Cardiac monitoring in patients with electrocution injury

The necessity of admitting patients exposed to electrocution injuries for monitoring and observation in the emergency department (ED) remains controversial.

We evaluated the medical records of 102 patients (86 male, 16 female; median age 29.5; range 18 to 68 years) admitted to the adult ED with electrocution injuries over the past 20 years.

Only 9 deaths were reported: 3 as a result of contact with low-voltage electricity and 6 after contact with high-voltage electricity. With the exception of a case of sepsis, all deaths were related to early rhythm abnormalities immediately following the incident. The ECG findings of surviving patients in the study group were as follows: 70 normal, 8 sinus tachycardia, 3 sinus bradycardia, 4 ST-T wave changes, and 1 ventricular extrasystole. ECG recordings of 7 patients could not be found. 72 cases had been followed up with repeat ECG recordings. There were no observed ECG changes requiring any medical or electrical therapies in the surviving patients.

Cardiac rhythm abnormalities related to electrocution injuries are usually observed at the time of the incident. If the patient's overall clinical condition is good and they have a normal ECG at the time of admission to the ED, the probability of observing any delayed serious dysrhythmia is unlikely.