Electrical Injuries in a Pediatric Emergency Department, ,

Study objective: To examine the spectrum of electrical injuries and develop guidelines for management. Design: Retrospective review of charts compiled during a 6-year period (1988 through 1993). Setting: Pediatric emergency department. Participants: Seventy-eight patients seen for electrical injuries. Results: Fifty-four percent of patients were boys, and the mean age of the patients was 5.3 years. Eighty-two percent sustained burns. We divided patients into those who were involved in major electrical current events (n=8) (water contact and high voltage) and minor electrical current events (n=70) (injury sustained while placing an object in an outlet or touching/plugging in a cord or during oral contact with a cord). Of the minor events, all burns (n=61) involved less than 1% of body surface area. Eighteen patients sustained second-degree burns, and 19 sustained third-degree burns. Of the eight major-event patients, one had abnormal ECG/rhythm strip findings, two had abnormal urinalysis results, and six had abnormal levels of creatine phosphokinase. All eight were admitted. Of the 70 minor-event patients, 2 of 53 had abnormal ECG/rhythm strip findings, 1 of 48 had abnormal urinalysis results, and 2 of 40 had abnormal creatine phosphokinase levels. Thirty-six of the 70 minor-event patients were admitted. Patients involved in major events were more likely to undergo studies (P =.002), to have an abnormal result (P =.000008), and to be hospitalized (P =.008). In minor-event patients, hospitalization was limited to observation and the fitting of oral appliances. Conclusion: Children involved in electrical events are usually exposed to low-voltage household current resulting in minor injury. Asymptomatic children with minor electrical injuries do not require laboratory evaluation or hospitalization. [Garcia CT, Smith GA, Cohen DM, Fernandez K: Electrical injuries in a pediatric emergency department. Ann Emerg Med November 1995;26:604-608.]