Electrical Burns: Highlights from a 5-Year Retrospective Analysis
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Neurological and Neurourological Complications of Electrical Injuries
REVIEW ARTICLE Neurologia i Neurochirurgia Polska Polish Journal of Neurology and Neurosurgery 2021, Volume 55, no. 1, pages: 12–23 DOI: 10.5603/PJNNS.a2020.0076 Copyright © 2021 Polish Neurological Society ISSN 0028–3843 Neurological and neurourological complications of electrical injuries Konstantina G. Yiannopoulou1, Georgios I. Papagiannis2, 3, Athanasios I. Triantafyllou2, 3, Panayiotis Koulouvaris3, Aikaterini I. Anastasiou4, Konstantinos Kontoangelos5, Ioannis P. Anastasiou6 1Neurological Department, Henry Dunant Hospital Centre, Athens, Greece 2Orthopaedic Research and Education Centre “P.N. Soukakos”, Biomechanics and Gait Analysis Laboratory “Sylvia Ioannou”, “Attikon” University Hospital, Athens, Greece 31st Department of Orthopaedic Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece 4Medical School of Athens, National and Kapodistrian University of Athens, Athens, Greece 51st Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece 61st Urology Department, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece ABSTRACT Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries. PubMed was searched for English language clinical observational, retrospective, -
Thoracic Trauma ● Esophagus ● Heart Tessa Woods, DO ● Thoracic Vascular Injuries
10/1/2018 Outline ● Emergency Department Thoracotomy ● REBOA ● Lung ● Trachea Thoracic Trauma ● Esophagus ● Heart Tessa Woods, DO ● Thoracic Vascular Injuries EAST Practice Management Guidelines ● EDT Survival Predictors ○ 1. Injury mechanism ○ 2. Anatomic injury location ○ 3. Presence of life on presentation ED Thoracotomy EAST Scenarios EAST Scenarios ● Patient 1: Pulseless to ED with signs of life after penetrating thoracic injury? ● Patient 5: Pulseless to the ED with signs of life after blunt injury? ○ Yes ○ Yes, Conditionally ● Patient 2: Pulseless to ED without signs of life after penetrating thoracic ● Patient 6: Pulseless to the ED without signs of life after blunt injury? injury? ○ No ○ Yes, conditionally ■ Some voting “conditionally” ● Patient 3: Pulseless to the ED with signs of life after penetrating extrathoracic ■ Low quality of evidence injury? ○ Yes, conditionally ■ Does not pertain to cranial injuries ● Patient 4: Pulseless to the ED without signs of life after penetrating extrathoracic injury? ○ Yes, conditionally ■ Low quality of evidence 1 10/1/2018 Resuscitative Endovascular Balloon Occlusion of the Aorta2-12 ● Benefits: ○ Maximizes cerebral and coronary perfusion ○ Limits infradiaphragmatic hemorrhage REBOA ○ Avoids thoracotomy ● Limitations/complications: ○ Vascular injury ○ Time consumptive? ○ Learning curve ○ Appropriate setting/provider ● https://youtu.be/L3z5utZvnq4 Upcoming studies ● EPR-CAT (Emergency Preservation and Resuscitation for Cardiac Arrest From Trauma) ○ Compares pulseless penetrating trauma victims -
Accident, First Aid and Medical Conditions Policy
Accident, First Aid and Medical Conditions Policy Many children and staff will at some time become unwell at school, have a condition that requires medication or have an accident that requires First Aid. Our school is an inclusive community that supports the pupils to be healthy, stay safe and be prepared for moving onto their next school. This policy outlines the procedure concerning : 1. Reporting of Injuries, Diseases and Dangerous Occurrences 2. First Aid Procedures 3. The Administration of Medicines 4. Supporting pupils with medical conditions 1. Reporting of Injuries, Diseases and Dangerous Occurrences The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) require that employers report all fatal and specified major injuries, any injuries that result in the inability of an employee to work more than 3 days, or any injury which results in a person being admitted to hospital for more than 24 hours. The regulations relate to any employee or other person within the school or engaged upon an activity arranged by the school. Under the requirements of the Regulations, where someone dies or suffers a specified major injury or condition, or there is a dangerous occurrence, as defined in the Regulations, the school has to notify the Health and Safety Executive (HSE) immediately by the quickest practicable means. In practice, compliance with either of these provisions will normally mean a telephone call to the Incident Contact Centre (ICC) on 0845-300-9923 during normal office hours. The ICC operator will complete a report form over the phone and a copy will be sent to the school. -
Complex Airway After Electric Burns in the Neck - a Challenge for the Anesthesiologist Nitika Goel*1, Indumohini Sen2, Kiran Jhangra3 and Mukesh Kumar4
