Smartphone Caused Electrical Injury In Bathtub
A 13-year-old girl with a deep burn injury was referred to the burn center. She had held a charging smartphone in her right hand while taking a bath. After hearing a loud scream, the mother of the patient disconnected the charger from the spark plug and took her daughter out of the bath. According to the mother, the patient was briefly unconscious and showed muscle contractions. After receiving a precordial thump, the patient became responsive again.

Physical examination showed two deep burns: 1. a circumscribed, oval-shaped lesion of approximately 1 × 1 cm, with a central zone of pallor on the palmar side of the hand between thumb and index finger, 2. and a stripe-shaped laceration of the skin of approximately 1 × 12 cm, on the abdomen, near the epigastric region, surrounded by a zone of hyperemia. The patient’s total body surface area burned was less than 0.5%.

The patient’s serum creatinine kinase (CK) level was 1294 U/L, which is severely elevated. Muscle twitches, the severity of the burns, and muscle decay (elevated CK level) indicated that an alternating current with 240 V caused the electrical injury. Moist skin is more vulnerable to electrocution injury because of decreased resistance.

The burns were treated conservatively with silver sulfadiazine cream, which was altered to fusidic acid cream after 1 week. After 21 days, the abdominal burn had healed insufficiently. Therefore, surgical resection and transposition of the skin were performed. This resulted in satisfactory healing with little scarring.

Points to Discuss:-
1. It is clear that smartphone use among children has become increasingly popular. The prevalence of electrocution due to misuse of smartphones can probably be explained by both lack of supervision and lack of awareness among users.
2. The severity of burn injury due to electrocution depends on the factors of electricity and the human body. The type and intensity (that is, voltage) of current, the location and duration of contact on the body, and the organs are affected are factors.
3. Serum CK level and signs of myoglobinuria should be investigated directly after presentation at the emergency department and can indicate internal damage.

Source: https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-019-2231-4
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