ProQuestDocuments-2015-04-06(1)

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Fatal High Voltage Accidental Electrocution

Two Case Reports

Manigandan G1, Peranantha !", !hanuga

#$

1 Senior Resident, Forensic Medicine &

Toxicology, JIPMER, Puducherry 60006, Indi!"

# Senior Resident, Forensic Medicine &


$ Junior Resident, Forensic Medicine &


%orres'onding (uthor

M!nig!nd!n ), M*"

Senior Resident, Forensic Medicine & Toxicology,

JIPMER,Puducherry 60006, Indi!Tel+ 1 -.66.

E/!il+dr"!nig!nd!n.6g!il"co

Recie2ed+ July 1., #0134 (cce'ted+ (ugust 16,

#0134Pu5lished+ (ugust 1, #013

it!tion+ M!nig!nd!n ), Per!n!nth! S,

Sh!nug! 7#0138 F!t!l 9igh :olt!ge

(ccident!l Electrocution T;o !se Re'orts" Int J

Forensic Sci P!thol" #7-8, -/60"

o'yright+ M!nig!nd!n )< #013" This is !n o'en/

!ccess !rticle distri5uted under the ters o= the

re!ti2e oons (ttri5ution >icense, ;hich

'erits unrestricted use, distri5ution !nd

re'roduction in !ny ediu, 'ro2ided the origin!l

!uthor !nd source !re credited"

A%stract

Electric !ccidents c!use serious in?uries 5y direct

he!t ex'osure or 5y igniting clothes" The se2erity

2!ries 5et;een si'le h!rless shoc@s to de!th"M!ny !t ties the 2ictis !re thro;n to ground

=ro the electric 'oles sust!ining =!t!l non electric

in?uries" In this !rticle t;o c!ses o= high 2olt!ge

electrocution !re re'orted !nd discussed" In the

=irst c!se the 2icti sust!ined in?uries due to !rcing

o= current" In the second c!se, there ;ere ulti'le

exit ;ounds in 5oth legs indic!ting t;o di==erent

directions in the =lo; o= current" Aoth the 2ictissu==ered =!t!l he!d in?uries due to =!ll"

ey;ords + (uto'sy, Suicide, Methods, Poisoning,

9!nging

&ntroduction

M!n used =ire !s his !in source o= doesticenergy in !ncient ties" >!ter ;ith incre!sed need

!nd industri!liB!tion ;ind, ;!ter, co!l, !nd l!stly

nucle!r 'o;er sources !re 5eing used to 'roduce

energy" Tod!y ;e donCt @no; ho; ;e ;ould

sur2i2e ;ithout electricity" It h!s 5ecoe !n

integr!l '!rt in to the hu!n li=e =ro household

'ur'oses, industri!l ;or@s to 'roduction o= other

sources o= energy" It h!s ingled ;ith the li2es o=

the 'eo'le" Aut ;e should not =orget the d!ngers

in2ol2ed in the us!ge o= this in2!lu!5le energy

source" Electric shoc@ occurs ;hen ! su==icient!ount o= current '!sses through 5ody '!rts 5y

!ny source o= electricity" Electric shoc@ is usu!lly

c!used 5y cont!ct ;ith =r!yed cords, 'oorly

insul!ted ;ires, ungrounded electric instruents

!nd ;or@ing in electric 'osts ;ithout !ny

'rotecti2e gu!rd" The se2erity 2!ries =ro si'le

h!rless shoc@ to se2ere uscle contr!ctions,

unconsciousness !nd de!th" Soeties the 2ictis

!y 5e thro;n to ground c!using ore =!t!l

in?uries" Electrocution results ;hen ! 'erson is

ex'osed to leth!l !ount o= electricity !nd it


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in2ol2e 5oth high 2olt!ge 7D600 to -0:8 !nd lo;

2olt!ge 7600:8 currents" :irtu!lly !ll c!ses o=

electrocution !re !ccident!l in n!ture, ;ith suicides

r!re !nd hoicides e2en r!rer" e here5y re'ort

t;o c!ses o= electric =!t!lities !nd sho; ho;

d!nger is the electric!l shoc@ in outdoor setu'"

