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Narrative Review: Electrocution and Life-Threatening Electrical Injuries

Christian Spies, MD; and Richard G. Trohman, MD
[+] Article and Author Information

From Rush University Medical Center, Chicago, Illinois.


Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Richard G. Trohman, MD, Department of Medicine, Section of Cardiology, Rush University Medical Center, 1653 West Congress Parkway, Suite 983, Chicago, IL 60612; e-mail, rtrohman@rush.edu.

Current Author Addresses: Dr. Spies: Department of Medicine, Cardiovascular Medicine Fellowship Program, Rush University Medical Center, 1653 West Congress Parkway, Jelke 1021, Chicago, IL 60612.

Dr. Trohman: Section of Cardiology, Rush University Medical Center, 1653 West Congress Parkway, Suite 983, Chicago, IL 60612.


Ann Intern Med. 2006;145(7):531-537. doi:10.7326/0003-4819-145-7-200610030-00011
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The authors reviewed the mechanisms and pathophysiology of typically encountered electrical injuries by searching English-language publications listed in MEDLINE and reference lists from identified articles. They included relevant retrospective studies, case reports, and review articles published between 1966 and 2005. The authors also searched the Internet for information related to electrocution and life-threatening electrical injuries. They found that familiarity with basic principles of physics elucidates the typical injuries sustained by patients who experience electrical shock. Death due to electrocution occurs frequently. However, patients successfully resuscitated after cardiopulmonary arrest often have a favorable prognosis. Approximately 3000 patients who survive electrical shock are admitted to specialized burn units annually. Patients with serious electrical burns admitted to the intensive care unit are trauma patients and should be treated accordingly. Initial prediction of outcome for patients who have experienced electrical shock is difficult, as the full degree of injury is often not apparent.

Figures

Grahic Jump Location
Figure 2.
Lichtenberg figures caused by lightning strike in a 54-year-old man.

The fern-like pattern vanished within 2 days. (Adapted with permission from the New England Journal of Medicine[49]).

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Figure 3.
Prediction of outcome in nontraumatic patients with coma.

Adapted with permission from Annals of Internal Medicine(63).

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Corrections to Electrical Injuries
Posted on October 9, 2006
Eric H. Stern
Mount Sinai School of Medicine
Conflict of Interest: None Declared

I believe that two of the items in the fine review by Spies and Trohman need to be corrected:

Current (in amperes) is the FLOW (or flow rate) not the AMOUNT of electrons. The unit of quantity or amount of electrons (or electric charge) is the Coulomb, a unit rarely seen by physicians. Thus, a Coulomb is the amount of electric charge as a result of a current of 1 ampere flowing for 1 second.

Although DC can be used for power transmission (particularly at extremely high voltage), most of the power transmission lines in the USA are AC, not DC.

Conflict of Interest:

None declared

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