Electrical burn.pdf

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Electrical burn 1

Electrical burn

Electrical burn on hand

An electrical burn is a burn that results from electricity passing

through the body causing rapid injury. Approximately 1,000 deaths per

year due to electrical injures are reported in the United States, with a

mortality rate of 3-5%.[1] Electrical burns differ from thermal or

chemical burns in that they cause much more subdermal damage.[2]

They can exclusively cause surface damage, but more often tissues

deeper underneath the skin have been severely damaged. As a result,

electrical burns are difficult to accurately diagnose, and many people

underestimate the severity of their burn. In extreme cases, electricity

can cause shock to the brain, strain to the heart, and injury to other

organs.[3]

PathophysiologyThree electrical factors determine the severity of the damage caused by electrical burns: voltage, current, and

resistance. The severity of the burn also depends on the pathway the current takes through the body.[4]

Generally, the

pathway of the current will follow the course the least resistant tissues: firstly blood vessels, nerves, and muscle, then

skin, tendon, fat, and bone.[5]

Most commonly, electric injuries primarily damage the outer limbs, but more critical

portions of the body may be affected as well causing severe complications.[6]

As the body comes into contact with an electrical source, it becomes part of the electrical current. As such, the

current has a point of entry and an exit at two different points on the body. The point of entry tends to be depressed

and leathery whereas the exit wound is typically more extensive and explosive. It is hard to accurately diagnose an

electrical burn because only the entry and exit wounds are visible and the internal damage is not.[7]

Causes and classification

Electrical burns can be caused by a variety of ways such as touching or grasping electrically live objects,

short-circuiting, inserting fingers into electrical sockets, and falling into electrified water. Lightning strikes are also a

cause of electrical burns, but this is a less common event.[8]

With the advances in technology, electrical injuries are

becoming more common and are the fourth leading cause of work-related traumatic death.[9]

One third of all

electrical traumas and most high-voltage injuries are job related, and more than 50% of these injures result from

power line contact.

Electrical burns can be classified into six categories, and any combination of these categories may be present on an

electrical burn victim:

Low-voltage burn. A burn produced by contact with a power source of 500 volts or less is classified as a

low-voltage burn. The current at this voltage is not enough to cause tissue damage along its path except at the

contact site. This type of burn may be mild, superficial, or severe depending on the contact time.[10]

High voltage burn. This burn is very severe as the victim makes direct contact with the high voltage supply and

the damage runs its course throughout the body. Exterior injuries are misleading as most of the damage occurs

underneath the skin. In this case, subdermal tissues are severely damaged.

Arc burn. This type of burn occurs when electrical energy passes from a high-resistance area to a low-resistance

area. No contact is required with an arc burn as the electricity ionizes air particles to complete the circuit. The

heat generated can be as high as 4,000 degrees Celsius - hot enough to vaporize metal and ignite a victims

clothing. A form of explosion dissipates excess energy from the arc. In addition, a high-amperage arc can produce

a pressure wave blast in excess of 1000 pounds per square inch of pressure. This can throw the victim and cause
http://en.wikipedia.org/w/index.php?title=Pressure_wavehttp://en.wikipedia.org/w/index.php?title=Pressure_wavehttp://en.wikipedia.org/w/index.php?title=Electric_archttp://en.wikipedia.org/w/index.php?title=High-voltagehttp://en.wikipedia.org/w/index.php?title=Lightning_strikehttp://en.wikipedia.org/w/index.php?title=Short-circuitinghttp://en.wikipedia.org/w/index.php?title=Electric_currenthttp://en.wikipedia.org/w/index.php?title=Electrical_resistancehttp://en.wikipedia.org/w/index.php?title=Electrical_currenthttp://en.wikipedia.org/w/index.php?title=Voltagehttp://en.wikipedia.org/w/index.php?title=Electric_shockhttp://en.wikipedia.org/w/index.php?title=Subdermalhttp://en.wikipedia.org/w/index.php?title=Chemical_burnhttp://en.wikipedia.org/w/index.php?title=Burnhttp://en.wikipedia.org/w/index.php?title=Electricityhttp://en.wikipedia.org/w/index.php?title=Burnhttp://en.wikipedia.org/w/index.php?title=File%3AElectrical_burn_on_hand.jpg


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Electrical burn 2

severe injuries.[11]

Flash burn. Flash burns are caused by electrical arcs that pass over the skin. The intense heat and light of an arc

flash can cause severe burns. Although the burns on the skin are largely superficial and cover a large area, tissues

beneath the skin are generally undamaged and unaffected.

Flame burn. Associated with flash and arc burns, flame burns are caused by contact to objects that were ignited

by an electrical source.

Oral burns. This is caused by biting or sucking on electrical cords, and it most commonly happens to

children.[12]

Electrical current typically passes from one side of the childs mouth to the other, possibly causing

deformity.

Treatment

First aid

An electrically burned patient should not be touched or treated until the source of electricity has been removed.

