[Criteria for assessing the severity of the lesion and the outcome of the electric injury, depending on the parameters of the current and its pathways]. / Kriterii otsenki tyazhesti porazheniya i iskhoda elektrotravmy v zavisimosti ot parametrov toka i putei ego prokhozhdeniya.

The purpose of the work is to establish the relationship between the magnitudes of the electric current and clinical and physiological manifestations (outcome) on the basis of data from special literature. When performing forensic medical examinations, questions are often raised about the possibility of saving the life of an injured person in the provision of timely medical care, as well as the possibility of taking active actions after causing damages. The totality of the above information will enable to answer these questions reasonably. Besides, the data summarized in the article are necessary when planning experimental work in the study of electropathology and when conducting biomedical tests.

Diurnal raptors at rescue centres in the Czech Republic: Reasons for admission, outcomes, and length of stay.

Rescue centres play an important role in the protection of raptors living in the wild by caring for injured or debilitated animals and abandoned young with the aim of returning them to the wild. A total of 22,538 raptors were admitted to 34 rescue centres in the Czech Republic in the years 2010-2019, with an increasing trend during the monitored period (rSp = 0.7333, p < 0.05). The most frequent reasons for their admission were other injuries and fractures (26.52%), the admission of young (22.98%), and the admission of raptors injured by electric shock injuries (20.51%). It proved possible to release 42.45% of admitted raptors back into the wild, the majority of which (91.05%) were released using the hard-release method. Foster parents were used in 1% of cases and a replacement nest in 0.2% of cases involving the rearing of young. In spite of all the care provided at rescue centres, a total of 39.97% of raptors admitted either died or had to be euthanized. Among them, most raptors were euthanized or died due to injuries caused by collision with a vehicle, electric shock injuries, and other injuries. This generally occurred shortly after admission (a median of two days). The importance of the work of rescue centres lies not merely in returning injured raptors back into the wild (which proves possible in around half of all cases), but also in obtaining information about the factors endangering raptors in the wild and contributing toward a decline in their populations. The findings provide information about human-wildlife interactions in the Czech Republic and their implications for conservation as well as on the effectiveness of rescue centres to successfully treat and subsequently release raptors back into the wild.

Electric scooter related injuries in Calgary emergency departments.

OBJECTIVES: Electric scooters (e-scooters) have contributed to a rise in injury burden and emergency department (ED) utilization since their local introduction 3 years ago. This study is a novel collaboration between the City of Calgary's Department of Transportation and emergency medicine researchers to better understand the nature and frequencies of e-scooter injuries. It quantifies the incidence and characteristics of e-scooter related injuries treated in Calgary EDs/urgent care centres (UCCs). METHODS: Administrative data from electronic medical records of all patients presenting to Adult Emergency Departments and one Urgent Care Centre in Calgary with an e-scooter related injury between July 8, 2019, and Oct 1, 2019, and May 22, 2020, and September 30, 2020 were collected. Additional data were obtained from paper EMS reports. Descriptive statistics were used to characterize injury-specific variables and comparisons were drawn between ED visits for other transportation modalities. RESULTS: 1272 ED/urgent care visits were attributed to an e-scooter related incident. The majority of incidents occurred between 20:00 and 24:00 (47%). Most injuries occurred to the lower limb (54.8%), followed by facial injuries (42.9%). The overwhelming majority of injuries happened to the e-scooter drivers (97.6%). E-scooter injuries made up approximately 15% of all trauma presentations to Calgary area adult EDs during the e-scooter season and 1 in 1400 e-scooter rides resulted in a visit to an ED/UCC. CONCLUSIONS: Traumatic ED visits related to e-scooter use represent an increasing burden of preventable injuries. This study identified specific characteristics to focus future education and public policy efforts on.