Case Report 1

The 2icti ;!s ! 13 ye!r old 5oy re=erred to our

hos'it!l c!su!lty ;ith history o= sust!ining electric

shoc@ ;hile 5ird/nesting in !n electric 'ole ;hich

is !5out #0 =eet height =ro the ground le2el"

Initi!lly he ;!s conscious, oriented !nd his 2it!ls

;ere st!5le, 5ut gr!du!lly his condition ;orsened

!nd died ;ithin 6 hours o= !dission in the

hos'it!l" 9is 5iocheic!l in2estig!tions ;ere;ithin nor!l liits" (uto'sy re2e!led ulti'le

5urnt !nd 'unched out lesions in2ol2ing le=t h!l= o=

the trun@, inner !s'ect o= le=t u''er li5 !nd inner

!s'ect o= 5oth thighs including the genit!l region

7Fig 18" Gn dissecting the he!d, =r!cture o= le=t

te'or!l !nd '!riet!l 5ones ;ere seen" Hnderlying

the =r!cture extr!dur!l h!eorrh!ge ;ith 5lood

clot ;eighing !round #0 gr!s ;!s =ound" Ar!in

underlying the extr!dur!l h!eorrh!ge ;!s =ound

to 5e de'ressed !nd the te'or!l lo5e on the le=t

side ;!s contused"

Fig 1' Multiple %urnt and punched out lesions

in(ol(ing trun) and genitalia*

Case Report "

( 30 ye!r old line!n h!d sust!ined electric shoc@

!nd 5urn in?uries ;hile re'!iring high tension

;ires !nd ;!s 5rought de!d to c!su!lty" The 2icti

;!s ;e!ring ! cotton shirt !nd it c!ught =ire during

the incident" Gn !uto'sy 5urn in?uries ;ere seen

o2er =ront o= chest, !5doen !nd !nterior !s'ect o=

5oth thighs, ;hich ;ere due to 5urning o= his

clothes" ( ch!rred !nd dee'ly scorched electric

!r@ ;!s =ound o2er the l!ter!l !s'ect o= the right

index =inger suggesti2e o= the entry ;ound o= the

'!ss!ge o= current" Multi'le exit ;ounds ;ere seeno2er the 'ul's o= !ll the toes o= the right =oot 7Fig

#8" ( 5urn !re! o= siBe 6x$" c ;!s seen o2er the

'l!nt!r !s'ect o= the right =oot suggesti2e o=

he!ting u' o= the tissues, dissolution o= @er!tin !nd

se'!r!tion o= e'ider!lder!l l!yers 5y the

current" ( dee'ly scorched ;ound ;!s seen o2er

the edi!l !s'ect o= le=t =oot 7Fig $8" In this c!se

the exit ;ounds !re ulti'le !nd !re seen in 5oth

the =oot, indic!ting th!t the '!ss!ge o= the current

is in t;o di==erent directions" Gn o'ening the

cr!ni!l c!2ity, extr!dur!l h!eorrh!ge ;!s seen


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o2er the le=t '!rieto/te'or!l !re!" *i==use

su5!r!chnoid h!eorrh!ge ;!s seen in the le=t

cere5r!l heis'here !long ;ith contusion o= the

te'or!l lo5e ;ithout !ny =r!cture o= the s@ull"

Fig "' Multiple e+it wounds o right oot*

Fig $' A deepl- scorched wound o(er edial

aspect o let oot*

.iscussion

In electrocution =or de!th to occur, the hu!n 5ody

ust 5ecoe ! '!rt o= !n !cti2e electric!l circuit

h!2ing current c!'!5le o= o2er stiul!ting the

ner2ous syste or c!using d!!ge to intern!l

org!ns 1" The 5!sic 'hysics o= electric current

c!n 5e ex'ressed 5y the =orul!+ (K:LR" The

ters ( !nd * re'resents the =lo; o= current"*irect current 7*8 tr!2els in one direction, !nd
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!ltern!ting current 7(8 resulting =ro the

ch!nging direction o= the electric =lo; #" The

extent o= in?uries recei2ed de'ends on the

!gnitude o= the current 7e!sured in ('s8, the

'!th;!y o= the current, the dur!tion o= current =lo;