Electrical injuries often extend beyond burns and include cardiac arrhythmia, such as ventricular fibrillation. First aid

treatments include assessment of consciousness of the victim, evaluation of pulse and circulation, and treatment of

burns.[13]

Hospitalization

Typically, an electrical burn patient has a lower affected body surface area than other burn patients, yet complication

risks are much higher due to internal injury.[14]

Often, the damaged internal tissue demands hospitalization. If not

treated, this damaged tissue can cause complications (such as gaseous gangrene from dead tissue or loss of blood

flow to limbs) and the damaged body parts may need to be amputated. Repeated removal of the damaged tissue and

extensive rehabilitation are common while limb amputation rates for victims who experience direct electrical contact

can be as high as 75%.[15]

Burn treatment for severe wounds may require skin grafting, debridement, excision of

dead tissue, and repair of damaged organs.[16]

Rehabilitation

Electrical burning has an effect on most vital body functions and is accompanied by several other electrical related

injuries:

Damage to the veins and arteries which can cause ischaemic necrosis.

Involuntary contraction of muscles due to electrical interference which can cause bone fractures and dislocations.

Interference with the electrical conductivity of organs such as the heart and nerves. This can lead to seizures, lung

injury due to severe central nervous system damage, and cardiac arrest.

Forceful propulsion of the body, producing such injuries as spinal and limb fractures.

These injuries must be treated in addition to the burns themselves.
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Electrical burn 3

Prevention

Basic electrical safety

The following are some basic safety rules for preventing electric injury (cannot cover every possible scenario):[17]

Avoid using electrical appliances while showering or bathing.

Avoid using electrical equipment and appliances when wet, with an exception for quality appliances intended for

the bathroom when not simultaneously showering, bathing, or being in a path of water going to plumbing.

Use child safety plugs in all outlets, and keep children away from electrical cords.

If the prongs of an electrical cord are too wide or narrow, never adjust them with your fingertips while

simultaneously plugging the cord into the power mains.

Follow manufacturer safety instructions for electrical appliances. This includes not using and immediately

unplugging any appliance with a damaged electrical cord.

Never touch metallic areas of an AC electrical appliance while simultaneously touching faucets, water pipes,

another metallic AC appliance, or being even partly immersed in water (including wet feet). This avoids

grounding the body through metal or water.

Have a qualified electrician install Ground Fault Circuit Interrupter (GFCI) outlets or circuit breakers in all rooms

with plumbing, bare concrete flooring, exposed to the elements, or outdoors. (Many newer homes already have

these devices pre-installed.) Do not defeat the safety feature by running an extension cord from non-GFCI areas

such as bedrooms and hallways. Oral burns (above) cannot be prevented by GFCI.

Although 12-volt batteries used in vehicles are at a safe voltage, a short circuit can still cause electrical burns and

an explosion. Always double check polarity before doing a jump start, and never attempt on a frozen battery.

Replace high-risk appliances of decades past with new ones (blow dryers, corded electric drills, etc.)

Always inquire about the voltage when traveling abroad for those residing in the Americas, Japan, and Taiwan

(countries with 110-125 volts). This includes inter-American travel, as a few countries commonly use 220-240

volts. A matching electrical socket (power mains) does not necessarily mean the voltage is the same as back

home. The doubling of voltage results in a very dangerous four-fold increase in power and heat. Make certain any

dual-voltage small appliances have been adjusted correctly for 220-240 volts.

Never go near or under a downed power line, even if there's no direct contact with the wire. (If crossing is

absolutely unavoidable, lie as flat as possible while crawling underneath where the wire is at its highest point.)

See also Lightning safety

Residential electrical wiring

While installing, modifying, and repairing residential wiring is not for the inexperienced, some basic safety rules are:

Never work without wearing shoes. Wearing rubber (or similar) gloves is highly recommended. If not wearing

gloves, do not touch more than one bare wire at a time, in addition to not touching any bare metal with the other

hand or exposed skin elsewhere on the body.

Turn off the circuit breaker before doing any type of electrical wiring work, and be absolutely certain the disabled

breaker is the correct one. If in doubt (e.g. wiring was already dead), turn off the master circuit breaker (no

matter how inconvenient). Never assume malfunctioning wiring is on the same circuit as nearby wiring.

If any tingling in the skin is felt where it is touching a bare wire, assume the wire is live, and immediately let go

of wire and stop all work. Take precautions to avoid a short circuit, isolate wire, and turn off the master circuit

breaker. (This is caused by a very small amount of current passing through the body to ground with sufficient

resistance to avoidfor the momenta devastating shock or burn.)

If checking voltage using a multifunction electrical tester, make certain both the dial and test leads are in the

correct position for "volts." A tester previous set to measure amperage ("amps") will short and explode, possiblycausing an electrical burn. (Unlike voltage, amperage is measured in series with the appliance or electrical

device.)
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Electrical burn 4

Always use the correct thickness ("gauge") of wiring and proper ground connections.

Wiring running through a hole in sheet metal must be protected by a rubber grommet (e.g. overhead fluorescent

lighting).

If using wire nut connectors, closely follow directions, and always use the correct size (by color) for the gauge

and quantity of the joined wires. These should be placed in normally inaccessible locations only. Make certain

there is no protruding bare wire (except ground wiring) and all connections are firm.

