Julia Searle1, Anna Slagman, Wibke Maaß, Martin Möckel. 1. Charité Universitätsmedizin Berlin, Department of Cardiology and Department of Anesthesiology and Operative Intensive Care Medicine, Campus Virchow and Campus Charité Mitte.
Abstract
BACKGROUND: There is no uniform, standardized procedure for the treatment of persons with electrical injuries in Germany. Even if they have no risk factors, such persons are often hospitalized and observed on an intensive care unit because of concern that cardiac arrhythmia might arise some time after the initial accident. We analyzed secondary data to determine the frequency of cardiac arrhythmia in survivors of electrical accidents. METHOD: Using the hospital information system (HIS), we retrospectively identified all patients admitted to the Charité Berlin, Campus Virchow Klinikum, for the ICD diagnostic code T75.4 (effects of electric current) in the years 2001 to 2008. The data pertaining to each case were extracted from the patients' medical records. RESULTS: Over the study period, 268 children and adults were admitted to our hospital with electrical injuries. All underwent cardiac rhythm monitoring, usually for more than 12 hours. On admission, 33 children (28.7%) and 33 adults (24.2%) had mild cardiac arrhythmias of various types (sinus tachycardia, sinus bradycardia, isolated extrasystoles). No patient developed a cardiac arrhythmia requiring intervention at any point in his or her hospital course. CONCLUSION: Even though too few patients were included to permit any definitive conclusions from this retrospective study alone, the present findings accord with the findings of multiple earlier studies implying that asymptomatic, otherwise unharmed patients without any ECG changes may not need to be admitted to the hospital for observation. There should be an evidence-based, standardized procedure for the treatment of patients with electrical injuries, so that these patients can be cared for safely and cost-effectively.
BACKGROUND: There is no uniform, standardized procedure for the treatment of persons with electrical injuries in Germany. Even if they have no risk factors, such persons are often hospitalized and observed on an intensive care unit because of concern that cardiac arrhythmia might arise some time after the initial accident. We analyzed secondary data to determine the frequency of cardiac arrhythmia in survivors of electrical accidents. METHOD: Using the hospital information system (HIS), we retrospectively identified all patients admitted to the Charité Berlin, Campus Virchow Klinikum, for the ICD diagnostic code T75.4 (effects of electric current) in the years 2001 to 2008. The data pertaining to each case were extracted from the patients' medical records. RESULTS: Over the study period, 268 children and adults were admitted to our hospital with electrical injuries. All underwent cardiac rhythm monitoring, usually for more than 12 hours. On admission, 33 children (28.7%) and 33 adults (24.2%) had mild cardiac arrhythmias of various types (sinus tachycardia, sinus bradycardia, isolated extrasystoles). No patient developed a cardiac arrhythmia requiring intervention at any point in his or her hospital course. CONCLUSION: Even though too few patients were included to permit any definitive conclusions from this retrospective study alone, the present findings accord with the findings of multiple earlier studies implying that asymptomatic, otherwise unharmed patients without any ECG changes may not need to be admitted to the hospital for observation. There should be an evidence-based, standardized procedure for the treatment of patients with electrical injuries, so that these patients can be cared for safely and cost-effectively.
Authors: Martin Mockel; Julia Searle; Reinhold Muller; Anna Slagman; Harald Storchmann; Philipp Oestereich; Werner Wyrwich; Angela Ale-Abaei; Joern O Vollert; Matthias Koch; Rajan Somasundaram Journal: Eur J Emerg Med Date: 2013-04 Impact factor: 2.799
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