Elektrik Çarpması Olgularının Adli Tıbbi Değerlendirilmesi

Öz

Çalışma, elektrik çarpması nedeniyle acil servise başvuran hastaların demografik özelliklerini, yaralanma türlerini, tedavi süreçlerini ve düzenlenen adli rapor içeriklerini incelemeyi amaçlamaktadır. Bu retrospektif çalışmaya 2019-2024 yılları arasında Harran Üniversitesi Hastanesi'ne elektrik çarpması nedeniyle yatırılan 132 hasta dahil edildi. Hasta verileri, yaş, cinsiyet, giriş veya çıkış lezyonlarının varlığı, adli rapor tutulup tutulmadığı, adli rapor tutulmuş ise içeriği, lezyonların anatomik konumu, mortalite durumu ve hastanede kalış süresi gibi bilgiler hastanenin bilgi yönetim sisteminden elde edildi. 132 hastanın %61,4'ü erkek olup ortalama yaşları 25,0±14,91 yıl, %38,6'sı kadın olup ortalama yaşları 21,4±16,67 yıldı. Elektrik çarpması olayları en sık evde (%47) meydana gelirken, bunu işyeri (%18,9) ve dış mekanlar (%25) takip etti. Giriş lezyonları en sık ellerde (48 vaka) görülürken, çıkış lezyonları en sık ayaklarda (7 vaka) görüldü. On üç hasta entübasyon gerektirdi ve bunlardan 7'si daha sonra öldü. Toplam 11 hasta elektrik çarpması nedeniyle öldü. Elektrik çarpması olguları sıklıkla genç erişkinlerde ve çocuklarda görülmekte olup, özellikle ev ve iş kazaları ile ilişkilidir. Giriş-çıkış lezyonları, hem klinik ciddiyetin hem de adli değerlendirme gerekliliğinin önemli bir göstergesi olarak öne çıkmaktadır. Acil servis hekimlerinin, yalnızca tedavi değil, aynı zamanda adli raporlama konusundaki sorumlulukları konusunda daha fazla farkındalık ve eğitim almaları gerektiği vurgulanmalıdır.

Anahtar Kelimeler

• Elektrik çarpması;
• Elektrik yaralanması;
• Acil servis;
• Adli değerlendirme

Forensic Medical Evaluation of Electric Shock Cases

Öz

The study aims to examine the demographic characteristics, types of injuries, treatment processes and contents of forensic reports of patients admitted to the emergency department due to electric shock. This retrospective study included 132 patients admitted to Harran University Hospital between 2019-2024 due to electric shock. Patient data, including age, gender, presence of entry or exit lesions, whether a forensic report was kept, If a forensic report has been prepared, its content, anatomical location of the lesions, mortality status, and length of hospital stay, were obtained from the hospital's information management system. Of the 132 patients, 61.4% were male, with a mean age of 25.0±14.91 years, and 38.6% were female, with a mean age of 21.4±16.67 years. Electric shock incidents occurred most frequently at home (47%), followed by the workplace (18.9%) and outdoor areas (25%). Entry lesions were most commonly observed on the hands (48 cases), while exit lesions were most often seen on the feet (7 cases). Thirteen patients required intubation, and 7 of them subsequently died. A total of 11 patients died due to electric shock. Electrical injury cases are frequently observed in young adults and children and are particularly associated with domestic and occupational accidents. The presence of entry and exit wounds serves as a significant indicator of both clinical severity and the necessity for forensic evaluation. It is emphasized that emergency physicians should not only focus on clinical treatment but also require increased awareness and training regarding their responsibilities in forensic documentation.

