Electric Shock Injuries
Electric shock injuries are caused by lightning or electric current from a mechanical source passing through the body. Electric shocks cause about 1,000 deaths in the United States each year; about 3-15% of cases are fatal. Injuries range from barely noticeable tingling to instant death, and can affect every part of the body. The severity depends on the current's pressure (voltage), the amount (amperage) and type of current (direct vs. alternating), the body's resistance to the current, the current's path through the body, and how long the body remains in contact with the current. Injuries from household appliances and other low-voltage sources are less likely to produce extreme damage. Many survivors require amputation or are disfigured by burns. How electric shocks affect the skin is determined by how wet, thick, and clean the skin is. Thin or wet skin is much less resistant than thick or dry skin. When skin resistance is low, the current may cause little or no skin damage but severely burn internal organs and tissues. High skin resistance can produce severe skin burns but prevent the current from entering the body. The nervous system (the brain, spinal cord, and nerves) is easily injured by electric shocks. Some of this damage is minor and clears up on its own or with medical treatment, but some is severe and permanent. Neurological problems may be apparent immediately after the accident, or gradually develop over up to three years. Damage to the respiratory and cardiovascular systems is worst at the moment of injury. Electric shocks can paralyze the respiratory system or disrupt heart action, causing instant death. Smaller veins and arteries can develop blood clots. Damage to the smaller vessels is probably one reason why amputation is often required after high-voltage injuries. Other injuries possible after an electric shock include: cataracts, kidney failure, substantial destruction of muscle tissue, falling or getting hit by debris from exploding equipment, fire on clothing or nearby flammable substances, and broken or dislocated bones.
Electric shock injuries are diagnosed through information about the accident, a thorough physical examination, and watching cardiovascular and kidney activity. The victim's neurological condition can change rapidly and requires close observation.
A computed tomography scan (CT scan) or magnetic resonance imaging (MRI) may be used check for brain injury. When an electric shock accident happens at home or work, immediately shut off the main power. If that cannot be done, and current is still flowing, push the victim away from the source of the current by standing on a dry, nonconducting surface such as a folded newspaper, or plastic or rubber mat and using a nonconducting object such as a wooden broomstick. Do not touch the victim or the source while the current is flowing. Call emergency medical help as quickly as possible. People who are trained to perform cardiopulmonary resuscitation (CPR) should, if appropriate, begin first aid while waiting for help to arrive. Burn victims usually need to go to a burn center. Fluid replacement therapy restores lost fluids and electrolytes. Severely injured tissue is repaired surgically, which can involve skin grafting or amputation. Antibiotics and antibacterial creams are used to prevent infection. Victims may also require treatment for kidney failure. Following surgery, physical therapy to facilitate recovery, and psychological counseling to cope with disfigurement, may be necessary.
Many electric shocks can be prevented. Parents and other adults should know about possible electric dangers in the home. Damaged electric appliances, wiring, cords, and plugs should be repaired only by people with the proper training or replaced. Hair dryers, radios, and other electric appliances should never be used in the bathroom or anywhere else they might accidentally come in contact with water. Young children need to be kept away from electric appliances and taught early about the dangers of electricity. Electric outlets need safety covers in homes with young children. During thunderstorms, people should go indoors immediately, and boaters should return to shore as quickly as possible. People who cannot reach indoor shelter should move away from metallic objects such as golf clubs and fishing rods and lie down in low-ground areas. Standing or lying under or next to tall or metallic structures is unsafe. An automobile is appropriate cover, as long as the radio is off. Telephones, computers, hair dryers, and other appliances that can act as conduits for lightning should not be used during thunderstorms.
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