Treat neutral wiring with the same respect as "hot" wiring. Although neutral provides the path to ground, it has

not reached ground yet, and can contain dangerous voltages.

Never cut a live electrical cord or wiring, as it will short across the metal cutting tool, causing an explosion.

Electrocution is also possible.

When installing a Ground Fault Circuit Interrupter (GFCI) outlet, replace the first outlet on the circuit with GFCI

to protect all the other outlets (if any) on same circuit. GFCI can protect downstream, but not upstream. Follow

the manufacturer's safety and installation instructions.

In addition, electricians, power-line repair, and other industry workers should always follow proper safety

procedures. What is safe at 120-240 volts in the home can be very dangerous at higher voltages.

References

[1] Electrical Injuries in Emergency Medicine. Medscape Reference. n.p. n.d. Web. 29 September 2011. < http://emedicine. medscape.com/

article/770179-overview>.

[2] Electrocution Burns. Burn Survivor Resource Center. n.p. n.d. Web. 29 September 2011.

.

[3] Health Care Advisor: Burn Treatment Self Help Guide. n.p. n.d.. Web. 29 September 2011..

[4] Electrical Burns: Causes and Treatment. Anapol Schwartz: Attorneys at Law. Anapol Schwartz Weiss Cohan Feldman & Smalley. n.d.

Web. 29 September 2011. .

[5] Docking, P. Electrical Burn Injuries. Accident and emergency nursing 7.2 (1999): 70-76. Print.

[6] Xu, X ; Zhu, W ; Wu, Y. Experience of the treatment of severe electric burns on special parts of the body. Annals of the New York

Academy of Sciences Vol.888 (1999): 121-30. Print.

[7] What is an Electrical Burn? Electrical Safety. n.p. n.d. Web. 29 September 2011.

.

[8] Electrical Burn Injuries. Department of Surgery, Government Medical College, Miraj and General Hospital, Sangli, Maharashtra, India. 17

August 2003. Web. 29 September 2011. .

[9] Etiology. Medscape Reference. n.p. n.d. Web. 29 September 2011. .

[10] Electrical Burns. Burnsurgery.org. n.p. n.d. Web. 29 September 2011. .

[11] Burn Injury Facts: Arc Flash/ Blast. Hazard Prevention. April 2006. 1-2. Print.

[12] Toon, Michael H ; Maybauer, Dirk M ; Arceneaux, Lisa L ; Fraser, John F ; Meyer, Walter ; Runge, Antoinette ; Maybauer, Marc O.

Children with burn injuries--assessment of trauma, neglect, violence and abuse. Journal of injury & violence research 3.2 (2011): 98-110.

Print.

[13] How to Treat and Electrical Burn. Livestrong.com. Demand Media, Inc. n.d. Web. 29 September 2011.

.

[14] Tredget, E E ; Shankowsky, H A ; Tilley, W A. Electrical injuries in Canadian burn care. Identification of unsolved problems. Annals of

the New York Academy of Sciences Vol. 888 (1999): 75-87. Print.

[15] "Electical Injury." Cetri.org, n.p. 2010. Web. 23 July 2013 < > (http://cetri.org/electrical_injury.html)

[16] Orgill, D P; Pribaz, J J. Functional Reconstruction following Electrical Injury. Annals of the New York Academy of Sciences Vol.888.

(1999): 96-104. Print.

[17] Electrical Burns Prevention. ThirdAge.com. ThirdAge Media, LLC. n.d. Web. 29 September 2011.

.
http://cetri.org/electrical_injury.htmlhttp://en.wikipedia.org/w/index.php?title=Accident_and_emergency_nursinghttp://emedicine.medscape.com/article/770179-overviewhttp://emedicine.medscape.com/article/770179-overviewhttp://en.wikipedia.org/w/index.php?title=Electrocutionhttp://en.wikipedia.org/w/index.php?title=Twist-on_wire_connectorhttp://en.wikipedia.org/w/index.php?title=Fluorescent_lightinghttp://en.wikipedia.org/w/index.php?title=Fluorescent_lightinghttp://en.wikipedia.org/w/index.php?title=Cable_grommethttp://en.wikipedia.org/w/index.php?title=Sheet_metalhttp://en.wikipedia.org/w/index.php?title=Ground_%28electricity%29http://en.wikipedia.org/w/index.php?title=Wire_gauge


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Article Sources and ContributorsElectrical burn Source: http://en.wikipedia.org/w/index.php?oldid=585007843 Contributors: ASCIIn2Bme, BD2412, Chris the speller, Docdiehl, Eagle112800, Electrokinetic, Jmarks31,

Kilopi, Lifung, LittleWink, MisterShiney, Moswento, Pinethicket, Regulov, Wtshymanski, 14 anonymous edits

Image Sources, Licenses and ContributorsFile:Electrical burn on hand.jpg Source: http://en.wikipedia.org/w/index.php?title=File:Electrical_burn_on_hand.jpg License: Creative Commons Attribution 2.0 Contributors: National

Institute for Occupational Safety and Health (NIOSH) from USA

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