Low-voltage Injury Research Articles

Evisceration due to full thickness injury to the abdominal wall, with intestinal involvement, plus trauma to the chest wall, extremities and genitals due to high voltage electrical burn; case report and review of the literature

Electrical burns are one of the most drastic traumas to which an individual can be exposed; being able to directly or indirectly compromise almost all tissues of the human body. They cause more than 3,000 admissions to specialized burn units in the United States. Up to 40% of serious electrical injuries are fatal, resulting in approximately 1000 deaths per year.Its incidence depends on the type of exposure to electricity: low voltage, due to contact with electrical cables or plugs. High voltage, due to occupational exposures and power lines while climbing trees or poles. These voltages are more likely to cause injuries to deep tissues and internal organs compared to low voltage injuries and also the degree of body surface area burned.Its approach constitutes a challenge, since the risks of visceral involvement are added to the morbidity and mortality inherent to the burn. Early treatment of intra-abdominal complications allows a more conservative approach, reducing ostomies and their associated comorbidity. It is preferable to manage the abdominal defect by preserving the tissues themselves and restoring the midline. In our case, it was feasible to perform a primary closure of the abdominal wall. Your treatment will depend on factors such as: the amount of tissue lost, intra-abdominal contamination, general condition, and factors such as: physical resources and experience of the hospital. Mortality from burns ranges between 3 and 55%, those with the highest risk of death are those at extreme ages, higher degrees of burns, injuries associated with inhalation, and injuries in patients with comorbidities.

Low-Dose Electrocution and Atrial Fibrillation.

Emergency electrocution incidents present with various injuries, which can range from minor to severe injuries including death. Cardiac-related complications have a higher mortality incidence among patients with low-voltage injuries (M. R. Zemaitis et al., 2023). When managing electrical injury patients, the literature recommends managing them as both trauma and cardiac cases. However, the diagnostic approach is based on each individual case and patient presentation. Electrical injury complications include arrhythmias, myocardial tissue damage, and conduction disturbances (Pilecky et al., 2019). The purpose of this case study is to discuss a postelectrocution atrial fibrillation case and common related arrhythmias associated with electrical injuries.

Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa, Southeast Turkey (2012-2022).

Electric shock injuries (EIs) have high rates of morbidity and mortality in both children and adults. The aim of this study was to examine autopsy cases resulting from EIs and to compare pediatric and adult groups with respect to sociodemographic data, clinical characteristics, location of the incident, electricity entry-exit wound characteristics, current direction, pathological effects of the electric shocks on the body, and cause of death. A total of 8075 autopsies conducted between 2012 and 2022 were retrospectively examined. Şanliurfa is a city in the southeast of Turkey with the highest birth rate in the country. Of 123 cases of death resulting from EIs in Şanliurfa, 58 (47.2%) were children (age < 18 years). In the majority of children (81%), a low-voltage injury resulted from a domestic appliance while the children were playing at home in a rural area. In the vast majority of adults, a high-voltage injury (HVI) resulted from a workplace accident due to working with HVI materials in an area outside the home. The manner of death was accidental in all the electric shock injuries. The electricity entry and exit wounds formed as a result of EIs had similar characteristics in both children and adults, with no significant difference identified. In the province of Şanliurfa, Turkey, which borders Syria and where the main occupation is agricultural activities, there is a need to increase electrical safety precautions within the home, educate parents, and increase electrical safety conditions and worker education in the workplace.

Arrhythmias and laboratory abnormalities after an electrical accident: a single-center, retrospective study of 333 cases.

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 23years to determine the prevalence of cardiac arrhythmias (mainly malignant arrhythmias and delayed arrhythmias). 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. 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 (< 1000V, 91.6%). All participants had an initial ECG, and 77.5% of patients had continuous ECG monitoring, usually lasting 24h. 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. 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.