RéSUMé: OBJECTIFS: Les scooters électriques (e-scooters) ont contribué à une augmentation du fardeau des blessures et de l'utilisation des services d'urgence (SU) depuis leur introduction locale il y a trois ans. Cette étude est une nouvelle collaboration entre le Département des transports de la Ville de Calgary et des chercheurs en médecine d'urgence afin de mieux comprendre la nature et la fréquence des blessures causées par le scooter électrique. Il quantifie l'incidence et les caractéristiques des blessures liées aux scooters électriques traitées dans les services d'urgence/soins d'urgence de Calgary. MéTHODES: Données administratives provenant des dossiers médicaux électroniques de tous les patients se présentant aux services d'urgence pour adultes et à un centre de soins d'urgence de Calgary avec une blessure liée à un scooter électrique entre le 8 juillet 2019 et le 1er octobre 2019 et entre le 22 mai 2020 et le 30 septembre 2020. Des données supplémentaires ont été obtenues à partir des rapports papier des SMU. Des statistiques descriptives ont été utilisées pour caractériser les variables spécifiques aux blessures et des comparaisons ont été établies entre les visites aux urgences pour les autres modes de transport. RéSULTATS: 1 272 visites aux urgences ou aux soins d'urgence ont été attribuées à un incident lié à un scooter électrique. La majorité des incidents se sont produits entre 20 h 00 et 24 h 00 (47 %). La plupart des blessures se sont produites au niveau des membres inférieurs (54,8 %), suivies des blessures au visage (42,9 %). La grande majorité des blessures sont survenues chez les conducteurs de scooters électriques (97,6 %). Les blessures liées aux scooters électriques représentent environ 3,5 % de toutes les présentations de traumatismes dans les services d'urgence pour adultes de la région de Calgary et 1 sur 1 400 trajets en scooter électrique a entraîné l'admission dans un service d'urgence. CONCLUSIONS: Les visites aux urgences traumatiques liées à l'utilisation des scooters électriques représentent une charge croissante de blessures évitables. Cette étude a identifié des caractéristiques spécifiques sur lesquelles il convient de concentrer les efforts futurs en matière d'éducation et de politique publique.

[Case studies in expert review of electrical injury]. / Vozmozhnost' resheniya situatsionnykh zadach v ramkakh ekspertizy elektrotravmy.

Electrical injury is quite rare in forensic practice, and situational examinations for this type of injury are even rarer. A case of an electrical injury is presented where the circumstances of the death and the conditions of injury were not obvious. As part of the commissioned examination, a repeated review of the accident scene and an examination of the alleged injuring object were conducted, which facilitated reconstruction of conditions and circumstances of the electric injury.

Alteraciones electrocardiográficas tras electrocución / Electrocardiographic alterations after electrocution

No disponible

Examination of the Contributing Factors to Fatalities in Electrical Trades Due to Contact With Electricity.

OBJECTIVE: The aim of this study was to examine contributing factors to fatalities in electrical occupations due to contact with electricity. METHODS: Proportionate mortality ratios were calculated along with the Mantel-Haenszel chi-square test of significance using Occupational Safety and Health Administration data. Cross-tabulation analyses were examined by the Pearson chi-square test of independence. RESULTS: Electricians and electrical power installers/repairers experienced significantly higher proportions of fatalities due to contact with electric current of machine, tool, or light fixture and contact with overhead power lines, respectively. Factors such as accident date, location, union status, project type, cost, electrical event, human factor, part of body, source of injury, and fatality cause, exhibited significant associations with electrical trade fatalities. CONCLUSIONS: Fatalities in electrical occupations are attributable to increased exposures to electrical hazards during regular work activities. Strict adherence to safe work practices and procedures is critical to electrical fatality prevention.

[Suicide by electric shock with the use of engineering skills]. / Samoubiistvo elektricheskim tokom s primeneniem inzhenernykh navykov.

A case of suicide using technical electricity is presented. The fact of electrical injury is confirmed by the typical macroscopic and microscopic picture of an electric mark. The location of the conductors on the body indicated the victim's knowledge of the effect of electric current on the human body, the ways of its propagation through the body through the vital organs, preparation and determination in the implementation of suicidal intentions. The interest of this case lies in the fact that electrical injury as a method of suicide is extremely rare in expert practice.

Neurological symptoms and disorders following electrical injury: A register-based matched cohort study.