ISSN: 2474-9206 Case Report Journal of Anesthesia & Pain Medicine Complex Airway after Electric Burns in the Neck - A Challenge for the Anesthesiologist Nitika Goel*1, Indumohini Sen2, Kiran Jhangra3 and Mukesh Kumar4 1 3Assistant Professor Anesthesia, PGIMER, Chandigarh, India. *Corresponding author Nitika Goel MD, Assistant Professor Anesthesia, PGIMER, Chandigarh, 2Professor Anesthesia PGIMER, Chandigarh, India. India, Tel: +91 8826622159; E-mail: [email protected]. 4Senior Resident Anesthesia PGIMER, Chandigarh, India. Submitted: 30 July 2017; Accepted: 08 Aug 2017; Published: 22 Sep 2017 Abstract High voltage electric burns can cause massive damage to the body tissues. Direct contact with the live electric wires may result in the severe damage of the underlying subdermal tissues. However the superficial presentation is often misleading as most of the damage occurs under the skin. Very less literature has been found regarding the presentation of high voltage burns in head and neck region. We present a patient who sustained high voltage burns in the neck region resulting in massive damage of the underlying tissues. Keywords: Electric Burns, Burns Neck, Tracheal Injury. was referred to our institute for further management. The patient came to our hospital 5 days after his injury. Here the patient was Introduction planned for debridement and flap coverage on the burnt area. With widespread use of electricity, electric burn injuries are getting Preoperative evaluation revealed normal routine investigations. more common nowadays. Direct contact with the live electric wires Patient was communicative with no abnormality in speech. A may result in the severe damage of the underlying sub dermal tissues huge dressing was present around the neck. -
Of Cellular Injury in Electrical Trauma by Diane C
Physical Mechanisms of Cellular Injury in Electrical Trauma by Diane C. Gaylor B.S.E.E. University of Arizona (1984) S.M.E.E. Massachusetts Institute of Technology (1987) Submitted to the Department of Electrical Engineering and Computer Science in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Electrical Engineering at the Massachusetts Institute of Technology September 1989 - Diane C. Gaylor, 1989. All rights reserved. The author hereby grants to MIT permission to reproduce and to distribute copies of this thesis document in whole or in part. Signature of Author D 4artmeof"Electricaal Engineering 11 August 1989 Certified by , Raphael C. Lee Thesis Supervisor Accepted by Aritj . Smith Chairman, Departmental Committee on Graduate Students MASSACHUSETTS INSTITUTE OF TECHN•OLO.Gy DEC 2 7 1989 ARCHIVEF UBRANRIE Physical Mechanisms of Cellular Injury in Electrical Trauma by Diane C. Gaylor Submitted to the Department of Electrical Engineering and Computer Science on 11 August 1989 in partial fulfillment of the requirements for the Degree of Doctor of Philosophy in Electrical Engineering ABSTRACT Clinical evidence indicates that skeletal muscle cell membrane rupture occurs in electrical trauma. The pathogenic mechanisms of this damage have not been clearly identified. While it is clear that Joule heating causes part of the tissue destruction, particularly near the skin contact points, it does not appear to explain the pattern of tissue injury frequently observed at sites distant from the contacts. In this thesis, the significance of the non-thermal mechanism of membrane electrical breakdown, often termed electroporation or electropermeabilization, is examined. The exposure thresholds for damage to skeletal muscle cells due to membrane electrical breakdown and to heating are determined experimentally. -
Supermicar Data Entry Instructions, 2006 365 Pp. Pdf Icon[PDF
SUPERMICAR TABLE OF CONTENTS Chapter I - Introduction to SuperMICAR ........................................... 1 A. History and Background ............................................. 1 Chapter II – The Death Certificate .................................................... 3 Exercise 1 – Reading Death Certificate ........................... 7 Chapter III Basic Data Entry Instructions ....................................... 12 A. Creating a SuperMICAR File ....................................... 14 B. Entering and Saving Certificate Data........................... 18 C. Adding Certificates using SuperMICAR....................... 19 1. Opening a file ....................................................... 19 2. Certificate ............................................................. 19 3. Sex ....................................................................... 20 4. Date of Death ....................................................... 20 5. Age: Number of Units ........................................... 20 6. Age: Unit............................................................... 20 7. Part I, Cause of Death .......................................... 21 8. Duration ................................................................ 22 9. Part II, Cause of Death ......................................... 22 10. Was Autopsy Performed....................................... 23 11. Were Autopsy Findings Available ......................... 23 12. Tobacco................................................................ 24 13. Pregnancy ........................................................... -
Practice Exam