Çocuklarda Düşük ve Yüksek Voltajlı Elektriksel Yanıklar: On Yıllık Deneyim

Objective: Burn injuries are an important public health problem for all ages. Due to electrical burns high mortality and morbidity rates, they should be evaluated differently from burns from other sources. This study aims to determine factors associated with high-and low-voltage electrical burns in children. Materials and Methods: The records of 72 patients who were treated for electrical burns were analysed. Electrical burns were divided into two groups: low and high voltage. Demographic data, treatment, outcomes were compared between the two groups. Results: In this study, low-voltage electrical burns were detected in 83.3% of the patients, and high-voltage electrical burns were detected in 17.7% of the patients. High-voltage burns were more common in rural residents (p&amp;lt;0.05). Low-voltage electrical burns mostly occurred as a result of home accidents (90%), while high-voltage injuries were mostly caused by work accidents (100%), (p&amp;lt;0.05). The most common cause of low-voltage injuries was contact with an electrical outlet (91.6%), for high-voltage injuries it was contact with a transformer (83.3%) (p&amp;lt;0.05). For high-voltage injuries, the severity of the burns was higher, the duration of the hospital stay was longer (p&amp;lt;0.05). Conclusion: Children generally have low-voltage injuries. High-voltage injuries are associated with more surgical treatment and morbidity, longer hospital stays. Electrical burns can be reduced by training on protective measures and proper arrangement of infrastructure in rural areas

Prevalence of Cardiac Arrhythmias, Clinical Spectrum and Complications of Electrical Injury

Background: Electrical accidents (EA) are rare, but can cause serious and potentially life-threatening injuries to multiple organs. The majority of epidemiological data refers to workplace accidents which account for a significant share of such accidents in adults. Exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. Objective: To evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: This was observational prospective study was carried out at the Dept. of Cardiology, Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh from January to June 2021. 51 consecutive patients with electrical injury who were admitted. Admission criteria were age ≥15 years, loss of consciousness, cardiac arrest, electrocardiographic abnormalities, soft tissue damage and burns. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82.3%) were male. Patients who sustain high voltage electrical injury (&gt;1000V) were 18 (35.2%) and low voltage injury (&lt;1000V) were 33 (64.7%).Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.0%, p=0.054), sinus bradycardia (11.1% vs 3.0% p=0.254), ventricular premature beats (5.6% vs3.0%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 81.8% p=0.560) and fatigue (55.6% vs 39.3%, p=0.328). Conclusion: In this study few non-fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. Parameters considered to be risk factors such as known structural heart disease, loss of consciousness, high voltage electric shock, burn and soft tissue injuries were also not significant predictors of the occurrence of arrhythmias. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.

A Severe Electrothermal Ring Burn Case and a Proposed Treatment Algorithm

Ring-associated burns are infrequent comprising only a tiny fraction of burn consults. Due to the circular nature of rings, these burns are often circumferential, with an increased risk for compartment syndrome and neurovascular injury. The severity of ring burn is related to the type of material and electrical current. Low-voltage injuries are generally due to contact with batteries and household devices, while high-voltage electric injuries occur with occupation-related accidents or natural disasters. Low-voltage ring burn can be managed conservatively with close follow-up. However, high-voltage ring burn might have dramatic consequences such as finger amputation. To date, there have been few cases reported in the literature of a ring burn. Most cases were superficial burns and managed with secondary healing or skin grafting. However, the literature has not reported the management of a severe ring burn with deteriorated finger circulation. In this case report, we present a circumferential electrothermal ring burn case with resulted in total loss of a finger. Furthermore, we propose an algorithmic approach to ring burn injuries.

Epidemiology of electrical burns and its impact on quality of life - the developing world scenario.

BACKGROUNDElectrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae. Epidemiological data regarding the etiology, socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy. These severe injuries often lead to amputations and thus hamper quality of life in the long termAIMTo identify the population at maximum risk of sustaining electrical burns. We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work. METHODSThe study was conducted at a tertiary referral teaching hospital over a period of eighteen months. All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study. All relevant epidemiological parameters and treatment details were recorded. The patients were subsequently followed up at 3 mo, 6 mo and 9 mo. The standardized Brief Version of the Burn Specific Health Scale (BSHS-B) was adopted to assess quality of life. Statistical analysis was conducted using IBM SPSS statistics (version 22.0). A P value of < 0.05 was considered statistically significant. RESULTSA total of 103 patients were included in the study. The mean age of the patients was 31.83 years (range 18-75 years). A significant majority (91.3%) of patients were male. The mean total body surface area (TBSA) in these patients was 21.1%. In most of the patients (67%), the injury was occupation-related. High voltage injuries were implicated in 72.8% of patients. Among the 75 high voltage burn patients, 31 (41%) required amputation. The mean number of surgeries the patients underwent in hospital was 2.03 (range 1 to 4). The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains. In eight of these domains, the difference was statistically significant. Similarly, the scores among the amputees were poorer when compared to non-amputees. The difference was statistically significant in six domains. CONCLUSIONElectrical burns remain a problem in the developing world. Most injuries are occupation-related. The quality of life in patients with high voltage burns and amputees remains poor. Work resumption was almost impossible for amputees. These patients could not regain pre-injury status. Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.

Autopsy findings and scene of incident examination in deaths resulting from electrical injury

ABSTRACT Electrocution injuries are divided into high (HVI) and low voltage injuries (LVI). The aim of this study was to examine the sociodemographic data of cases where autopsy was performed because of death originating from electric shock, together with the clinical characteristics, scene of incident, electrical entry-exit wound localizations, pathological effects of electric shock on the body, and cause of death. A total of 4210 autopsies were retrospectively reviewed, and 49 had died from electrocution. The mean age of the cases was 29.2 ± 16.04 years and 87.8% were males and 12.2% were females, 49% of the cases were the result of HVI and 51% the result of LVI. The presence of electrical entry and/or exit wounds were significantly higher in electrocution injuries due to home accidents than work accidents (p < 0.005). There was no statistically significant difference between the deaths caused by the direct effect of electric shock and those who died with LVI and HVI. The deaths of all the cases were accidental in origin, with no suicide or homicide. Deaths due to electrocution due to home or workplace accidents can be determined by examining the crime scene, witness statements, autopsy and histopathological findings.

Patterns and Outcomes of High-Voltage vs Low-Voltage Pediatric Electrical Injuries: An 8-Year Retrospective Analysis of a Tertiary-Level Burn Center.

Although electrical injuries (EIs) are rare traumas in the pediatric age group, they are considered one of the most devastating injuries. We aimed to evaluate the patterns and outcomes of pediatric high-voltage injuries (HVIs) vs low-voltage injuries (LVIs), admitted to the burn center within the efforts of determining evidence-based data for contributing to burn prevention strategies. A retrospective study was conducted on children with EIs hospitalized in the Burn Center of Adana City Training and Research Hospital for 8 years (2013-2020). Data including the patients' clinical and demographic characteristics, the percentage of total body surface area with burns (%TBSA), length of hospital stay, exposure place, electrical current type, and treatment results were collected and analyzed. EIs were detected in 57 (2.5%) of 2243 acute pediatric burn injury admissions. EIs were most frequently observed in the form of HVIs, among children within the age range of 13 to 18 years, mostly in residential outdoor environments, where the high-power lines still passing close to the home roofs and balconies, resulting from contact with them. Besides, to a lesser extent in LVIs, in the home environment among children younger than 5 years, which was caused by connection with substandard electrical cords/poor-quality electrical devices and inserting an object into the electric sockets. Concerning the mean of %TBSA, HVIs suffered more extensive burns than LVIs. The most frequently affected anatomical regions among HVIs and LVIs were the upper limb, followed by the lower limb. While superficial partial- and deep partial-thickness burns were significantly more common among the LVIs, full-thickness burns were more prevalent among the HVIs. The amputation rate was 12% of which only one of them was major amputation (forearm above the elbow joint). HVIs had more elevated creatine kinase (CK) and CK-myocardial band (CK-MB) levels than LVIs but were not correlated with electrocardiography findings. Only one death (caused by HVI) was observed, with a mortality rate of 1.8%. Pediatric EIs are less common than scald or fire flame-related burns in this age group but can cause significant morbidity and even mortality, especially in severe burns. It is possible to prevent possible morbidity and mortality by strengthening compliance with safety precautions, especially with parental education and raising social awareness. In this context, taking necessary precautions for passing high-voltage power lines under the ground, the standardization of electrical cables by the relevant legal regulations, the use of socket covers in homes, promoting the widespread use of residual current relays, and arrangements to be taken against the use of illegal electricity are among measures for the prevention strategy.

