Cardiac monitoring not needed in household electrical injury if the patient is asymptomatic and has a normal ECG
Report by: Wendy Dollery - Consultant in Emergency Medicine
Search checked by: Katrina Herren - Research Fellow in Emergency Medicine
Institution: Manchester Royal Infirmary
Date Submitted:
Date Accepted:
Last Modified: 15 November, 2024
Three Part Question
In [patients who have sustained a household voltage electrical injury with normal initial ECG] is [admission for monitoring] necessary to [reduce the risk of sudden death from cardiac arrhythmias]?
Clinical Scenario
A 30 year old male elctrician attends the emergency department having suffered an electrical shock while servicing a washing machine. There was no water involved.
Search Strategy
Medline 1966-10/03 using the OVID interface.
[exp electric injuries OR exp burns, electric OR electric injuries.mp OR electrocution.mp] AND [exp monitoring, physiologic OR monitoring.mp]
Search Outcome
102 papers found of which 96 were irrelevant. The remaining 6 papers are shown in the table.
Relevant Paper(s)
| Author, Date, and Country |
Patient Group |
Study type (level of evidence) |
Outcomes |
Key results |
Study Weaknesses |
| Fatovich DM & Lee KY1991Australia |
20 patients exposed to 240 volts AC electric supply |
Observational study, literature review |
Initial ECG
Cardiac monitor
|
2/20 abnormal, no new abnormality detected
|
Retrospective, no statistical analysis |
| Tollemache N2017UK |
Patient Group |
Study Details |
Outcomes
Here's a new line |
Key Results |
Weaknesses |
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Comments
While there are numerous case reports in the literature of dysrythmias developing after both 240 and high voltage electrical injury no studies have shown onset of dysrythmias after initial assessment. Only observational studies were identified looking at household electrical injury and late onset cardiac arrythmias.
Bottom Line
Routine cardiac monitoring is not required after household voltage electrical injury if the patient is asymptomatic and has nomral initial electrocardiography. Asymptomatic patients involved in minor electrical events do not require investigation or admission.
References
- Fatovich DM & Lee KY. Fatovich DM & Lee KY
- Tollemache N. Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials.
- asdgsadg. test