Outcomes of electrical injuries in the emergency department: a 10-year retrospective study

Electrical injuries are challenging to assess and current guidelines are based on few studies and case reports. Recommendations on cardiac monitoring were published for certain risk factors, but indications for hospital observation are less clear. Furthermore, the risk of late arrhythmias is not known. Therefore, we aimed to assess possible cardiac complications, including death and immediate or delayed dysrhythmia, after an electrical accident in a sample of patients presenting to the Emergency Department (ED).

Medical records of patients presenting to the ED of the University Hospital Basel, Switzerland, during 2004-2013 were retrospectively reviewed. Follow-up in terms of the survival of these patients was performed through hospital databases, and direct contact with patients and caregivers. The primary endpoint was in hospital mortality and mortality within 10, 30, and 90 days, respectively. For our secondary endpoint, we investigated patient charts for the occurrence of dysrhythmias and laboratory findings.

During the study period, a total of 240 patients were identified. Twelve patients were lost to follow-up. Initial ECG was performed in 234 (97.5%) patients and 149 (62.1%) patients received cardiac monitoring. During the time of monitoring, four dysrhythmias (sinus bradycardia, two ventricular premature beats, and atrial fibrillation) were observed. All patients survived, and no potential late serious dysrhythmia requiring a medical intervention was recorded.

No cardiac complications occurred during ED stay or during the 90-day follow-up period. Therefore, the need for continued cardiac monitoring after electrical injury is not supported by our data.