Case 1: A 78 year old woman is found with decreased LOC in her apartment by her daughter. She was last seen well 3 days ago. When EMS arrives, they find her temperature to be 30.2 degrees Celsius. Questions: 1. Input from cutaneous cold receptors travels via afferent fibers to which area of the brain? a. Pre-optic nucleus of the anterior hypothalamus 2. This area of the brain then initiates a number of physiologic responses. Please list three general categories of physiologic responses that either aim to increase heat production or decrease heat loss and give one example for each. a. activation of autonomic nervous system (vasoconstriction) b. activation of endocrine system (increased cortisol) c. stimulation of extra-pyramidal skeletal muscle (shivering) d. adaptive behavioural responses (move to area of warmth) 3. Define mild, moderate and severe hypothermia. a. mild 33-35 b. moderate 28-32 c. severe <28 4. List at least 10 clinical manifestations of moderate hypothermia References: 1. Hanania NA et al. Accidental hypothermia. Crit Care Clin 1999;15:235-249. 2. Mallet ML. Pathophysiology of accidental hypothermia. Q J Med 2002; 95:775–785 Case 2 You are completing rounds in the ICU when a Code Orange is called. The operations leader runs into the ICU and quickly updates you. The G-7 summit is currently going on in town and terrorists have set off a “dirty-bomb” at one of the main venues. They fear that in addition to powerful explosives, this bomb contained radioactive material. Questions: 1. Please draw the dose-response relationship for radiation exposure. -
Electric Shock During Pregnancy
clinical challenge défi clinique Ran D. Goldman, MD Adrienne Einarson, RN Gideon Koren, MD, FRCPC Electric shock during pregnancy ABSTRACT QUESTION A 24-year-old patient of mine, who was 23 weeks pregnant at the time, suffered a minor electric shock while using her hair dryer. She said she felt the current in her right hand and she was wearing shoes. She was observed in an emergency room for several hours and then discharged home. Is her pregnancy or fetus at risk now or later in the pregnancy? ANSWER There are confl icting reports on how harmful electric shock is to a fetus. The clinical spectrum of electrical injury ranges from a transient unpleasant sensation felt by a mother and no effect on her fetus to fetal death either immediately or few days later. Several factors, such as the magnitude of the current and the duration of contact, are thought to affect outcome. In this case, it appears the current did not travel through her abdomen. Recommendations for fetal monitoring after electrocution have been published. RÉSUMÉ QUESTION Une de mes patientes, âgée de 24 ans, a subi un choc électrique mineur alors qu’elle était enceinte de 23 semaines en utilisant son séchoir à cheveux. Elle a dit avoir senti le courant dans sa main droite et elle portait des chaussures. Elle a été sous observation à l’urgence pendant quelques heures pour ensuite recevoir son congé. Sa grossesse ou son fœtus sont-ils à risque maintenant ou plus tard durant la grossesse? RÉPONSE Il existe des rapports confl ictuels sur les dommages causés à un fœtus par un choc électrique. -
Management of Burns and Scalds in Primary Care
ACC15029-1-Pr#6 5/17/07 12:15 PM Page 1 C M Y CM MY CY CMY K Composite ACC15029-1-Pr#6 5/17/07 12:15 PM Page 2 C M Y CM MY CY CMY K Composite Kua tawhiti ke to haerenga mai, kia kore haere tonu He tino nui rawa ou mahi Kia kore e mahi nui tonu sir james henare of ngati hine iwi from te tai tokerau We have come too far not to go further We have done too much not to do more 1 AACC15029-2CC15029-2 Pr#6.inddPr#6.indd 1 55/17/07/17/07 112:11:012:11:01 PPMM 2 AACC15029-2CC15029-2 Pr#6.inddPr#6.indd 2 55/17/07/17/07 112:11:032:11:03 PPMM Endorsements This guideline has been endorsed by the Australian and New Zealand Burn Association (until 2009), the Burn Support Group Charitable Trust, the Counties Manukau District Health Board (until 2009), the Royal New Zealand College of General Practitioners and St John. The Royal New Zealand College of General Practitioners 3 AACC15029-2CC15029-2 Pr#6.inddPr#6.indd 3 55/17/07/17/07 112:11:032:11:03 PPMM 4 AACC15029-2CC15029-2 Pr#6.inddPr#6.indd 4 55/17/07/17/07 112:11:052:11:05 PPMM Contents Endorsements ..................................................................................................................................................3 Purpose ............................................................................................................................................................9 About the guideline ........................................................................................................................................11 Summary ........................................................................................................................................................17 -
Electrical Injuries: Hospitalisations and Deaths
