Electrical injuries are the most serious and life-threatening emergencies that can occur from contact with an electrical source, such as live wires, household appliances, lightning, or faulty electrical systems. The complexity of electrical injuries is that the damage is not always visible and can range from minor burns to cardiac arrest. Quick and informed action is key to reducing harm and recovery. This guide will show you how to recognise, respond and manage electrical injuries.
Electrical Injuries
Types of Electrical Injuries:
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Electrical Burns: Where the current enters and exits the body. These burns may look small on the surface but can cause internal damage. A burn injury from electrical sources can cause severe damage beneath the skin due to tissue resistance, requiring careful monitoring and treatment. The heat from the current can also burn tissues and organs.
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Electrical Shock: When the current passes through the body it can cause an electrical shock which disrupts normal bodily functions. An electric shock occurs when a person's body comes into contact with an electrical energy source, allowing electricity to flow through the body. This can affect the heart (causing arrhythmias or cardiac arrest), the nervous system (causing seizures or unconsciousness), the muscles (causing contractions or spasms).
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Arc Flash Injuries: An arc flash is when a strong electric current travels through the air and produces intense heat and light. This can cause severe burns, blindness and damage to the respiratory system if inhaled.
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Lightning Strike Injuries: Lightning strikes are a form of high voltage electrical injury. The effects can be similar to other electrical injuries but often include blunt force trauma from the force of the strike.
Physiological Effects:
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Cardiac Arrhythmias: The heart is most susceptible to electrical currents which can disrupt its normal rhythm. This can cause arrhythmias, ventricular fibrillation or asystole (cardiac arrest).
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Muscle Damage: Electrical currents can cause severe muscle contractions which can cause fractures, dislocations or rhabdomyolysis (where muscle tissue breaks down and releases harmful substances into the bloodstream).
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Nervous System Damage: The electrical current can cause neurological damage which can cause seizures, confusion, memory loss or paralysis. This can be temporary or permanent depending on the severity of the injury.
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Internal Organ Damage: Electrical currents can damage internal organs including the brain, kidneys and lungs. This internal damage may not be visible but can have long term effects.
Immediate Response to Electrical Injuries
1. Scene Safety
Assess the Scene:
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Personal Safety First: Before you attempt to help the injured person, assess the scene to make sure it is safe for you to approach. If the electrical source is still live there is a high risk of you getting injured as well.
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Turn Off Power: If it is safe to do so, switch off the power by turning off the circuit breaker, unplugging the appliance or switching off the power supply. This is crucial to prevent further injury to the victim and the rescuer.
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Use Non-Conductive Material: If you can't switch off the power, use a non-conductive object (wooden stick or plastic tool) to carefully separate the person from the electrical source. Never use metal objects as they can conduct electricity and cause further injury.
Approach with Care:
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Avoid Water: Water is a good conductor of electricity. If the person is in contact with water or standing in water, make sure the power is off before you approach.
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Check Surroundings: Be aware of potential hazards like live wires, fallen electrical lines or unstable structures that could add to the risk.
2. Victim Assessment
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Consciousness: Approach the person carefully and check if they are conscious by gently tapping them and calling out their name. If they don’t respond assume the situation is critical.
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Breathing and Pulse: If the person is unconscious, check for breathing and pulse. If they are not breathing or no pulse, start CPR immediately.
Look for Physical Injuries:
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Entry and Exit Wounds: Check for visible signs of entry and exit wounds where the electrical current entered and exited the body. These areas are usually burned and may be charred or blistered. The severity of these burns will depend on the voltage and duration of exposure.
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Other Injuries: Check for other injuries like fractures from falls, head injuries from being thrown by the shock or secondary injuries from the environment (e.g. cuts, lacerations or abrasions).
Look for Shock:
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Pale, Cool or Clammy Skin: Shock is a critical condition that can occur after severe injury including electrical trauma. Signs are pale or blue-tinged skin, cool and clammy skin, rapid heartbeat, shallow breathing and weakness.
