Evaluation of demographic and clinical features of patients with electrical injuries in picu

Objectives: Electrical injuries are frequently encountered among young children and usually home accidents. Electrical injuries are still a very important cause of morbidity and mortality. İt results in a wide range of conditions, from simple burns to very serious organ injuries. The primary objective of this study is to evaluate the sociodemographic data and follow-up result of the cases observed in the pediatric intensive care unit due to injuries originated from electrical injuries. Materials and Methods: In this study, 54 cases which were admitted to Pediatric Intensive Care Unit (PICU) at Dicle University Medical Faculty from January 2011 to August 2017 were reviewed. All the patients were 0-18 years old and from Diyarbakir and surrounding provinces and were exposed to electric shock. The cases have been examined thoroughly in terms of age, sex, location and cause of accident, season, place of residence, type of voltage, additional pathologies, level of consciousness, laboratory data of Glasgow Coma Scale (GCS), mechanical ventilatory (MV) support and its duration. Findings: Of the 54 patients included in the study, 37% were female and 63% were male. The age range of the patients was between 11 months and 176 months (14 years) and the mean age was 72.6 ± 44.5 months. When the patients place of residence is taken into consideration: 23 patients were from the city center, 21 of them from the nearby districts and villages, 10 of them from the different cities. When cases of electric shocks are examined in terms of seasons; it was observed that the patients were mostly injured in summer with 42.6%. When the type of voltage causing the accident is examined; it was determined that 20% of the patients were exposed to high voltage, and 80% were exposed to low voltage. It was observed that 26% of the accidents which occurred due to low voltage is caused by unsafe water heaters. Of the other sources of injuries, 17% were originated from electric outlets, 13% of electric cables, 5% from refrigerators, 5% from ovens, 4% from electric heaters, 4% from ventilators, 4% from portable lamps used in balconies, and 2% from water dynamos used in the gardens. During their hospitalization in intensive care unit, 36 of the patients were found to have spontaneous respiration and 18 of the patients were intubated. The mean duration of the stay of mechanically ventilated patients who were intubated was 19.8 ± 32.4 days. The duration of stay in the intensive care unit was at least 1 day and a maximum of 120 days with a mean of 8.59 ± 20.1 days. When the causes of deaths were examined, it was determined that patients died due to brain edema, sepsis, respiratory failure and cardiac insufficiency. The mortality rate was found to be 20.3%. When the relationship between mortality and laboratory values is examined, Creatine Kinase (CK), Creatine Kinase-Muscle Brain (CK-MB), Aspartate Transferase (AST), Alanine Transferase (ALT) and Lactate Dehydrogenase (LDH) values of patients who died were evaluated at the time of admission to the hospital. The mean CK was 2860,8±1742,5 U/L, CK-MB 137, 1 ± 139,6 ng/ml, LDH 1362,6±708,5 U/L and AST 307,8±262,6 U/L in death-related cases. In the comparison to the type of voltage and sex, all 11 patients who were exposed to high voltage were male. Of the 43 patients who were exposed to low voltage, 23 were male and 20 were female. While the number of cases of male and female patients in injuries caused by low voltage was close to each other, it was determined that the cases arisen from high voltage were the only male. The comparison between sex and type of voltage was found to be statistically significant (p: 0.004). Conclusion: It has been determined that the most common reasons of electric shocks in this study were the use of unsafe water heaters used for bathing. Instead, it is necessary to use a safe devices. High voltage sources such as transformers should be located in less populated areas. Electric outlets and electric cables should be located at a height that children can not reach. Injuries originated from electric shocks indicate the necessity of first aid training for parents and caregivers because this type of injuries is preventable and often occurs at home. Educational and informative guidelines are needed. As we cannot give up electricity which is fundamental to modern life, everyone shares the responsibility to minimize these accidents arise from manufacturing defects and misuse of devices. Keywords: Electrical injuries, child, precaution