INTRODUCTION: Electric shocks may have neurological consequences for the victims. Although the literature on the neurological consequences of electric shocks is limited by retrospective designs, case studies and studies of selected patient groups, previous research provides some evidence of a link between electric shocks, and diseases and symptoms of the central nervous system (CNS)(e.g. epilepsy, migraine and vertigo) and the peripheral nervous system (PNS)(e.g. loss of sensation, neuropathy and muscle weakness). This study aims to employ a register-based, matched cohort study, to investigate whether individuals demonstrate a greater risk of neurological diseases and symptoms of the CNS or PNS in the years following an electrical injury. MATERIALS AND METHODS: We identified 14,112 electrical injuries over a period of 19 years in two Danish registries, and matched these with three different groups of persons in a prospective matched cohort study: (1) patients with dislocation/sprain injuries, (2) patients with eye injuries and (3) persons employed in the same occupation. Year of injury, sex and age were used as matching variables. The outcomes we identified comprised neurological disorders and central or peripheral nervous system symptoms that covered a range of diagnoses in the Danish National Patient Register. The associations were analysed using conditional logistic regression for a range of time periods (six months to five years) and conditional Cox regression for analyses of the complete follow-up period (up to 20 years). RESULTS: For victims of electric shock, the CNS sequelae we identified included an increased risk of epilepsy, convulsions, abnormal involuntary movements, headache, migraine and vertigo. We also identified an uncertain, increased risk of spinal muscular atrophy and dystonia, whereas we identified no increased risk of Parkinson's disease, essential tremor, multiple sclerosis or other degenerative diseases of the nervous system. For victims of electric shock, the PNS sequelae we identified included an increased risk of disturbances of skin sensation, mononeuropathy in the arm or leg and nerve root and plexus disorders. We also identified an uncertain, increased risk of facial nerve disorders, other mononeuropathy, and polyneuropathy. CONCLUSION: Our results confirm that electrical injuries increase the risk of several neurological diseases and symptoms of the CNS or PNS in the years following the injury. Most often the diseases and symptoms are diagnosed within the first six months of the injury, but delayed onset of up to 5 years cannot be ruled out for some symptoms and diagnoses. Some of the conditions were rare in our population, which limited our ability to identify associations, and this warrants cautious interpretation. Therefore, further studies are needed to confirm our findings, as are studies that examine the mechanisms underlying these associations.

Motor vehicle-related electric scooter injuries in the US: A descriptive analysis of NEISS data.

INTRODUCTION: The introduction of scooter-share programs across the United States has led to an increased incidence of electronic scooter (e-scooter) injuries presenting to emergency departments (EDs). As legislation begins to push scooters from the sidewalk to the street, injuries resulting from collisions between e-scooters and motor vehicles are an important, but poorly characterized consideration. This study leverages data from a national injury surveillance system to characterize e-scooter versus motor vehicle collisions resulting in ED presentation. METHODS: This study utilizes data from the National Electronic Injury Surveillance System (NEISS). NEISS was queried for e-scooter-related injuries from January 1st, 2015 through December 31st, 2019. Injuries were characterized as motor vehicle-related (MV-involved) or non-motor-vehicle-related (MV-uninvolved) based on a manual review by the study investigators. Weighted tabular analyses were used to characterize both types of e-scooter injuries across demographic, diagnostic, and event-related factors. RESULTS: Over the study period an estimated 60,554 (95% CI: 37,525-84,594) injuries were treated in US EDs. Approximately 19% of these injuries involved motor vehicles. Those sustaining MV-involved injuries were significantly younger (p = 0.01), with a higher proportion of males injured (p = 0.01). Additionally, when compared to MV-uninvolved injuries, a significantly higher proportion of those with MV-involved injuries were admitted to the hospital for treatment (8.8% vs. 14.6%, p < 0.01). MV-involved injuries occurred primarily in the street (96.3%), while MV-uninvolved injuries were split across streets (44.0%), at one's home (~20%), and on public property (~20%) (p < 0.01). CONCLUSIONS: Electric scooter injuries involving a motor vehicle differed from those that did not across several key categories. As e-scooters and motor vehicles start to share the road more frequently, greater consideration should be made regarding how these two modes of transportation interact with each other. The promotion of thoughtful e-scooter legislation and infrastructure changes could help promote safer travel.

Low-voltage electric shock - proposed new recommendations. / Strømgjennomgang fra lavspenning ­ forslag til nye anbefalinger.

We propose new recommendations for the emergency treatment of low-voltage electric injuries (<1 000 volts). A large proportion of these patients can be treated as outpatients.

Delayed, Unprovoked, Hemodynamic Collapse with Following Asystole in a Pediatric Patient Following a High-Voltage Injury: A Case Report and Literature Review.

