Electrical shock closely monity9/6/2023 ![]() ![]() The majority of electrical injuries occur in a domestic environment (63.1% n = 169). ![]() The study period was chosen in this way because the electronic documentation of diagnoses in the HIS started no earlier than January 2001. The patients included in this study were not contacted or interviewed they did not undergo any additional study-related interventions. Since continuous cardiac rhythm monitoring was performed in many patients, but not or not continuously documented, it was accepted as evidence that the patient did not develop arrhythmia if no cardiac arrhythmia was mentioned in the patient records. ![]() who presented with no arrhythmia after the electrical accident. Delayed cardiac arrhythmias were defined as arrhythmias requiring treatment in patients who do not show arrhythmia after the electrical injury, i.e. This study’s primary endpoint, the incidence of delayed cardiac arrhythmias, was determined from the patient records. Both primary and secondary diagnoses were included in this search. Patient identification was based on the ICD codes recorded in the HIS an automatic search covering the above mentioned period was performed with the help of the IT department. The clinical data of all patients admitted with the ICD diagnosis T75.4 (effects of electric current) to the Charité Berlin-Campus Virchow Medical Center between January 2001 and December 2008 were included in the analysis. The present study represents a secondary analysis of data from the hospital information system (HIS) and patient records. In this study, the clinical data of all patients admitted with the ICD diagnosis T75.4 (effects of electric current) to a University hospital in Berlin during a period of eight years were retrospectively analyzed for the incidence of delayed cardiac arrhythmias. Even studies with an exclusive focus on high-risk patients failed to show such association ( 11, 12) (n = 48 and n = 134). Several clinical studies showed for pediatric and adult patients that electrical injuries were not associated with the occurrence of delayed arrhythmia however, the case numbers in most of these studies were comparatively small ( 7– 10) (n = 145, 151, 212, and 31, respectively). The fear of delayed cardiac arrhythmias is primarily fueled by case reports ( 3– 6) however, from these no causal relationship between electrical injury and arrhythmia can be derived. Only in a minority of hospitals these guidelines are followed closely. The European Resuscitation Council Guidelines for Resuscitation 2010 recommend that “all those who survive electrical injury should be monitored in hospital if they (…) have had loss of consciousness cardiac arrest electrocardiographic abnormalities soft-tissue damage and burns“ ( 2). It is, according to our experience, common practice in many clinical centers in Germany to admit patients with electrical injuries to monitoring units-even if no associated signs and symptoms or diagnostic findings are present-to ensure that delayed arrhythmia can be excluded. Of these, 58 patients had the admission diagnosis “effects of electric current,” representing 0.17% of all emergency patients ( 1). The CHARITEM study, an analysis of Charité Berlin, evaluated the data of all 34 333 adult medical patients presenting to the Department of Emergency Medicine at the Campus Virchow-Klinikum or the Department of Emergency Medicine at the Campus Benjamin Franklin during a one-year period (2/2009 until 2/2010). Virtually no information is available on the prevalence of survived electrical injuries in Germany. ![]()
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