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Electrical Burns

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Definition

Electrical burns and injuries are the result electrical currents passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Extent of the damage depends on the strength and duration of the electrical current.

Causes

Electrical burns and injuries result from accidental contact with exposed parts of electrical appliances, wiring, or lightning strikes.

Appliance or wiring injuries may occur when:

  • Children bite on electrical cords
  • Utensils or other metal objects are poked into electrical outlets or appliances, such as a plugged-in toaster
  • The power supply is not shut down before making home repairs or installation
  • A plugged-in appliance is dropped into water

Occupational accidents can occur from electric arcs from high-voltage power lines. Electric arcs occur when a burst of electricity jumps from one electrical conductor to another, creating bright flashes.

Risk Factors

Factors that may increase your chance of an electrical burn or injury include:

  • Occupations with exposure to electric currents, such as a utility worker
  • Occupations involving outdoor work, such as agriculture
  • Being outside during thunderstorms or in areas where thunderstorms are common
  • Working with electrical installations or appliances without proper training

Symptoms

Symptoms will depend on the amount of electricity that passed through the body and length of time the current was in contact with the body.

An electrical shock can cause severe muscle contractions. These contractions can causes falls or injuries, including broken bones. Other symptoms include:

  • Numbness or tingling
  • Weakness
  • Visible burns on the skin
  • Headache
  • Feeling disoriented

The electrical current can also disrupt certain functions in the body which may cause:

  • Low blood pressure which can lead to lightheadedness and weakness
  • Seizures
  • Heart arrhythmias which may be unnoticed or feel like flutters in the chest

Electricity can also cause cardiac arrest, respiratory failure, and/or unconsciousness.

Diagnosis

Electrical burns and injuries will be diagnosed based on events and symptoms. A physical exam will be done.

Like other burns, electrical burns have 3 degrees of severity, each with distinctive symptoms:

  • First-degree burns—Injury is only to the outer layer of skin. They are red and painful, and may cause some swelling. The skin turns white when touched.
  • Second-degree burns—These burns are deeper and more severe. They cause blisters and the skin is very red or splotchy. There may be more significant swelling.
  • Third-degree burns—These cause damage to all layers of the skin down to the tissue underneath. The burned skin looks white or charred. These burns may cause little or no pain because the nerves in the skin are destroyed.
Classification of Skin Burns
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It may be more difficult to diagnosis damage under the skin caused by electricity. Tests may include:

  • Electrocardiogram (EKG)—to detect rhythm disturbances of the heart
  • Urine or blood tests—to check for severe damage to muscles
  • CT or MRI scans

Treatment

If possible, cut the power source by throwing a switch or circuit breaker, or unplugging the power. Do not endanger yourself. Call for emergency medical services right away. Treatment will depend on the extent of injuries.

Treatment will depend on the individual's response to the electric shock and what injuries were caused.

Less severe symptoms may only require observation and time to fade. Some symptoms can linger over long periods of time.

Emergency Care

Severe shocks that have caused the heart to stop, a loss of consciousness, seizures or severe injury will need emergency help. Emergency response and first aid must be done quickly to restore breathing and prevent further injury or death. Some emergency steps may include:

  • Cardiopulmonary resuscitation (CPR)—if the heart has stopped beating, CPR can provide oxygen-rich air to the vital organs of the body until advanced care is reached
  • Airway and breathing support
  • IV fluids to restore balance in the body (may not be used for lightning strikes)

Surgery may also be needed to care for deeper burns or repair some wounds.

Follow-up Care

Some complications from electrical injuries can have a delayed onset. Observation and future testing may be needed for symptoms that develop after the incident. Later complications may arise from heart, kidney, or nerve damage.

Prevention

To help reduce your chances of electrical burns and injuries:

  • Use child safety plugs in all outlets.
  • Keep electrical cords out of children's reach.
  • Avoid electrical hazards by following manufacturer's safety instructions when using electrical appliances. Always turn off circuit breakers before making repairs to wiring.
  • Avoid using electrical appliances while showering or wet.
  • Never touch electrical appliances while touching faucets or cold water pipes.
  • Avoid being out in lightening storms. If you are outside seek safe shelter as soon as possible.

Revision Information

  • Burn Prevention Network

    http://www.burnprevention.org

  • Safe Kids Worldwide

    http://www.safekids.org

  • Health Canada

    http://www.hc-sc.gc.ca

  • Healthy Alberta

    http://www.healthyalberta.com

  • Electrical injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 26, 2013. Accessed November 3, 2014.

  • Electrical injuries. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/electrical%5Fand%5Flightning%5Finjuries/electrical%5Finjuries.html. Updated March 2014. Accessed November 3, 2014.

  • Fire safety. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/home/fire.html. Updated July 2011. Accessed November 3, 2014.

  • Fish RM, Geddes LA. Conduction of electrical current to and through the human body: A review. Eplasty. 2009;9:e44.

  • Lightning injuries. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/electrical%5Fand%5Flightning%5Finjuries/lightning%5Finjuries.html. Updated March 2014. Accessed November 3, 2014.

  • Sanford A, Gamelli RL. Lightning and thermal injuries. handb Clin neurol. 2014;120:981-986.