What is Electrical Burns?
Electrical injuries happen when a large amount of electricity passes through the body because of contact with an electric source. These injuries can be caused by the electricity itself flowing through the body, an arc flash – which is a type of electrical explosion, or by clothes catching on fire. In the first two cases, the electricity is turned into heat inside the body, leading to a type of burn called thermal burn.
The key thing to remember is that the visible damage of an electrical burn might not show the full picture of the injury. The internal tissues or organs might be severely damaged, even if the skin doesn’t look badly burned.
Another important thing to understand is what the term “electrocution” means. It is used when someone dies because of exposure to electricity. So, when someone survives after being exposed to an electric source, the correct term is not “electrocution”.
What Causes Electrical Burns?
Electrical injuries happen when a person’s body touches an electrical source. This can happen directly or through any material that can conduct electricity. For example, let’s say a utility worker falls from a truck and, in response, grabs a power line in an attempt to stop the fall. This could cause him to sustain an electrical injury. Similarly, if the worker was holding a pole that touched a power line, this could also result in an electrical injury.
People often become victims of electrical injuries at home as well. This might occur if an electrical cord from an appliance becomes exposed and hits the body. Or, it might happen if an electrical source comes into contact with water that the person is also touching, like if a hair dryer were to fall into a bathtub.
Risk Factors and Frequency for Electrical Burns
Electricity-related burns account for about 4% to 5% of all burns seen in a medical setting. In the United States, around 1,000 deaths per year stem from electrical injuries, with 400 of those being tied to high-voltage accidents. These injuries commonly occur at work for adults and at home for children.
- Electricity-related burns make up 4% to 5% of all burns treated medically.
- Accidental high-voltage electrical injuries lead to about 400 deaths per year in the U.S.
- Each year, there are around 1,000 electrical injury-related deaths in the U.S.
- For adults, such injuries typically happen at work while for children, they occur at home.
- Males are more prone to electricity-related injuries than females.
- The hands are the most common points of contact, followed by the head.
- The feet usually act as the ground point.
Signs and Symptoms of Electrical Burns
Patients with electrical burns need to be checked and treated in a specific way. This includes first attending to key areas known as ABCDEs (Airway, Breathing, Circulation, Disability, and Exposure), then a primary and secondary survey, which are thorough examinations of the patient’s condition.
Doctors also need to gather information about the patient’s incident including the source of the electrical injury, the voltage and type of current (AC or DC), how long the electrical exposure lasted, and how the injury happened. They should also ask about the patient’s heart health, especially any past irregular heartbeats. An examination from head to toe should be performed, with special focus given to the skin, including the scalp.
Typically, patients will have burn marks that look like normal heat burns apart from their location, which often lines up with the electrical source and ground. For instance, the patient might have burns on their hands where they touched the electricity and at their feet, where it exited their body. This flow of electricity through their body can result in injuries. These patients have a higher chance of heart injuries if the electrical current passed through their heart. The shock from the electricity can also cause them to fall, leading to broken bones, spinal fractures, or joint dislocations.
It’s important to note that sometimes there are no visible injuries, like when a person accidentally drops a hair dryer into the bath. When recording the burns, they should rather be referred to as “contact points” instead of entry or exit wounds.
Testing for Electrical Burns
If you’ve been exposed to an electrical shock, especially from a high voltage source, your doctor will want to check your heart health and other important bodily functions. They’ll perform an electrocardiogram, or EKG, which is a simple test that measures the electrical activity of your heart to see how well it’s working.
Your doctor will also order tests called “cardiac enzymes” which look for proteins in your blood that can indicate if your heart muscle has been damaged. Another test, called a “CBC” or complete blood count, will be used to check the overall health of your blood cells to see if there is any damage or disease.
Your doctor will also check your urine to make sure your muscles haven’t been damaged too much by the shock. This is because when muscles are damaged, they release a substance called myoglobin that can be harmful if too much of it reaches your kidneys.
If you were in contact with a high voltage source, your doctor would want to monitor your heart constantly during the evaluation, to promptly catch any potential complications.