!nd the resist!nce o==ered 5y the 5ody" The ost

i'ort!nt =!ctor in electrocution is the !'er!ge or

the !ount o= current =lo;" (s the 2olt!ge 7:8 is

const!nt, the !in =!ctor ;hich deterines the

!ount o= !'eres entering the 5ody is the

resist!nce o==ered 5y the 5ody !g!inst the current"

The ini!l !ount o= !'er!ge 'erce'ti5le to !

hu!n !s ! tingle is 1 (, ;here!s ( 'roduces

treors !nd 1/1- ( c!uses contr!cture o= the

uscles, ;hich 're2ents the 2icti =ro rele!sing

the li2e conductor" :entricul!r 5rill!tion occurs

5et;een - !nd 100 ( $" Extreely high

currents do not c!use 2entricul!r 5rill!tion, 5utr!ther results in 2entricul!r !rrest" Most =!t!lities

occur ;ith the doestic 2olt!ge 5et;een 110 !nd

$.0 :, ;hich is the 2olt!ge r!nge o= houses !nd

industri!l electricity" The tr!nsission 7o2er

1$,.00:8 !nd distri5ution 7=e;er th!n 1$,.00 :8

lines ty'ic!lly c!rry the high 2olt!ges 3" S@in

o==ers higher resist!nce to the '!ss!ge o= current

th!n intern!l tissues" The resist!nce 7R8 2!ries

gre!tly !ccording to thic@ness o= the @er!tin

co2ered e'ideris4 so th!t '!ls, soles !nd

c!lloused s@in 'ro2ide ore resist!nce th!n thethin s@in else;here" The resist!nce is !lso !==ected

5y the oisture 'resent o2er the s@in" ith 1#0 :,

dry s@in !y h!2e ! resist!nce o= 100,000 ohs4

dry !nd c!lloused s@in u' to ! illion ohs4 oist

s@in 1,000 ohs or less, !nd oist, thin s@in !s lo;

!s 100 ohs"J!==e 71#.8 st!ted s;e!ting could

reduce s@in resist!nce =ro $0000 to #00 ohs

6" here!s, in high 2olt!ge currents s@in

condition 'l!ys no signi=ic!nt role in resist!nce"

Electric current t!@es the '!th o= le!st resist!nce

!nd cre!tes he!t, c!using ther!l d!!ge to

2!rious tissues !long its '!ss!ge $" Most o= the

de!ths =ro electricity !re =ro c!rdi!c

!rrhythi!s, usu!lly 2entricul!r =i5rill!tion le!ding

to c!rdi!c !rrest" It is due to '!ss!ge o= current

through the yoc!rdiu !nd 'ossi5le disloc!tion

o= '!ce!@ing nodes" *e!th !y occur !s ! result

o= res'ir!tory !rrest, due to '!r!lysis o= intercost!l

uscles !nd di!'hr!g or r!rely 5y !==ecting the

5r!in ste, ;hen the current enters through the

he!d" Aut it ust !l;!ys 5e ree5ered th!t non/

electric!l tr!u! is Nuite coon" ith electric

source o= gre!ter th!n $00 :, current ight 5e

tr!nsitted 5y e!ns o= !rcing, c!used 5y

=or!tion o= conducti2e 'l!s! 5et;een the

source !nd the ground" The 5l!st e==ect o= high/

2olt!ge !rcing c!n thro; the 2icti !;!y =ro the

source, c!using =!t!l in?uries #,-" The dist!nce to;hich !n electric !rc c!n ?u' is 'ro'ortion!l to

the 2olt!ge" The current c!n !rc u' to $ c in

100000 : or !y 5e !s little !s =e; in 1000 :

."

