Cardiac Complications and Diagnostic after Electrical Injury in Childhood

Objectives: The aim of the study was to identify cardiac complications after electrical injury in childhood and to establish a diagnostic approach to distinguish between harmless injuries and cases with necessary monitoring.

Methods: We performed a retrospective study using the hospital information system to collect all patient cases < 18 years with admission ICD diagnostic code T75.4 (effects of electric current) admitted to the Pediatric clinic of the University hospital of Heidelberg in the years 2008 until 2016. We identified the cause of the electrical injury, clinical symptoms, results of blood analysis, and the electrocardiography at admission as well as the appearance of cardiac complications during the monitoring period.

Results: In the study period of eight years, 290 children were presented and admitted with electrical injury. Cardiac rhythm monitoring was performed for a mean period of 25 hours. On admission, 19% of the examined children had anomalies in the electrocardiography of various types (bundle branch blocks, atrioventricular blocks, extrasystoles, ST-segment alterations, sinus bradycardias). None of the children showed increased Troponin values nor developed cardiac arrhythmias requiring medical or electrical intervention, none of them died. In 28% of the cases, creatine kinase (CK)-values were above the age-related range, in one case >1,000 U/L.

Conclusion: With review of the available published data, his study comprises the highest number of cases with electric injuries in childhood concerning diagnostic of cardiac complications. Electrical injury in childhood often occurs at home with low current but without cardiac complications. Based on our results and the published data, we suggest that children without loss of consciousness, electric mark or contact with current in a humid area (water, mucosa) and a normal ECG can be discharged at home. Children with relevant cardiac diseases, neurologic/ cardiac symptoms or contact with high voltage current/ lightning are recommended to be monitored. This recommendation does not include burns.