Electrical incidents are common and mostly uneventful, though can be severe and sometimes lethal. Aside from skin, muscle and soft tissue damage, electrical injuries can cause cardiac arrhythmias, the most common cardiac complication. The case of a 14-year-old girl who sustained 48.5% TBSA burns following a high-voltage electrical injury is described. She suffered five episodes of asystole 78 h following the injury, requiring extracorporeal membrane oxygenation. The cause of the delayed asystole was investigated and a PubMed literature search was conducted to explore late presenting cardiac sequelae following electrical injuries. This yielded fifteen studies, identified as relevant, of high quality and in the English language. These studies included a total of 1411 patients of whom only 3 were found to have had late potentially lethal arrhythmias, all manifesting within the first 24 h after the injury. Of these patients, 32 suffered cardiac arrests shortly after the electrical injury, 11 of which were documented as asystolic arrests though these were all from a single study with the rural locale and prolonged delay in arrival to the hospital setting contributing to this finding. To our knowledge, this is the only pediatric cardiac arrest developing in a stable patient over 72 h following the initial electrical injury. No other patient has suffered any significant cardiac complications first presenting outside the initial 24-h period following the electrical injury. Guidelines and recommendations on post electrical injury observation of patient vary and further research into this field is required to allow for guidance unification.

Patients with low-voltage electric shock referred to an Emergency Department. / Pasienter med strømgjennomgang fra lavspenning henvist til et akuttmottak.

BACKGROUND: Patients exposed to electricity are often referred to the Emergency Department, but guidelines differ as to how they should be managed. In this article, we describe patients with low-voltage electric shock in the Emergency Department at St Olav's Hospital, Trondheim University Hospital. MATERIAL AND METHOD: Retrospective data from patients referred to the Emergency Department following low-voltage electric shock (< 1,000 V) in the period 1.1.2012-31.12.2017 (N = 210) were included. RESULTS: The median age was 26 years and 186/210 (89 %) were men. Out of the 210 patients, 165 (79 %) had symptoms following electric shock. Localised pain and chest discomfort occurred in 84/165 (51 %) and 57/165 (35 %) of patients respectively. ECG findings were normal in 168/209 (80 %), and no patients had arrhythmias requiring treatment or elevated troponin T or creatine kinase. No patients had serious complications or died. INTERPRETATION: Low-voltage electric shock did not cause serious arrhythmias or elevated levels of troponin T or creatine kinase. It should be possible to manage asymptomatic patients with normal findings on clinical examination and ECG in a prehospital setting without reducing patient safety.

Hands-on defibrillation with safety drapes: Analysis of compressions and an alternate current pathway.

BACKGROUND: Hands-on defibrillation (HOD) could theoretically improve the efficacy of cardiopulmonary resuscitation (CPR) though a few mechanisms. Polyethylene drapes could potentially facilitate safe HOD, but questions remain about the effects of CPR on polyethylene's conductance and the magnitude of current looping through rescuers' arms in contact with patients. METHODS: This study measured the leakage current through 2 mil (0.002 in.) polyethylene through two different current pathways before and after 30 min of continuous compressions on a CPR mannequin. The two pathways analyzed were the standardized IEC (International Electrotechnical Commission) leakage current analysis and a setup analyzing a current pathway looping through a rescuer's arms and returning to the patient. First, ten measurements involving the two pathways were obtained on a single polyethylene drape. 30 min of continuous compressions were applied to the drape on a CPR mannequin after which the ten measurements were repeated. RESULTS: Twenty patients undergoing elective cardioversion for atrial fibrillation (18/20) or atrial flutter (2/20) at Emory University Hospital underwent analysis all receiving 200 J shocks (age 38-101, 35% female). Through the IEC measurement method the peak leakage current mean was 0.70 +/- 0.02 mA before compressions and 0.59 +/- 0.19 mA after compressions. Only three of the ten measurements assessing current passing through a rescuer's arms had detectable current and each was of low magnitude. All measurements were well below the maximum IEC recommendations of 3.5 mA RMS and 5.0 mA peak. CONCLUSIONS: Polyethylene may facilitate safe HOD even after long durations of compressions. Current looping through a rescuer's arms is likely of insignificant magnitude.

Imaging Utilization Patterns and Injury Characteristics Associated with Electric Standing Scooters in a Major Urban Area.

