• Benoit Bailey, Pierre Gaudreault, and Robert L Thivierge.
• Division of Emergency Medicine, CHU Ste-Justine, Montréal, Québec, Canada. benoit.bailey@umontreal.ca
• Emerg Med J. 2007 May 1; 24 (5): 348-52.

ObjectiveTo report our experience monitoring patients with previously identified theoretical risk factors of significant electrical injury.MethodsPatients 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.ResultsOf 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.ConclusionAlthough 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.

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