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Rapid response to:
Practice
Clinical updates
Electrical injury
BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1418 (Published 12 April 2017) Cite this as: BMJ 2017;357:j1418
Infographic available
Click here for a visual overview of assessment for people with electrical injuries, including when to admit, and when people at low risk of complications can safely be discharged.
Rapid Response:
Re: Electrical injury, Waldmann et al, BMJ 2017; 357:j1418
Why contradict the evidence?
The authors of this article recommend a period of 24 hours cardiac monitoring after low voltage injuries as the most commonly adopted approach. However the evidence they themselves quote clearly shows that cases of low voltage injuries without any loss of consciousness, cardiac arrest or ECG abnormality, are low risk injuries and occurrence of serious arrhythmias is very low or absent. There is no evidence to support the 24hours monitoring period for this group.
Our practice based on our experience in Queen Victoria Hospital is to discharge patients with low risk injuries after the initial assessment and investigations are clear. We have not experienced any morbidity or complications requiring re-admission for these low risk group patients in the last 10 years since adopting this evidence based approach. We would encourage the authors and the readership to be guided by the evidence rather than common practice. This approach is not only cost effective it also avoids unnecessary inconvenience for both patients and hospitals.
Competing interests: None to be declared.
Nada Ibrahim; MBBS, MRCSed, PG Cert Medical Research.
Baljit Dheansa; Consultant Buns and Plastic Surgery, QVH.
Competing interests: No competing interests