Electrical burns in train climbers treated in the Helsinki Burn Centre during the last 30 years.

Background: Patients who climb onto the roof of a stationary train carriage and sustain a high voltage electrical injury from the overhead cables represent a rare type of electrical injury. The aim of this study was to review all the electrical burns and their outcomes in train climbers treated in the Helsinki Burn Centre during the last three decades.

Methods: 18 patients who had climbed onto the roof of a stationary electric train between November 1993 and December 2022 were included. Trauma- and outcome-related variables were collected. The primary outcome endpoints were in-hospital mortality and major amputations.

Results: 16 (88.9%) patients were male. The median age was 15.5 years (range: 13-29 years). All the burns were high-voltage electrical burns. The mean burn size was 45% of the total body surface area. Three (16.7%) patients died in hospital. The mean length of the Burn Centre stay was 50 days. On average, the patients underwent 5 operations (range: 0-32) during their inpatient stay. Three patients required major amputation. Eight of the patients underwent late operations. Seven (38.9%) patients exhibited late neurological dysfunction or neuropsychological symptoms at long term follow-up.

Discussion: In conclusion, train climbers represent a rare group of young patients with electrical burns. Precautionary strategies should be implemented to prevent these injuries that are associated with high morbidity and mortality.