Patient outcomes after electrical injury \u2013 a retrospective study

IntroductionPeople 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.MethodsWe 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.ResultsMean 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.ConclusionNo 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.

Evaluation of Electrical Burn Injuries in Iran: A 7-Year Retrospective Study.

Electrical burn injuries can cause devastating and debilitating morbidities and impairments for patients. This cross-sectional descriptive study was performed on electrical burn patients hospitalized from 2014 to 2019 to evaluate electrical burn injuries' epidemiology and characteristics. A total number of 726 patients with the mean age of 31.17 years were evaluated for electrical burn injuries. Mean total burn surface area (TBSA) was 16.61 ± 12.56. Most victims were male (696 cases, 95.7%) and most patients did not have a constant job (n = 458, 63%). Most affected burn sites were hands (28.6%) and upper limbs (27.8%). A total number of 89 (12.2%) patients suffered amputations with the hand fingers (64 cases) as the most common site. Low-voltage injuries were more common (n = 649, 89%). Most incidents happened at the workplace (n = 459, 63%). Comparison of patients with high-voltage and low-voltage injuries showed significant correlations and statistical difference between these two groups regarding TBSA, mean hospital stays, escharectomy, fasciotomy, amputations, debridement, fracture, and mortality rate (P = .001). Our observation revealed that electrical burn injuries are still significant causes of morbidity and mortality among trauma patients. In contrast to previous studies, low-voltage injuries were more common than high-voltage ones. We propose improvements in the manufacturing of electrical appliances; paying attention to safety measures will reduce the number of incidents. Moreover, training and education play important roles in reducing the number of incidents and mortality rates.

561 Bilateral Upper Extremity Amputation After High Voltage Electrical Injury: A Case Report

Abstract Introduction Electrical injuries represent 0.4–3.2% of admissions to burn units and are responsible for &amp;gt;500 deaths per year in the United States. Approximately half occur in the workplace and are the fourth leading cause of work-related-traumatic death. The extent of injury can be drastically underestimated by total body surface area percentage (TBSA). Along with cutaneous burns, high voltage electrical injuries can lead to necrosis of muscle, bone, nervous tissue, and blood vessels. Aggressive management allows for patient survival, but at significant cost. Newer technologic advances help improve functional outcomes. Methods This case-report was conducted via retrospective chart review of the case presented. Results A 43-year-old male sustained a HVEI (&amp;gt;10, 000 V) after contacting an active wire while working as a linesman for an electric company. He presented after less than 15-minute transport from an outside hospital with full thickness burns and auto-amputation to all fingers on both hands and the distal third of the left hand (Images 1 and 2). There were full thickness circumferential burns to the entire left and right upper extremities with contractures, with the burns extending into the axilla, and chest wall musculature. The patient had 4th degree burns and a large wound to the left shoulder with posterior extension to the scapula, flank and back with approximately 25% TBSA (Image 3). Compartments were tense in both upper extremities. Patient was sedated and intubated to protect the airway and placed on mechanical ventilation. A femoral central line was then placed, and the patient was given pain control, continued fluid resuscitation, and blood products. Dark red colored urine from a foley catheter that was immediately identified as rhabdomyolysis induced myoglobinuria. Labs drawn demonstrated elevated troponin I, CK &amp;gt;40,000. BUN 18, creatinine 1.0, K+ 5.2 and phosphate 5.6. Decision was made immediately for operative intervention with emergent amputation of both upper extremities in the light of rhabdomyolysis secondary to tissue necrosis and oliguria. During the patient’s hospital course, he underwent multiple operations for further debridement with vacuum-assisted closure therapy and skin grafting of sites, as well as targeted muscle reinnervation (TMR) 6 months later at an outside hospital. Conclusions Although HVEI only account for a small percentage of burn admissions, they are associated with greater morbidity than low-voltage injuries. Patients with HVEI often incur multiple injuries, more surgical procedures, have higher rates of complications, and more long term psychological and rehabilitative difficulties. Despite the need for amputation in some of these critically ill patients, options exist that allow for them to obtain long term functional success.

