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Background: Electrical accidents are potentially fatal incidents with effect on the cardiovascular, nerve and musculoskeletal systems and on the skin (burns). The electrical engineering industry points out that the follow-up of injured persons from site of accident to hospital is quite random. This paper gives a review of the current literature and proposes guidelines for the follow-up of victims of electrical accidents., Material and Method: A search of the literature was conducted on Medline, Embase, Biosis, Healthline, the Cochrane Library, the ISI citation databases, and on several other search engines. The revised guidelines were developed in consultation with 23 medical and industry institutions., Results and Interpretation: Serious acute effects of electrical accidents include cardiac arrest, respiration failure, burns (also (internal burns) with necrosis of e.g. muscle tissue), injuries to the nerve system, and renal failure. Traumas caused by falls are also frequent. Possible chronic effects are mostly seen in the nerve system as encephalopathy and psychological sequelae or as spinal cord and peripheral nerve injury. Most importantly, long latent periods are possible for some chronic nerve injuries. This paper suggest guidelines for acute (on the spot) action and criteria for referral to hospital, observation in hospital and further follow-up.

This article describes the symptomatology of three patients following electrical accidents. The flow of the current was from hand to hand, voltage was 220/380 V, and duration was at least a few seconds for all patients. The development of symptoms was the same, and may be explained as a thermal effect of electricity on the tissue. Initially the patients experienced transient confusion, followed by stiff muscles after 1 to 3 days, and then pain in the muscle attachments and joints close to path of the current. This pain increased slowly during the first two weeks. Recovery was gradual, but often incomplete. The case notes showed that electrical accidents may be followed by chronic rotator cuff tendinitis. The clinical examination also revealed a hearing loss at about 2,000 Hz and above 4,000 Hz. The neuropsychological testing indicated a diffuse impaired function in only one patient.

This paper describes the basic physical aspects of electricity and the harmful effects of electric shock to the various human organ systems. Treatment of electrical injuries differs from treatment of burns. Damage to muscles and subcutaneous structures necessitates a more aggressive fluid replacement regimen than the one predicted by the commonly used burn fluid resuscitation formulas. It is of paramount importance to avoid renal complications. Early fasciotomy and repeated surgical debridements are often necessary. Routine arrhythmia-monitoring is now considered unnecessary in individuals exposed to low tension alternating current unless arrhythmias requiring treatment are present at the primary medical contact.