A Case Report: Low Voltage Electric Injuries Culminating in Cardiac Arrest and Direct Lung Injury

Abstract

Serious electrical injuries are rare but may have life-threatening consequences. Voltage exposure injuries are divided into low voltage injury (LVI) or high voltage injury (HVI). An LVI current can result in severe injury, depending on the length of exposure, the size of the individual, the cross-sectional area in contact with the electrical source, and environmental humidity. The authors present a 31-year-old male with accidental electrocution with low voltage current and cardiopulmonary arrest. A detailed revision by organs and systems is presented. LVI is uncommon and can occur with a variety of clinical presentations, rarely presenting with direct lung injury. Early recognition and support are the cornerstones of treatment.

Noncardiogenic pulmonary edema in small animals

“…Sympathetic discharge as the cause of pulmonary edema due to electrocution is further supported by the fact that necropsy findings of dogs with pulmonary edema due to electrocution showed subendocardial and subepicardial ecchymoses, which is commonly recognized as a consequence of severe sympathetic activation 64,75 . NPE is not a common feature of electrical accidents or lightning strikes in people 80–84 …”

“…64,75 NPE is not a common feature of electrical accidents or lightning strikes in people. [80][81][82][83][84] Electric injury and lightning injury can have a multitude of other effects on the mammalian body. Alternative causes for respiratory distress, such as edema in the upper respiratory tract or lung injury via other mechanisms (transmission of electric energy to heat, cellular necrosis), should be considered in electric or lightning injury victims.…”

“…Mechanical ventilation may become indicated in people and small animals with a wide range of NCPE types. 11,12,16,58,80,100,135 However, most details on mechanical ventilation have been published on the treatment of ARDS in these species. The cornerstone of mechanical ventilation in human ARDS patients is lung-protective ventilation.…”

Electrical Injuries: Cardiovascular Implication and Management

“…3 It is often thought that the magnitude of electrical hazard is proportional to voltage, but in fact, it depends more on the intensity (I in Amperes), which is linked both to voltage and resistance. Thus, even a low voltage shock can be fatal, 8 In case of decreased resistance, with a ventricular fibrillation threshold of 50-100 mA (Table 1). However, voltage is often the only variable known with certainty after exposure to electricity and as such is the most important factor used to categorize electrical shocks (lowvoltage electrical shocks are less than 1000 V and highvoltage are 1000 V or more).…”

“…1,4 While exposure to high-voltage (like lightning) or direct current will most likely cause ventricular asystole, even low-voltage alternating current can also cause sudden cardiac death by ventricular fibrillation. 8 Current transversing the myocardium during its vulnerable period, analogous to an 'R-on-T phenomenon', may trigger ventricular fibrillation. 3 4 International Journal of Scientific Advances ISSN: 2708-7972…”