Electrical injuries can result in body trauma, and come with a high rate of morbidity and mortality. Even a small amount of current that passes through the body can cause significant harm, and in several cases, electrocution can be instantly fatal. In some cases where it’s not life-threatening, it can result in the dysfunction of multiple organs or tissues in the body.

Electrical injuries can occur as a result of a lightning strike, low-voltage, or high-voltage injury. The exact effect of electric shocks is dependent upon several factors, including the amount of the voltage, which parts of the body are involved, the length of time the current flowed into the patient’s body, and how long before medical help was administered. In general, low voltage electric current (less than 500 volts) exposure does not normally cause significant injury. Exposure to high voltage electric current (greater than 500 volts), however, can potentially result in serious damage.

The Clinical Manifestations of Electrical Injuries

Exposure to electric current even with as low as 50 volts applied between two parts of the body can cause electricity to flow which can block the normal electrical signals between the brain and the muscles. The effects can include the following:

• Arrhythmias and direct myocardial damage

A high voltage of current or DC typically causes asystole where the heart stops functioning, while AC usually causes Ventricular fibrillation or VF. Patients with fatal arrhythmia condition should be monitored for a minimum of 6 hours after injury.

• Respiratory arrest

Electric current may disrupt the normal cyclical output of the respiratory center leading to respiratory muscle paralysis or tetanic contractions.

• Neurological injuries

Electrical exposure can cause significant damage to the head and spinal cord which can result in paralysis, autonomic dysfunction, weakness and memory disturbances.

• Skin burns

Electrical skin burns may occur when electrical current passes through the body ranging from superficial to deep burns that may require major surgery.

• Loss of muscle control

Damage below the skin may be more serious than it appears and may cause loss of muscle control due to painful muscle spasms sometimes strong enough to dislocate joints or break bones.

• Oral burns may occur among young children resulting from sucking or biting an electrical wire or appliances.

Treatment or Management

Victims of electrical injuries require immediate medical attention that includes basic life support measures for airway and breathing. At least until the full extent of the electrical injuries has been quantified, the injured individual should be treated as a multi-trauma patient. As a general rule, the rescuer must first and foremost ensure that the hazard for potential further electrical injury has been removed to allow for a safe environment during the assessment.

The physician may order different tests to identify if a hidden injury exists. The test may include ECG to check the heart, CBC or complete blood count, x-rays to check for bone fractures, CT scan, and urine test. Skin burns from electric shock must be initially treated with dressings. The patient’s tetanus immunization history must be checked and if the victim isn’t immune, tetanus vaccination can be considered.

If the patient is pregnant, checking for fetal harm after electric shock may be necessary. Additionally, consultations with trauma or critical care specialists, surgical specialists, and orthopedists must be considered as soon as possible to avoid any complications or long-term damage.

In most cases, if someone who has been exposed to electricity does not suffer immediate cardiac arrest and does not have severe burns, the patient is likely to survive. Before the patient is discharged, he or she must be educated about potential sources of electrical hazards and schedule of follow-ups as needed must be followed.

Important Safety Reminders

• Never attempt to touch the injured person if he or she is still in contact with the electrical current. Otherwise, you’ll risk getting electrocuted too.
• Call 911 or your local emergency number promptly if the source of the burn is a lightning strike or high-voltage wire.
• Keep a safe distance from high-voltage wires until the power is turned off. Overhead power lines are usually not insulated. Stay at least 6 meters or 20 feet away to avoid dangers of electric arcing.
• Do not move the injured person unless he or she is in immediate danger.
• To avoid the risk of electrical injuries, never attempt to do electrical works on your own without proper training and experience, instead contact a qualified electrician to assist you.