Advanced Trauma Life Support (ATLS) recommends prolonged ECG monitoring of patients with high risk factors post electric injuries, for detecting and treating potentially life threatening arrhythmias. We hereby present our experience of high voltage electric injuries (HVE) patients with high risk factors, managed at a level 1 Trauma Centre. Seven patients of high voltage electric injuries with significant burns (BSA > 10% of 2nd degree and above) were admitted over a year (Jan 1, 2019 to Dec 31, 2019), age ranging from 11 to 51 (median 25 yrs). Six out of seven patients (85.7%) were males. Mode of injury was recreational in one, workplace related in one and accidental in five (71.4%). Six patients had entry wounds in extremities, and three underwent emergency limb saving surgery (all escharotomies). Three patients underwent eventual amputation of injured extremity. Serum creatine kinase was monitored in all and multisystem involvement was seen in three patients; one patient (referred) required haemodialysis due to renal failure. There was no mortality. In all cases, 24 h continuous ECG monitoring was carried out as per ATLS and ERC (European Resuscitation Council) guidelines. There was no episode of paroxysmal or persistent rhythm disturbance in our patients during in-hospital stay or follow up. Review of pertinent literature suggests similar experiences of other authors. HVE is a rare injury and most centres have reported on their experience with small number of patients as in our study. Currently, continuous ECG monitoring post HVE seems to be the safe practice for patients with cardiac co-morbidities. Further studies are required to find other subsets of HVE patients likely to benefit from ECG monitoring, and the clinical significance of ‘delayed arrhythmias’ post HVE.

高级创伤生命支持 (ATLS) 建议对电击伤后具有高风险因素的患者进行长时间的心电图监测，以检测和治疗可能危及生命的心律失常。我们在此介绍我们在 1 级创伤中心管理的具有高风险因素的高压电伤 (HVE) 患者的经验。一年内（2019年1月1日至2019年12月31日）收治了7名严重烧伤（BSA> 10% 2度及以上）的高压电伤患者，年龄从11岁到51岁（中位数25岁）。七名患者中有六名 (85.7%) 是男性。一种伤害方式是休闲，一种是工作场所，另一种是意外伤害（71.4%）。6 名患者的四肢有进入伤口，3 名患者接受了紧急保肢手术（均为骨痂切除术）。三名患者最终接受了受伤肢体的截肢。对所有患者的血清肌酸激酶进行了监测，3 名患者出现了多系统受累；一名患者（转诊）因肾功能衰竭需要血液透析。没有死亡。在所有情况下，根据 ATLS 和 ERC（欧洲复苏委员会）指南进行 24 小时连续心电图监测。我们的患者在住院期间或随访期间没有发生阵发性或持续性节律紊乱。对相关文献的回顾表明其他作者也有类似的经历。HVE 是一种罕见的损伤，大多数中心都报告了他们在我们的研究中对少数患者的经历。目前，HVE 后持续心电图监测似乎是心脏合并症患者的安全做法。需要进一步研究以发现其他可能受益于心电图监测的 HVE 患者亚群，以及 HVE 后“迟发性心律失常”的临床意义。