increase in stool frequency and urgency. Anorectal manometry detected a reduction in threshold to rectal balloon distention and an abnormal anal sphincter control. Bowel function improved with meselamine. Psychiatric symptoms involving memory and concentration were observed in varying degrees. CONCLUSIONS: To our knowledge, these induced physiological and psychological changes after exposure to electrical shock injury have not yet previously been described. Our findings should encourage further clinical investigations to better anticipate, diagnose, and manage these and other as yet unrecognized delayed complications of electrical shock injury.

Electric Shock Injuries in Hospitals

Electric Shock Injuries in Hospitals

Electrocution in the Operating Room

The manner in which a patient sustained an electrical shock injury from improperly wired equipment during the course of an operation was described in order to acquaint others with a potentially hazardous situation. A patient requiring surgical treatment had the ground plate of an electrocautery unit placed under her buttocks and the electrodes of an EKG unit attached to her shoulders and her precordium. During the course of the operation, the EKG monitor was subject to electrical interference. In an effort to correct the problem, the surgeon instructed the nurse to unplug the monitor and reinsert the plug into a 2nd wall receptable. As the plug was reinserted, the physician suffered a minor shock and the patient experienced an intense shock. She became cyanotic and her pulse stopped. The patient was revived and later recovered completely. Inspection of the equipment revealed that the EKG's power plug was incorrectly wired. The chassis ground was connected to the neutral plug instead of the ground plug. Furthermore, the 2nd wall receptacle was wired with reversed polarity. When the plug was inserted into the 2nd receptacle, a 110 volt alternating current developed between the precoidal EKG lead and the ground plate. If the monitor had been plugged into the 2nd receptacle prior to the operation, the monitor would not have functioned. The technician probably would have assumed that the machine was not in working order and would have substitued another machine. In order to minimize electrical shocks, EKG leads should be applied only to the extremities and not to the precordium region.