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.
- CPK, creatine phosphokinase
- CPK-MB, creatine phosphokinase myoglobin
- ED, emergency department
- IRB, institutional review board
- electrical injuries
- cardiac monitoring
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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.