Anahtar Kelimeler

• Electric shock;
• Electrical injury;
• Emergency department;
• Forensic evaluation

Kaynakça

1. Gentges J, Schieche C, Nusbaum J, Gupta N. Points & Pearls: Electrical injuries in the emergency department: an evidence-based review. Emergency Medicine Practice. 2018;20(Suppl 11):1-2.
2. 2. Aydın F, Yavuz MS, Akın U, Kahraman İ. Forensic medical evaluation of electric shock injury. Ege Journal of Medicine. 2018;57(2):116-118.
3. 3. Schissler K, Pruden C. Pediatric electrical injuries in the emergency department: an evidence-based review. Pediatric Emergency Medicine Practice. 2021;18(12):1-24.
4. 4. Jin X, Chen D, Li X, Zeng X, Xu L, Hu B, Xu G. Advances in forensic diagnosis of electric shock death in the absence of typical electrical marks. International Journal of Legal Medicine. 2021;135(6):2469-2478.
5. 5. Tıraşçı Y, Durmaz U, Altınal A, Bulut K, Özdemir Y, Cengiz D, Uysal C, Gören S. A retrospective evaluation of judicial reports issued by Forensic Medicine Department of. Dicle Medical Journal. 2016;43(3):424-430.
6. 6. Zhang J, Qiao YR, Yang YD, Pan GZ, Lv CQ. Recovering from prolonged cardiac arrest induced by electric shock: A case report. World Journal of Clinical Cases. 2024;12(13):2248-2253.
7. 7. Özdel S, Çakıcı EK, Saylı TR. Pediatric electrical injury in Turkey: five-year retrospective hospital-based study. Pediatric International. 2019;61:1155-1158.
8. 8. Behera C, Sikary AK, Rautji R, Gupta SK. Electrocution deaths reported in South Delhi, India: a retrospective analysis of 16 years of data from 2002 to 2017. Medicine Science and Law. 2019;59:240-246.

9. 9. Korkmaz M, Uysal C. Evaluation of the death cases due to electric current being performed autopsies between 2007 and 2014 years in Diyarbakır. Bulletin of Legal Medicine. 2021;26(1):27-32.
10. 10. Türk Ceza Kanunu’nda Tanımlanan Yaralama Suçlarının Adli Tıp Açısından Değerlendirilmesi Rehberi. Erişim Tarihi: 22.04.2025, Erişim: https://www.atk.gov.tr/tckyaralama24-06-19.pdf
11. 11. Y-Salehi SH, Sadat Azad Y, Bagheri T, Ghadimi T, Rahbar A, Ehyaei P, Momeni M. Epidemiology of occupational electrical injuries. Journal of Burn Care Research. 2022;43(2):399-402.
12. 12. Demir U, Asirdizer M, Kartal E, Etli Y, Hekimoğlu Y. An investigation of the effect of the COVID-19 (SARS-CoV-2) pandemic on occupational accidents (Tokat-Turkey). Archives of Environmental Occupational Health. 2023;78(1):28-37.
13. 13. Dündar AS, Altın İ, Aksöz C, Sarın AB, Özdemir B. Deaths associated with electric shock injuries in children and adults: A 10-year retrospective examination in Şanlıurfa, Southeast Turkey (2012–2022). Journal of Forensic Sciences. 2023;68:2076-2084.
14. 14. Zemaitis MR, Lopez RA, Huecker MR. Electrical Injuries. [Updated 2025 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448087/
15. 15. Kılınç O, Karagöz Y, İlhan M, Bakan HU. Evaluation of Cases with Forensic Reports Issued Due to Injury Caused Result of Electric Shock Between 2010-2022 by Akdeniz University Forensic Medicine Department. Akdeniz Medical Journal. 2024;10(3):450-456.
16. 16. Khor D, AlQasas T, Galet C, Barrash J, Granchi T, Bertellotti R, Wibbenmeyer L. Electrical injuries and outcomes: A retrospective review. Burns. 2023;49(7):1739-1744.
17. 17. Berksoy EA, Yazıcı S. Clinical, Demographic Characteristics and Factors Affecting the Clinical Outcome of Children with Electrical Injury: A Single-Center Pediatric Emergency Clinic Experience. Bulletin of Legal Medicine. 2019;24(1):30-35.
18. 18. Demirdöken ED, Karbuz A. Retrospective evaluation of forensic cases at pediatric emergency admissions. Journal of Forensic Medicine. 2023;37(1):33-38.
19. 19. Zhang J, Lin W, Lin H, Wang Z, Dong H. Identification of Skin Electrical Injury Using Infrared Imaging: A Possible Complementary Tool for Histological Examination. PLoS One. 2017;12(1):e0170844.