Effect on specific organ systems

effects on specific organ systems

Electrical injuries may vary from transient unpleasant sensation (without an apparent injury) to massive tissue damage with life threatening internal organ damage.

• cardiac
  • arrhythmias
    • is the commonest complication
    • includes - supraventricular arrhythmias (sinus tachycardia, atrial extrasystoles or atrial fibrillation) and ventricular arrhythmias (extrasystoles, tachycardia, or fibrillation)
    • majority of life threatening events are seen immediately after shock, but delayed ventricular arrhythmias have been reported (up to 12 hours in both low and high voltage accidents)
  • bradycardia
    • results from interference with the normal electrical activity of the heart
    • can occur months or years after the accidents
  • heart muscle injury
    • caused by reduced blood supply or direct tissue death (necrosis)
    • patient may not complain about chest pain, it may manifest as
      • increased myocardial proteins (troponins)
      • other abnormalities such as altered contraction patterns on echocardiography or cardiac MRI
    • rarely, myocardial infarction can be caused by blood clots or spasms (mostly after high voltage accidents)
    • cardiac function recovers soon after the incident, but abnormalities may persist in some instances
• respiratory
  • may cause paralysis of respiratory muscles (such as diaphragm) or cause them to seize up abruptly (titanic contraction) by interfering with normal nerve conduction
  • inhibition of centre controlling breathing in the brain
• skin
  • loss of body fluids and infection due to loss of skin barrier may occur due to extensive burn
• neurological
  • nerve tissue damage may result in loss of consciousness, impaired recall, spinal cord injury, paralysis, loss of sensations in limbs
  • neuropsychological problems, although rare have been reported e.g. - post traumatic stress disorder, depression, chronic neuropathic pain
• vascular
  • blood clots caused by vessel wall injury may compromise blood flow to organs
• kidney
  • myoglobin released by damaged muscles may cause tubular precipitations
• musculoskeletal
  • bone fractions and luxations
  • rhabdomyolysis
  • compartment syndrome

Reference:

• (1) Waldmann V et al. Electrical injury. BMJ. 2017;357:j1418