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Confusion or Unconsciousness: Confusion, disorientation or loss of consciousness are also signs of shock. If shock is suspected, lay the person down with their legs elevated, keep them warm and call for emergency help. If shock is suspected, it is crucial to get the person to the emergency department as soon as possible for a thorough evaluation and treatment.
3. Immediate First Aid for Electrical Burns
CPR (Cardiopulmonary Resuscitation):
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Start CPR: If the person is not breathing and no pulse, start CPR. Place the person on their back on a firm surface, heel of your hand on the center of the chest and your other hand on top. Perform chest compressions about 2 inches deep at a rate of 100-120 compressions per minute. If you are trained in CPR, give rescue breaths after every 30 compressions.
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Use an AED if Available: If an Automated External Defibrillator (AED) is available, use it as soon as possible. Follow the prompts given by the device to deliver a shock if advised. AEDs are designed to be used by people with minimal training and can be life saving in cases of cardiac arrest.
Cool the Burns:
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Cool the Affected Area: Once the person’s heart and breathing are stable, treat any visible burns. Gently cool the burn with running cool water for 10-20 minutes. Proper first aid for electrical burns includes cooling the affected area with running cool water for 10-20 minutes to reduce pain, swelling, and tissue damage.
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Avoid Ice or Ice-Cold Water: Don’t apply ice or ice-cold water directly to the burn as this can cause further damage by cooling the skin too quickly and cause frostbite and additional injury.
Dress the Burns:
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Non-Stick Dressings: After cooling the burn, cover it with a non-stick, sterile dressing or clean cloth. Don’t use adhesive bandages directly on the burn as they will stick to the damaged skin and cause pain when removed.
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No Ointments or Creams: Don’t apply any ointments, creams or oils to the burns as they will trap heat in the tissue and increase the risk of infection. Let medical professionals decide on the treatment.
Special Considerations
4. Unique Scenarios and Factors
Electrical burns can occur in various scenarios, each presenting unique challenges and requiring specific considerations. For instance, electrical burns caused by lightning strikes are particularly severe due to the high voltage involved. These injuries often necessitate specialized treatment and immediate medical attention to address potential cardiac arrest and other complications.
In situations where electrical burns occur in water, such as when an electrical appliance falls into a bathtub, the risk of cardiac arrest is significantly heightened. Water is an excellent conductor of electricity, which can lead to more extensive internal injuries. In these cases, it’s crucial to ensure the electrical source is deactivated before attempting any first aid.
High-voltage power lines present another unique scenario. If an electrical burn is caused by contact with a power line, extreme caution is necessary. The power line may still be live, posing a severe risk to anyone who approaches. It’s best to wait for professional help to arrive and ensure the power line is safely de-energized before providing any assistance.
Industrial settings, such as construction sites or manufacturing facilities, also pose significant risks for electrical burns. In these environments, following proper electrical safety protocols is essential. Regular maintenance and inspection of electrical equipment can prevent accidents and ensure a safer workplace.
By understanding these unique scenarios and factors, you can better prepare to respond effectively to electrical burns, ensuring the safety of both the victim and the rescuer.
Advanced Care and Medical Help
4. Get Medical Help
Call Emergency Services Now:
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Urgent Medical Response: Electrical injuries, especially high voltage injuries, require immediate medical attention even if the person seems to be recovering. Call emergency services (911 or your local emergency number) as soon as possible. Even if the person seems to be recovering, it is crucial to take them to the emergency department for a thorough evaluation and treatment.
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Provide Information: When calling emergency services, give as much information as possible about the injury, the source of the electricity, the person’s current condition and any first aid given.
Monitor for Delayed Symptoms:
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Ongoing Observation: Even after initial treatment, electrical injuries can have delayed symptoms including internal organ damage, neurological complications, and cardiac issues. Monitor the person for any signs of distress or worsening condition.
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Prepare for Hospitalization: Depending on the severity of the injury, the person may need to be hospitalized for further evaluation, treatment, and monitoring. Be prepared for an extended hospital stay.