Evaluation of the Epidemiological Characteristics of the Patients Admitted to Our Clinic as a Result of Electric Shock.

Electric shocks (ESs) are common traumas in burn units that require treatment by specialists due to high mortality and morbidity. This study aimed to investigate the demographic and clinical characteristics of patients of ES, complications, and injury-related mortality and morbidity rates. The authors 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. 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. Electrical injuries are largely preventable with simple safety precautions in daily life as well as serious consideration of workplace safety.

Allodynia in Cervical Polyradiculopathy Due to Low-voltage Electrical Burn Injury: A Case Report

Neuropathic pain has been described following an electrical injury, whether as an immediate response or a late-onset sequela. There is much information on high-voltage injuries in literature due to its dramatic presentation, but limited studies on low-voltage injuries. However, low-voltage injuries can be as diverse and may have symptoms varying from minimal cutaneous involvement to full-thickness injury. Significant injuries may result from multiple factors, including prolonged duration of exposure and a higher amount of current transmitted. We illustrate an atypical presentation of a low-voltage injury in a 17-year-old female. The patient had a low voltage electrical injury with no cutaneous burn noted on the affected extremity. She initially presented with allodynia, which seemed disproportionate to the clinical findings expected in a low-voltage injury. The patient underwent an electrodiagnostic study, which showed cervical polyradiculopathy (C5, C6, C7 polyradiculopathy) and neuromusculoskeletal ultrasonology, which showed enlarged right C5 nerve root. Medical management, daily physical and occupational therapies, and psychological management, were instituted, which resulted in significant improvement of the patient’s pain level and functional status. We describe the importance of the multimodal approach (medical and rehabilitation) in managing this atypical case.

International Multi-Center Analysis of In-hospital Morbidity and Mortality of Low-Voltage Electrical Injuries.

Background : Patients with high- and low-voltage electrical injuries differ in their clinical presentation from minor symptoms to life-threatening conditions. For an adequate diagnosis and treatment strategy a multidisciplinary team is often needed, due to the heterogeneity of the clinical presentation. To minimize costs and medical resources, especially for patients with mild symptoms presenting after low-voltage electrical injuries, risk stratification for the development of further complications is needed.Methods : During 2012–2019 two independent patient cohorts admitted with electrical injuries in two maximum care university hospitals in Germany and Austria were investigated to quantify risk factors for prolonged treatment, the need of surgery and death in low-voltage injuries. High-voltage injuries were used as reference in the analysis of the low-voltage electrical injury.Results : We analyzed 239 admitted patients with low-voltage (75%; 276 ± 118 V), high-voltage (17%; 12.385 ± 28.896 V) or unclear voltage (8%). Overall mortality was 2% (N = 5) associated only with high-voltage injuries. Patients with low-voltage injuries presented with electrocution entry marks (63%), various neurological symptoms (31%), burn injuries (at least second degree) (23%), pain (27%), and cardiac symptoms (9%) including self-limiting thoracic pain and dysrhythmia without any therapeutic need. Seventy three percentage of patients with low-voltage injury were discharged within 24 h. The remaining patients stayed in the hospital (11 ± 10 days) for treatment of entry marks and burns, with an overall need for surgery of 12% in all low-voltage injuries.Conclusions : The only identified risk factors for prolonged hospital stay in patients with low-voltage electrical injuries were the treatment of burns and electric marks. In this multi-center analysis of hospitalized patients, low-voltage electrical injuries were not associated with cardiac arrhythmia or mortality. Therefore, we suggest that asymptomatic patients, without preexisting conditions, with low-voltage injury can be discharged after an initial check-up without prolonged monitoring.

