Electrocution Injury Research Articles

PP-175 THE IMPORTANCE OF LEFT ATRIAL DIVERTICULUM DURING CATHETER ABLATION FOR ATRIAL FIBRILLATION: A CASE REPORT

Objective: Inappropriate therapy for rhythm other than ventricular fibrillation and sustained ventricular tachycardia is common adverse event associated with ICD implantation. In the absence of damage to leads, electrical interference with ICD devices has rarely been identified as a cause of inappropriate therapy. We report a different case of inappropriate ICD shock which saved the patient from severe electrocution injury initiated by the leakage of alternating current in an external source. Conclusions: In this case the ICD recorded typical electromagnetic interference (EMI) arising from regular 50-Hz alternating current leak. The amount of current flow is the most important factor in deciding the degree of electrical injury, which may range from transient muscle tremors to death. There are some reports about ICD shocks given after EMI, but this is the report of a rare case about an ICD shock that terminated the contact from the source of electric leakage and prevent the patient from damage with electrical injury.

An unusual exit point from an electrocution injury

Injuries sustained from high voltage electrical current are well documented [1–3]. Cardiac arrest and death often ensue and survivors may have extensive damage to soft tissue and bone along with muscle necrosis and rhabdomyolysis. Decompression fasciotomy or amputation may be necessary [4]. Longterm neurological complications are also widely reported [5,6]. Cutaneous burns can occur at the entry and exit points of the path taken by the current. We present a case of a 19-year-old man who sustained a high voltage electrical injury causing cardiac arrest, diffuse brain injury and burns to the hands and feet. Several weeks after the initial injury additional exit points were noted on the labial surface of his upper central incisor teeth. To our knowledge this is the first reported case of electrical exit points causing cavitation of the teeth.

Holiday Ornament-Related Injuries in Children

Holiday ornament injuries in children have not been well documented in the medical literature. Our aim was to investigate the patterns of injuries sustained from these ornaments as a first measure toward prevention. This was a retrospective cohort analysis of all patients examined in an urban pediatric emergency department over a 13-year period ending in March 2008 for holiday ornament-related injuries. Cases were identified using a computer-assisted text query followed by a manual chart review. Data collected from each chart included the child's age, sex, injury characteristics, physical examination findings, radiographic imaging, interventions, and disposition. To analyze injury rates over the years, we used a multiplicative Poisson model allowing varying exposures. Over the study period, we identified 76 eligible patients. The median age was 2 years (interquartile range, 1.17-3.3 years); 44.7% were female. Forty-three of the 76 cases (53.9%) involved ingestions: 35 were of holiday ornaments, and 8 were of light bulbs. All but one of these ornaments were made of glass. In 28%, there was an associated bleed either from the mouth or as a delayed gastrointestinal bleed. Other patients experienced lacerations (27.6%), eye injuries (5.1%), and minor electrocution injury (2.5%). Imaging was performed in 85%. A subspecialty consult was obtained in 23%, primarily addressing a foreign body ingestion or removal after skin exploration. The incidence rate has not changed over the years. Holiday ornament-related injuries primarily involve foreign body ingestions and glass-related injuries. Over half of the injuries involved small light bulbs and ornaments made of glass placed at the level a toddler can reach. Pediatricians are advised to discuss these points with families during holiday season.

Cardiac magnetic resonance image of an electrocuted heart

A 43-year-old man was electrocuted while performing house repairs. Soon, he developed frequent presyncopal episodes associated with fast, regular palpitation. A seven-day Holter monitor revealed episodes of symptomatic ventricular tachycardia. There was no family history of arrhythmia or sudden cardiac death. He had a normal resting electrocardiogram, echocardiography and angiography showed unobstructed coronary arteries. Programmed ventricular stimulation induced fast monomorphic ventricular tachycardia. A cardiac magnetic resonance image demonstrated mid-wall fibrosis of the mid- to apical lateral left ventricular wall. Patients with known electrocution injury may present late with ventricular arrhythmia. In such cases, focal fibrosis has been documented from myocardial biopsy. The present report presents the first published cardiac magnetic resonance image of a cardiac scar induced by an electrocution injury (Figure 1). The patient was implanted with a cardiac defibrillator and commenced bisoprolol treatment with no further symptoms or arrhythmia. Figure 1) Electrocardiogram (left panel) and cardiac magnetic resonance image of a cardiac scar (right panels; arrows) induced by an electrocution injury

A 56-Year-Old Man with Sudden Onset of Portosystemic Encephalopathy Years after Severe Electrocution Trauma