In c!se 1, there ;ere no entry or exit ;ounds" The

sust!ined 5urn in?uries ;ere due to !rcing o= the

current, gi2ing rise to the !''e!r!nce o= Ocrocodile

s@in" The 2icti su==ered non/electric!l in?uries

=ro 5eing thro;n to the ground" In c!se #, 5oth

the entry !nd exit ;ounds ;ere seen" In this c!sethe exit ;ounds ;ere ulti'le !nd uch se2ere in

n!ture" This extreely high 2olt!ge current c!uses

the e'ider!l @er!tin to elt !nd, !=ter cooling, it

le!2es ! r!ised 5ro;n or yello; nodule o= =used

@er!tin surrounded 5y !n !reol! o= '!le s@in" *!s S

et !l re'orted ! c!se o= high 2olt!ge suicid!l

electrocution ;ith ulti'le exit ;ounds "

Electrocution is !n uncoon c!use o= de!th !nd

occurs coonly due to !ccident 10" *e!ths due

to electric!l in?uries !re lo; ;hen co'!red ;ith
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de!ths due to other c!uses" (s the electric in?uries

in2ol2e ulti'le 5ody systes, the entry !nd exit

;ounds =!ils to re=lect true extent o= the underlying

tissue d!!ge 11" In?uries =ro high 2olt!ge

electrocution 'ose ! serious thre!t to li=e incre!sing

the ort!lity r!te" Most o= the electrocution de!ths

!re 're2ent!5le in n!ture !nd they c!n 5e 're2ented

5y i'leenting 'ro'er educ!tion!l 'rogr!es

to the society including the electricity 5o!rd

;or@ers ;ith reg!rd to the us!ge o= s!=ety

!''li!nces !nd insul!tors" hildren should 5e

t!ught !5out the d!ngers o= electricity !nd

i'ort!nce o= electric s!=ety"

Conlict o &nterest

There is no con=lict o= interest, the !uthor do not

h!2e =in!nci!l or other rel!tionshi' ;ith other'eo'le or org!niB!tion th!t !y in!''ro'ri!tely

in=luence the !uthors ;or@"

Ac)nowledgent

e ex'ress iense gr!titude in th!n@ing the

!uthors o= 2!rious scienti=ic !rticles 'u5lished in

di==erent sites !s ;ell !s re=erence 5oo@s !nd

?ourn!ls"

Reerences

1. Shei@h!B!di (, i!ni M, )h!dy!ni M"

Electrocution/rel!ted ort!lity+ ! sur2ey o=

# de!ths in Tehr!n, Ir!n 5et;een #00# !nd

#006" ( J Forensic Med P!thol

#0104$1+3#3"

2. esner M>, 9ic@ie J" >ong ter seNuel!e o=

electric!l in?ury+ linic!l re2ie;" !n!di!n

F!ily Physici!n #01$4 "

3. *i M!io :J, *i M!io *" Forensic P!thology"

# nd ed" Aoc! R!ton+ R 'ress4 #001

4. u!r S, :er! (, Singh HS"

Electrocution/rel!ted ort!lity in northern

ndi! ( /ye!r retros'ecti2e study" Egy't J

Forensic Sci #01$

5. Aruner JMR, 9!!B!rds o= electric!l!''!r!tus" (n!esthesiology 16-4 #.+ $6/

3#"

6. S!u@@o P, night A" Forensic P!thology" In+

>ondon+ Ed;!rd (rnold4 #0034 $-#

7. Ph! TQ, )i5r!n QS" Ther!l !nd

Electric!l In?uries" Surg lin Q ( #00-4.-+

1.#06

8. Sornogyi E !nd Tedeschi ), In?ury 5y

electric!l =orce, in Tedeschi ), Ec@ert ),

Tedeschi >) 7Eds8+ Forensic Medicine"

Phil!del'hi!, A S!unders o 1--463/

6-6"

9. *!s S, P!tr! (P, Sh!h! , Sistl! S, Jen!

M" 9igh/2olt!ge suicid!l electrocution

;ith ulti'le exit ;ounds" ( J Forensic

Med P!thol #01$4$3718+$3/-

10. Fern!ndo R, >iy!n!ge S" Suicide 5y

electrocution" Med Sci >!; 104$0+#1

##0

11. *Bho@ic ), J!sin! J, *i@! (" Electric!l

In?uries+ Etiology, P!tho'hysiology !nd

Mech!nis o= In?ury" M!ced J Med Sci

#00.417#8+3/.
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