A total of 1,065 people hospitalised between Electrical injuries: 1 July 2014 and 30 June 2016 had sustained an electrical injury, and 55 people died as a result of hospitalisations and deaths electrocution or lightning strike. Almost half of people hospitalised with an electrical injury occurred while the person was in paid work (497 cases or 47%), and a further 150 people sustained an electrical injury 2014–15 and 2015–16 while doing unpaid work (14%). aihw.gov.au Stronger evidence, better decisions, improved health and welfare Stronger evidence, better decisions, improved health and welfare Injury Research and Statistics Series Number 117 Electrical injuries: hospitalisations and deaths 2014–15 and 2015–16 Australian Institute of Health and Welfare Canberra Cat. no. INJCAT 197 The Australian Institute of Health and Welfare is a major national agency whose purpose is to create authoritative and accessible information and statistics that inform decisions and improve the health and welfare of all Australians. © Australian Institute of Health and Welfare and Flinders University 2018 This product, excluding the AIHW logo, Commonwealth Coat of Arms and any material owned by a third party or protected by a trademark, has been released under a Creative Commons BY 3.0 (CC-BY 3.0) licence. Excluded material owned by third parties may include, for example, design and layout, images obtained under licence from third parties and signatures. We have made all reasonable efforts to identify and label material owned by third parties. You may distribute, remix and build upon this work. However, you must attribute the AIHW and Flinders University as the copyright holders of the work in compliance with our attribution policy available at <www.aihw.gov.au/copyright/>. -
Acute and Long-Term Clinical, Neuropsychological and Return-To-Work Sequelae Following Electrical Injury: a Retrospective Cohort Study
Open access Research BMJ Open: first published as 10.1136/bmjopen-2018-025990 on 14 May 2019. Downloaded from Acute and long-term clinical, neuropsychological and return-to-work sequelae following electrical injury: a retrospective cohort study Nada Radulovic,1 Stephanie A Mason,2 Sarah Rehou,2,3 Matthew Godleski,2,4 Marc G Jeschke 2,3 To cite: Radulovic N, ABSTRACT Strengths and limitations of this study Mason SA, Rehou S, et al. Objective To determine acute and long-term clinical, Acute and long-term clinical, neuropsychological, and return-to-work (RTW) effects of ► Our study evaluated broad sequelae, including clin- neuropsychological and return- electrical injuries (EIs). This study aims to further contrast to-work sequelae following ical, neuropsychological and return-to-work param- sequelae between low-voltage and high-voltage injuries electrical injury: a retrospective eters during acute and long-term intervals, which (LVIs and HVIs). We hypothesise that all EIs will result cohort study. BMJ Open have not been collectively investigated for electrical in substantial adverse effects during both phases of 2019;9:e025990. doi:10.1136/ injuries in prior studies. bmjopen-2018-025990 management, with HVIs contributing to greater rates of ► Outcome measures included a comprehensive list of sequelae. Prepublication history and neuropsychological symptoms and diagnoses that ► Design Retrospective cohort study evaluating EI additional material for this have not been contrasted between voltage groups paper are available online. To admissions between 1998 and 2015. in existing literature. Setting Provincial burn centre and rehabilitation hospital view these files, please visit ► Due to the longitudinal nature of our outcomes of the journal online (http:// dx. -
Electrocution Death: Exit Mark Injury Use in the Suggestion of Body Posture During Forensic Investigation
Electrocution Death: Exit Mark Injury use in the Suggestion of Body Posture during Forensic Investigation Pudji Hardjanto1,4 Simon Martin Manyanza Nzilibili1,3 Ahmad Yudianto1,2 1Forensic Science Program, Post Graduate School Universitas Airlangga, 4-6 Airlangga Rd., 60286 Surabaya – Indonesia. 2Department of Forensic and Medico-legal, Faculty of Medicine, Universitas Airlangga, Surabaya – Indonesia 3Ministry of Health, Community Development, Gender Elderly and Children, Dodoma – Tanzania. 4Criminal Investigative Unit, Polrestabes Surabaya, Indonesia. Keywords: Body Posture, Electrocution, Exit Injury, Forensic Reconstruction Abstract: Since then, electrocution and forensic investigation of electric death associated with criminal offenses have established the importance of mark injuries. The marks (entry and exit) came into significance as they were/are used to establish fatality and extent of electric power electrocuted. Unlike entry, exit injury has presented attention to scientists on its adequate and vital use in explaining forensic incident despite being infrequent. To enrich forensic understanding and make use of this “silent witness – exit mark”, this study used four cases of related scenario. Three of the four cases were literature-based cases and one case involved in investigation. By interpreting the cases, this paper argued that exit injury contains useful information that can be related to posture of the body before electrocution. This paper thereby suggested the presence of the exit injury to be related to body posture, sole plantar exit injury in particular (stood position). This would help investigators and scientists to determine the immediate probable position and state of victim before electrocution. Furthermore, the suggestion would assist reconstruction processes that seek to find out the event originality through responding to fundamental and core principle tools of incidence investigation, CoPRRR, and the 6Ws.