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


CONCLUSIONS
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.
Bailey
Benoit
B
Division of Emergency Medicine, CHU Ste-Justine, Montréal, Québec, Canada. benoit.bailey@umontreal.ca
Gaudreault
Pierre
P
Thivierge
Robert L
RL
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000453:epidemiology*; D002637:Chest Pain / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003402:Creatine Kinase / Q000378:metabolism; D004556:Electric Injuries / Q000453:epidemiology* / Q000378:metabolism; D004562:Electrocardiography / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors
D003402:Creatine Kinase