Cardiac Arrhythmias in Patients with Electrical Injury: Hospital Based Study

Background: Electrical injury and its consequences after exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. The aim of this study was to evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury.&#x0D; Methods: All 50 consecutive patients who were admitted in Chitwan Medical College from April 2018 to March 2020 were prospectively studied. Patients were categorized into high and low voltage injury group and their variables were compared.&#x0D; Results: The mean age of the patients was 32.3±10.4 years among them 41 (82%) were male. Patients who sustain high voltage electrical injury (&gt;1000V) were 18 (36%) and low voltage injury (&lt;1000V) were 32 (64%). Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.2%, p=0.054), sinus bradycardia (11.1% vs 3.1% p=0.254), ventricular premature beats (5.6% vs3.1%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 84.4% p=0.560) and fatigue (55.6% vs 40.6%, p=0.328).&#x0D; Conclusion: In this study few non fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.

The epidemiology of paediatric electrical injuries in a South African township

IntroductionIn South Africa 10% of inhabitants live in informal dwellings with no running water or electricity. Access to electricity may be improvised by redirecting current from existing fixtures. Injuries from contact with connecting wires are known to occur but are scarcely described. ObjectivesTo describe the epidemiology, presentation and management of electrical burn injuries experienced by Soweto children presenting to Chris Hani Baragwanath Academic Hospital. Materials and methodsA retrospective review of records for children with a diagnosis of an electrical injury between September 2013 and August 2016 was performed. ResultsAll children presenting with a history of an electrical injury were admitted. 103 cases were included in the study. 91% were low-voltage injuries with no mortalities, and 9% were high-voltage injuries with a 67% mortality rate. Mean age at presentation was 4.5 years. 81% of injuries were caused by outside wires and other illegal installations. There was a decreased frequency of injuries during the winter months. 73% had biochemistry derangements. Total body surface area affected ranged from 0% to 76%. ConclusionThe incidence of electrical injuries in this study was 7% of all burns related admissions. Injuries sustained carried significant morbidity and mortality. The dominant mechanism of injury in this study can be targeted in primary prevention strategies.

Epidemiology of electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China.

ObjectiveTo investigate the epidemiological profile and associated outcomes of electrical injuries at a major burn centre in southern China.MethodsThis retrospective study enrolled consecutive electrical burn patients admitted to the burn centre of the First Affiliated Hospital of Guangxi Medical University between 2008 and 2017. Demographic and clinical data and outcomes were recorded. Mann–Whitney U tests/Pearson’s chi-squared tests were used to examine the differences between low-voltage and high-voltage injuries.ResultsThere were 217 high-voltage injuries and 159 low-voltage injuries. High-voltage burns were frequently observed between March and August, and low-voltage burns peaked between June and September. Burn patients were mainly men. Most burns occurred in participants aged 21 to 50 years and in industrial workers and electricians at work or householders at home. Only one person with high-voltage burns died (a mortality rate of 0.46%). Amputation rates were 37.33% for high-voltage burns and 22.01% for low-voltage burns. High-voltage injuries were associated with more extensive burns, longer hospital stays, and more complications and amputations.ConclusionsMore attention should be paid to prevention of electrical burns in male adults. Particular focus is needed on industrial workers, incidents in the spring and summer, and high-voltage injuries.

Electricity: The Enemy Invisible

Electrical injuries, as such, are less prevalent in comparison to other forms of burn injuries. However, this type of injury is considered to be one of the most devastating injuries due to its high morbidity and mortality. It is also associated with high costs and long-term hospitalization as well as the need for multiple surgical procedures; therefore, specific management considerations are required for this type of injury.&#x0D; It is more prevalent in developing countries, with prevalence rate being higher among men. Most of the pediatric population suffers injuries at home from low voltage appliances.&#x0D; The patient with electrical injury is usually a young, employed person who can potentially return to a productive working life. Successfully achieving this goal would save society a great loss of human potential. The plastic surgeon is actively involved in all phases of the pursuit of maximal recovery of the patient with electrical injuries. Reconstructive procedures are required both in high voltage injuries and low voltage injuries and have improved the quality of lives of these patients by timely intervention.&#x0D; Precautionary measures are necessary to reduce the incidence of high voltage injuries and their devastating effects. The incidence of high voltage injuries would not have been so high had the electric workers been properly trained and hazards of high tension lines explained. Moreover emphasis must be laid on the use of safety measures.