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Emerg Med J 2007;24:348-352 doi:10.1136/emj.2006.044677
  • Original Article

Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study

  1. Benoit Bailey1,2,3,
  2. Pierre Gaudreault2,3,
  3. Robert L Thivierge3
  1. 1Division of Emergency Medicine, CHU Ste-Justine, Montréal, Québec, Canada
  2. 2Division of Clinical Pharmacology and Toxicology, CHU Ste-Justine, Montréal, Québec, Canada
  3. 3Department of Pediatrics, CHU Ste-Justine, Montréal, Québec, Canada
  1. Correspondence to:
 Benoit Bailey FRCPC MD MSc
 CHU Ste-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montréal, Québec, Canada H3T 1C5; benoit.bailey{at}umontreal.ca
  • Accepted 26 February 2007

Abstract

Objective: To report our experience monitoring patients with previously identified theoretical risk factors of significant electrical injury.

Methods: Patients who presented to one of 21 emergency departments between October 2000 and November 2004 were eligible to be enrolled in a prospective observational cohort study if after an electric shock they had one of several risk factors (transthoracic current, tetany, loss of consciousness or voltage source ≥1000 V) and therefore needed cardiac monitoring.

Results: Of the 134 patients enrolled, most were monitored because of transthoracic current (n = 60), transthoracic current and tetany (n = 39), tetany (n = 10), or voltage ≥1000 V (n = 10). There were 15/134 (11%) patients with abnormal initial ECGs. No patient developed potentially lethal late arrhythmia during the 24 hours of cardiac monitoring.

Conclusion: Although only patients deemed at risk of late arrhythmias were monitored, none developed potentially lethal late arrhythmias. Asymptomatic patients with transthoracic current and/or tetany and a normal initial ECG do not require cardiac monitoring after an electrical injury with voltage <1000 V and no loss of consciousness.

Footnotes

  • This study was supported by a grant from Hydro-Québec.

  • Competing interests: None declared

  • Presented in part at the Canadian Association of Emergency Physicians/Association des Médecins d’Urgence du Québec joint meeting, Montreal, April 2004 and the International Interdisciplinary Conference on Emergencies, Montreal, June 2005.

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