Elektrik �arpmas� yaralanmas� olan hastalarda kardiyak monit�rizasyon

Akka�, Meltem; Hocagil, Hilal; Didem, Ay; B�lent, Erbil; Mahir, Kunt Mehmet; Mahir, �zmen Mehmet

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Elektrik �arpmas� yaralanmas� olan hastalarda kardiyak monit�rizasyon [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2012; 18(4): 301-305 | DOI: 10.5505/tjtes.2012.69158

Elektrik �arpmas� yaralanmas� olan hastalarda kardiyak monit�rizasyon

Meltem Akka�¹, Hilal Hocagil¹, Ay Didem², Erbil B�lent¹, Kunt Mehmet Mahir¹, �zmen Mehmet Mahir¹
¹Hacettepe �niversitesi T�p Fak�ltesi, Acil T�p Ana Bilim Dal�, Ankara
²Yeditepe �niversitesi T�p Fak�ltesi, Acil T�p Ana Bilim Dal�, �stanbul

AMA�
Elektrik �arpmas� kazas�yla yaralanan hastalar�n, monit�rizasyon ve izlem i�in acil servise kabul� tart��mal�d�r.
GERE� VE Y�NTEM
Son 20 y�l i�inde, elektrik kazas� nedeni ile eri�kin acil servise ba�vuran 102 hastan�n (86 erkek, 16 kad�n; ort. ya� 29.5; da��l�m 18-68 ya�) kay�tlar� de�erlendirildi.
BULGULAR
�� d��k, alt�s� y�ksek voltaj temas� nedeniyle toplam dokuz olguda �l�m g�r�ld�. Bir sepsis olgusu d��nda, di�er olgular�n hepsinde �l�m, olay�n hemen sonras�nda geli�en erken ritim bozukluklar�na ba�l� idi. Ya�ayan hastalarda izlenen EKG bulgular�; 70�inde normal, 8�inde sin�s ta�ikardisi, ��nde sin�s bradikardisi, d�rd�nde ST-T dalga de�i�iklikleri, birinde ventrik�ler ekstrasistol olup, yedi olguda EKG kay�tlar�na ula��lamad�. Olgular�n 72�si tekrarlayan EKG �ekimleri ile izlendi. Ya�ayan hastalar�n hi�birinde medikal ya da elektriksel tedavi gerektirecek herhangi bir EKG de�i�ikli�i izlenmedi.
SONU�
Elektrik yaralanmalar�na ba�l� kardiyak ritim anomalileri genellikle olay an�nda g�r�l�r. E�er hasta klinik olarak iyi, acil servise kabul�nde normal EKG�ye sahip ise, gecikmi� ciddi bir ritim bozuklu�u g�r�lme olas�l�� pek m�mk�n de�ildir.

Anahtar Kelimeler: Elektrik yaralanmas�, kardiyak monit�rizasyon.

Cardiac monitoring in patients with electrocution injury

Meltem Akka�¹, Hilal Hocagil¹, Ay Didem², Erbil B�lent¹, Kunt Mehmet Mahir¹, �zmen Mehmet Mahir¹
¹Department Of Emergency Medicine, Hacettepe University Medical School, Ankara
²Department Of Emergency Medicine, Yeditepe University Medical School, Istanbul.

BACKGROUND
The necessity of admitting patients exposed to electrocution injuries for monitoring and observation in the emergency department (ED) remains controversial.
METHODS
We evaluated the medical records of 102 patients (86 male, 16 female; median age 29.5; range 18 to 68 years) admitted to the adult ED with electrocution injuries over the past 20 years.
RESULTS
Only 9 deaths were reported: 3 as a result of contact with low-voltage electricity and 6 after contact with high-voltage electricity. With the exception of a case of sepsis, all deaths were related to early rhythm abnormalities immediately following the incident. The ECG findings of surviving patients in the study group were as follows: 70 normal, 8 sinus tachycardia, 3 sinus bradycardia, 4 ST-T wave changes, and 1 ventricular extrasystole. ECG recordings of 7 patients could not be found. 72 cases had been followed up with repeat ECG recordings. There were no observed ECG changes requiring any medical or electrical therapies in the surviving patients.
CONCLUSION
Cardiac rhythm abnormalities related to electrocution injuries are usually observed at the time of the incident. If the patient�s overall clinical condition is good and they have a normal ECG at the time of admission to the ED, the probability of observing any delayed serious dysrhythmia is unlikely.

Keywords: Electrical injury, cardiac monitoring.

Sorumlu Yazar: Meltem Akka�, T�rkiye
Makale Dili: �ngilizce

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