She spent 10 days in the hospital after graft placements and received physical and occupational therapy. She was extubated within 24 hours and other than an initial mild cognitive impairment comprising short‐term memory and attention challenges was neurologically intact. Her creatine kinase level peaked at 480 U/L, lactic acid level normalized and transaminases and creatinine levels trended back within normal limits before discharge. She required ray amputation to the left index finger and had autografts placed to her left hand and right chest wall. She was given an intravenous bolus of 1L of lactated ringers and the respiratory rate and tidal volume were increased on the ventilator with repeat arterial blood gas showing resolution of hypercapnia (PaCO 2 40 mmHg) and improved pH (7.23) and lactic acid level (7.8 mmol/L) before transfer to a regional burn center. Postresuscitation electrocardiogram was sinus tachycardia with non‐specific t‐wave changes in the anterior leads. Postintubation arterial blood gas showed pH 6.90, PaO 2 232 mmHg, PaCO 2 67 mmHg, and HCO3 ‐ 13 mmol/L on 50% FiO 2 on mechanical ventilator. The remaining comprehensive metabolic panel and complete blood count were grossly normal. Urinalysis showed 1+ blood with 3 red blood cells. Urine drug screen (UDS) was positive for amphetamine and methamphetamine. Initial pertinent labs showed creatine kinase 321 U/L (43–179 U/L), lactic acid 15.2 mmol/L (0.4–1.3 mmol/L), creatinine 1.5 mg/dL (0.5–1.3 mg/dL) with unknown baseline, aspartate aminotransferase 131 U/L (10–37 U/L), and alanine aminotransferase 121 U/L (30–65 U/L).
#Fractal wood burning video full#
Further examination revealed total body surface area burns of 1%, composed of patchy partial thickness burns to her buttocks in addition to full thickness burns to the right chest wall, palmar side of the right hand including multiple digits, and palmar side of the left hand including the tip of the index finger with exposed bone. The initial rhythm on the cardiac monitor showed ventricular fibrillation and the patient achieved return of spontaneous circulation after initial defibrillation at 200 Joules (J). She was intubated and given 1 mg of epinephrine via intraosseous infusion. At initial assessment by ED staff, the patient was unresponsive and pulseless, and cardiopulmonary resuscitation was immediately started. En route to the ED via the friend's private vehicle, the patient abruptly became unresponsive about 2 minutes before arrival. A friend heard the patient groaning and walked in to find her clutching an electrical device in both hands, which appeared to be “arcing.” The friend was able to pull the patient away from the device, at which time she was reportedly awake and alert. The patient was at home making art with pyrography via a process called fractal wood burning. This article hopes to expand on the previous single publication, discuss the exceedingly high mortality rate, motivate emergency medicine providers and other clinicians to publish cases related to fractal wood burning‐related injuries, and promote public awareness of this perilous practice.Ī previously healthy 26‐year‐old female was brought to the emergency department (ED) after an electrical injury.
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There are countless online video tutorials that describe how to replicate this process however, the dangers of this practice are frequently omitted and have now become a growing public health concern. She was stabilized and then transferred to a regional burn center for additional care.įurther history revealed the patient had learned how to create art with Lichtenberg figures using a high‐voltage transformer extracted from a home microwave oven and a wooden canvas, a process called fractal wood burning. Further examination showed partial to full thickness burns to both hands, right chest wall, and buttocks. The patient achieved return of spontaneous circulation after defibrillation.
She was unresponsive, pulseless, and found to be in ventricular fibrillation upon arrival. A 26‐year‐old female was brought to the emergency department after an apparent electrocution.
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