Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Emerg Med. 2021 Feb;60(2):e33-e37. doi: 10.1016/j.jemermed.2020.09.039. Epub 2020 Oct 21.
Electrical injuries are common in daily life. The severity of electrical injury depends on the electric current, and assessing electrical damage is difficult because there appears to be no correlation between skin burns and visceral injury. We report a case of bilateral lung injury with pulmonary hemorrhage after exposure to low-voltage electricity.
A 23-year-old man was shocked by a low-voltage (110 V) electric current while at work. He had temporary loss of consciousness and twitching in the extremities, but soon regained consciousness and spontaneously stopped twitching. Electrical burn wounds were discovered on his back and forehead. Dyspnea and hemoptysis were noted. A computed tomography scan of the chest revealed patchy infiltration and consolidation of both lungs. The patient received treatment of tranexamic acid and prophylactic antibiotics for electricity-induced lung injury and pulmonary hemorrhage. Resolution of chest radiograph abnormalities was recorded on day 7. The mild dyspnea ceased approximately 2 weeks later. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Electricity-induced lung injury should be considered in patients with electrical injury through a suspicious electrical current transmission pathway, respiratory symptoms, and corresponding imaging findings. Pulmonary complications can be serious and require early intervention.
电伤在日常生活中较为常见。电伤的严重程度取决于电流，而且由于皮肤烧伤与内脏损伤之间似乎没有相关性，因此评估电损伤较为困难。我们报告了 1 例接触低电压（110 V）电后发生双侧肺损伤伴肺出血的病例。
1 名 23 岁男性在工作时被 110 V 电流电击。他曾短暂失去意识并出现四肢抽搐，但很快恢复意识并自行停止抽搐。背部和额头上发现电烧伤伤口。患者出现呼吸困难和咯血。胸部 CT 扫描显示双肺斑片状浸润和实变。患者接受氨甲环酸治疗和预防性抗生素治疗电击引起的肺损伤和肺出血。第 7 天记录到胸片异常的改善。大约 2 周后，轻度呼吸困难停止。
为什么急诊医生应该了解这个病例？：对于通过可疑电流传输途径、出现呼吸症状和相应影像学发现的电伤患者，应考虑电击性肺损伤。肺部并发症可能很严重，需要早期干预。