A 56-year-old white male painter, with a history of major electrocution and deep thermal injury, developed mental status changes initially ascribed to an acute neurological event. Unexpectedly, magnetic resonance imaging (MRI) of the head showed areas of high signal intensity in the basal ganglia, which can be observed in advanced liver disease. An electroencephalogram (EEG) suggested metabolic encephalopathy and coexistent elevation of ammonia, indicative of significant liver disease. The patient had had a long history of right upper quadrant pain and fluctuation in liver tests following the electrocution trauma. For these symptoms, he underwent surgery 7 years prior to his current presentation of portosystemic encephalopathy, and was found to have a gangrenous acalculous cholecystitis. Intraoperative cholangiogram suggested possible strictures within the right hepatic ducts. Multiple liver biopsies, however, showed only steatosis. Current evaluation including liver biopsy, MRI, magnetic resonance angiography (MRA), and magnetic resonance cholangiopancreatography (MRCP), revealed progression to biliary cirrhosis with large bile duct obstruction, and hepatic artery thrombosis/occlusion with evidence of left lobe atrophy and right lobe compensatory hypertrophy. The pathobiology of ischemic bile duct injury is discussed herein. The case is an example of serious late sequelae of an occupational injury.

Unilateral facial nerve paralysis after electrocution injury

We present a case of acute, unilateral facial nerve paralysis in a patient who had received a low voltage electrical current. This is an extremely rare cause of this neurological condition. The patient regained complete neurological function approximately three months after the incident. Unilateral facial nerve paralysis most commonly occurs due to infection or blunt or penetrating trauma; it has not been previously reported as a result of low voltage electrical injury.

Delayed progressive sensorineural hearing loss after electrocution injury

Delayed progressive sensorineural hearing loss after electrocution injury

Delayed Progressive Sensorineural Hearing Loss after Electrocution Injury

Delayed Progressive Sensorineural Hearing Loss after Electrocution Injury

Electroporation of cells and tissues

Electrical pulses that cause the transmembrane voltage of fluid lipid bilayer membranes to reach at least U/sub m//spl ap/0.2 V, usually 0.5-1 V, are hypothesized to create primary membrane "pores" with a minimum radius of -1 nm. Transport of small ions such as Na/sup +/ and Cl/sup -/ through a dynamic pore population discharges the membrane even while an external pulse tends to increase U/sub m/, leading to dramatic electrical behavior. Molecular transport through primary pores and pores enlarged by secondary processes provides the basis for transporting molecules into and out of biological cells. Cell electroporation in vitro is used mainly for transfection by DNA introduction, but many other interventions are possible, including microbial killing. Ex vivo electroporation provides manipulation of cells that are reintroduced into the body to provide therapy. In vivo electroporation of tissues enhances molecular transport through tissues and into their constitutive cells. Tissue electroporation, by longer, large pulses, is involved in electrocution injury. Tissue electroporation by shorter, smaller pulses is under investigation for biomedical engineering applications of medical therapy aimed at cancer treatment, gene therapy, and transdermal drug delivery. The latter involves a complex barrier containing both high electrical resistance, multilamellar lipid bilayer membranes and a tough, electrically invisible protein matrix.

Electrocution injury

Electrocution injury

Electrocution injuries. A case report

A case study of a high-voltage injury was presented. The short period that the patient was in contact with the electrical source prevented further systemic injury and may have saved her life. The patient's present neuritis is indicative of long-term sequelae of electrocution injury, in which ischemic necrosis of the surrounding nerves can occur near or at the site of the exit wound.

Electrical burns—incidence and prognosis in Western Scotland

A 10-year review of all patients admitted to the West of Scotland Regional Burns Unit with serious electrical burns indicated an incidence of only 2·6 cases per million of the population served by the Unit per year. Injuries following electrocution or electric flash, but excluding injuries caused by grasping the hot heating element of an electric fire, were suffered by 70 patients, 52 of whom sustained electrocution which was not immediately fatal. Ninety-one per cent of the patients were male. The patients who died in hospital did so as a result of sepsis rather than as a direct result of the electrical injury. All those patients who had ECG changes on admission recovered completely. In view of the very deep injuries, the amputation rate was high with 12 out of 52 patients (23 per cent) with electrocution injury requiring one or more amputations. The events preceding the serious electrical injury in our patients suggest that, 57 per cent of all the injuries could have been prevented, and in patients under 20 years of age this percentage rose to 91.