BACKGROUND: The recent proliferation of electric standing scooters in major urban areas of the United States has been accompanied by injuries of varying severity and nature, representing a growing public health concern. OBJECTIVE: Our aim was to characterize imaging utilization patterns for injuries associated with electric scooter (e-scooter) use, including their initial emergency department (ED) management. METHODS: We conducted a retrospective review of the electronic medical record for all patients presenting to affiliated EDs for e-scooter-related injuries between July 2018 and April 2020. Demographics, date and time of presentation, imaging study type, resultant injury, and procedural details were recorded. RESULTS: Ninety-seven patients were included; mean age was 27.6 years. Of these, 55 patients (57%) had injuries identified on imaging and 40% of all imaging studies were positive. Most identified injuries (61%) were musculoskeletal, with a small number of neurological (2%) and genitourinary (1%) injuries. The highest prevalence of presentations occurred in August; most patients (72%) presented between 3 pm and 1 am and granular peaks were between 12 am and 1 am and 5 pm and 6 pm. CONCLUSIONS: Patients presenting with e-scooter injuries have a high likelihood of injury to the radial head, nasal bone, and malleoli. Emergency physicians should be especially vigilant for injuries in these areas at presentation. Visceral injuries are uncommon but may be severe enough to warrant surgery.

Unspecified pain and other soft tissue disorders following electrical injuries: a register-based matched cohort study.

OBJECTIVE: This study investigates whether individuals who have sustained an electrical injury (EI) are diagnosed with unspecified pain or pain related to the musculoskeletal system in the years following the injury. METHODS: Individuals listed in Danish registers as having sustained EIs were matched for sex, age, and year of injury in a cohort study with individuals having experienced dislocations/sprains (match 1), eye injuries (match 2), and a sample of individuals with the same occupation without a history of electrical injuries (match 3). Outcomes were unspecified pain and unspecified soft tissue disorders. Conditional logistic regression and conditional Cox regression were applied. RESULTS: We identified 14,112 individuals who sustained EIs. A higher risk of both outcomes was observed for all three matches, and was highest at the 6- and 12-month follow-ups. The risk of both outcomes was considerably higher for match 3. CONCLUSIONS: This study confirms that exposure to EIs increases the risk of being diagnosed with unspecified pain or unspecified soft tissue disorders both at short and long terms. Our results also showed that the risk of unspecified pain as sequelae is related to the severity of the injury.

Long-term consequences of electrical injury without initial signs of severity: The AFTER-ELEC study.

BACKGROUND: There is no specificity of emergency or long-term management of benign electrical injuries (EI). The main objective of our work was to describe the occurrence of long-term complications of EI considered as benign. METHODS: Single-center retrospective study of a cohort of adult patients who consulted for EI without initials signs of severity in an emergency department between 2012 and 2019. All included patients were secondarily contacted by telephone at least one year after their EI to complete a questionnaire. RESULTS: 76 adult patients visited the emergency department and 48 of them could be contacted by phone. 82% of the recalled patients had at least one complication following their EI. The main long-term complications were neurological (65%), psychological (58%) and cardiological (31%). Patients recalled eight years after EI had higher rates of neuropsychological complications than those recalled one year after EI. Only the time spent in the emergency department was statistically longer in patients who developed long-term complications compared to those who did not. DISCUSSION: The occurrence of long-term neuropsychological complications predominates. The knowledge and management of these long-term consequences must be particularly well known by emergency physicians because they are often the first medical contact of the patient. Our results also seem to show a crescendo in time of the occurrence of long-term complications. CONCLUSION: all health professionals involved in the care of victims of a EI must be made widely aware of the occurrence of these long-term complications, particularly neuropsychological ones, in order to improve the long-term patient care.

Electric Bicyclist Injury Severity during Peak Traffic Periods: A Random-Parameters Approach with Heterogeneity in Means and Variances.

Accidents involving electric bicycles, a popular means of transportation in China during peak traffic periods, have increased. However, studies have seldom attempted to detect the unique crash consequences during this period. This study aims to explore the factors influencing injury severity in electric bicyclists during peak traffic periods and provide recommendations to help devise specific management strategies. The random-parameters logit or mixed logit model is used to identify the relationship between different factors and injury severity. The injury severity is divided into four categories. The analysis uses automobile and electric bicycle crash data of Xi'an, China, between 2014 and 2019. During the peak traffic periods, the impact of low visibility significantly varies with factors such as areas with traffic control or without streetlights. Furthermore, compared with traveling in a straight line, three different turnings before the crash reduce the likelihood of severe injuries. Roadside protection trees are the most crucial measure guaranteeing riders' safety during peak traffic periods. This study reveals the direction, magnitude, and randomness of factors that contribute to electric bicycle crashes. The results can help safety authorities devise targeted transportation safety management and planning strategies for peak traffic periods.