Shock:
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Recognize Shock: As mentioned earlier, shock is a critical condition that requires immediate treatment. In addition to keeping the person warm and comfortable, keep them calm and reassured until help arrives.
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No Food or Drink: Don’t give the person anything to eat or drink as they may need surgery or other medical interventions that require an empty stomach.
5. Long Term Care and Recovery
Hospital Care:
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Cardiac Monitoring: The person may need continuous cardiac monitoring in the hospital especially if they had cardiac arrest or irregular heartbeat. Electrical injuries can cause ongoing heart issues that need close monitoring.
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Burn Management: Severe burns may require specialized treatment including debridement (removal of dead tissue), skin grafts or plastic surgery. Pain management and infection prevention are key to burn care.
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Neurological Assessment: The person may need to undergo neurological assessment to determine the extent of nerve damage or cognitive effects of the electrical injury.
Follow Up and Rehabilitation:
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Physical Therapy: Depending on the severity of the injury the person may need physical therapy to regain strength, mobility and function especially if they had muscle or nerve damage.
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Psychological Support: Electrical injuries can be traumatic and the emotional impact should not be ignored. Counselling or therapy may be needed to help the person cope with the psychological effects of the injury including anxiety, depression or post-traumatic stress disorder (PTSD).
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Regular Check-Ups: Follow up appointments with healthcare providers are necessary to monitor the person's recovery and any complications that may arise.
Electrical Safety and Injuries Prevention
Workplace:
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Training and Education: Make sure all workers who are at risk of electrical exposure are trained in electrical safety including the use of personal protective equipment (PPE), safe work practices and first aid response.
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Regular Inspections: Inspect electrical equipment, wiring and systems regularly to identify and address potential hazards before they cause injury.
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Lockout/Tagout: Implement and enforce lockout/tagout procedures to ensure electrical equipment is de-energized and secured before maintenance or repair work is done.
Home:
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Childproofing: Use outlet covers and keep electrical cords out of reach to protect children from electrical hazards. Educate children about the dangers of electricity and not to tamper with electrical outlets or appliances.
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Surge Protectors: Use surge protectors to prevent electrical surges that can damage appliances and cause fire. Don’t overload electrical outlets as this can cause overheating and increase fire risk.
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Ground Fault Circuit Interrupters (GFCIs): Install GFCIs in areas where water and electricity are close together like bathrooms, kitchens and outdoor areas. GFCIs will shut off power when a ground fault is detected.
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Electrical Appliances: Ensure that electrical appliances are used properly and according to safety guidelines to prevent electrical burns and injuries.
7. Education and Awareness
Education and awareness are pivotal in preventing electrical burns and ensuring proper treatment when they occur. Public awareness campaigns, educational programs, and community outreach initiatives play a crucial role in educating people about electrical safety and the risks associated with electrical burns.
Healthcare professionals must be well-versed in the treatment and management of electrical burns. This includes recognizing the signs and symptoms of internal injuries, understanding the unique characteristics of electrical burns, and providing appropriate first aid and medical care. Continuous education and training for healthcare providers can significantly improve patient outcomes.
Promoting electrical safety awareness in the workplace is equally important, especially in industries where electrical equipment is frequently used. Employers should provide regular training on electrical safety protocols and ensure that all electrical equipment is properly maintained and inspected. This proactive approach can prevent accidents and reduce the incidence of electrical burns.
By fostering a culture of education and awareness, we can minimize the occurrence of electrical burns and ensure that those affected receive the best possible care. This collective effort can lead to safer environments both at home and in the workplace, ultimately saving lives and reducing the severity of electrical injuries.
Conclusion: Be Prepared and Respond Properly
Electrical injuries are serious and potentially life threatening emergencies that require immediate and informed action. By knowing what to do and how to do it you can provide life saving first aid and reduce the severity of the injury. Remember electrical injuries often have hidden internal damage that may not be apparent immediately so even if the person seems to recover quickly seek medical attention. With the right knowledge, preparation and response you can make a big difference in the outcome of an electrical injury emergency.