If you’re feeling confused, or if you fell or were thrown from the blast of an electrical shock, your doctor may decide to perform a special kind of X-ray test called a CT scan on your head. This will help them check for any injury to your brain or skull.
Treatment Options for Electrical Burns
The main goal in treating a person who’s been electrocuted is to ensure their safety without endangering the rescuers. Immediate steps involve:
* Disconnecting the power source to separate the patient from the electricity.
* Taking off the patient’s clothes, particularly if they have metal items like jewelry or equipment touching their skin.
If the patient doesn’t have a pulse, advanced life support measures should be followed.
For patients who are awake, the key focus is on managing pain and keeping them well-hydrated. This often involves a solution known as Lactated Ringers, which contains essential salts and minerals. Patients with serious injuries should have fluid replacement through a large intravenous (IV) line to restore normal hydration levels.
The amount of fluid should be adjusted to ensure adequate urine production, which is about 75 to 100 milliliters per hour in adults or 1 milligram per kilogram per hour in children. It’s important to maintain their body temperature and avoid them getting too cold.
We need to monitor the heart rhythm closely for patients who are pregnant, those who have had heart problems, or those who were exposed to a high-voltage electrical source. Pregnant women who are more than 20 weeks along should also have their baby’s heart rate monitored if they were exposed to a high voltage. Patients with serious burns should be referred to a specialist burn treatment center.
Electric shocks can cause internal injuries, which can be more difficult to diagnose than ordinary burns. So even if a patient seems stable, we’re more likely to send them to a burn center just to be safe. Once we’ve kept a close eye on them, made sure their tests results don’t show any problems, and treated any injuries or burns, they can be allowed to go home. This also includes updating their tetanus shot if needed., because burns can sometimes create a risk of tetanus infection.
What else can Electrical Burns be?
Even though electrical injuries often result in burns, it’s not always the case. So, if someone doesn’t have visible burns but has a history that suggests an electrical injury, it’s important not to dismiss the possibility of electricity being the cause.
What to expect with Electrical Burns
The outlook for someone who has experienced an electric shock can depend on several factors. These include the path the electric current took through the body, how long the person was exposed to the electricity, whether the current was direct or alternating, the strength of the electricity (voltage and amperage), and how much resistance the body’s tissues offered to the current. This topic is covered in more detail in the previous section.
Possible Complications When Diagnosed with Electrical Burns
Just like any other burn, electrical injuries can lead to similar complications such as infections (which can get severe and cause sepsis), compartment syndrome, and rhabdomyolysis, a condition characterized by severe muscle damage due to internal burns. There can also be additional injuries such as fractures, cuts, or even collapsed lungs, which can occur from an individual being thrown away from the source of electricity or falling from a height due to the shock. These types of injuries require immediate attention and treatment.
Patients with electrical injuries can also have heart complications, such as arrhythmia, a condition where the heart beats irregularly, which in some cases can be life-threatening. People who experience irregular heartbeats, chest pain, or other heart-related symptoms are at risk of arrhythmia for 24 to 48 hours after the injury. So, it’s crucial to continuously monitor the heart activities of those patients.
Children who bite into an electric cord, injuring the corners of the mouth, represent a unique case of electrical injuries. Parents should be warned about potential delayed bleeding from the artery in the lip about a week after the injury, even if the child is otherwise fine.
Finally, due to the complexity of electrical injuries, anyone suffering more than a minor electrical shock should be treated at a specialized trauma and burn center to ensure the best possible outcome.
Common Complications:
- Infections (which can progress to sepsis)
- Compartment syndrome
- Rhabdomyolysis (due to extensive muscle damage)
- Additional injuries from falling or being thrown (fractures, lacerations,
pneumothorax, etc.) - Cardiac complications such as arrhythmia
- For children who bite into an electric cord – delayed bleeding from the artery in the lip
Preventing Electrical Burns
Many electrical appliances come with safety warnings. These serve to alert users about the potential dangers of using these devices wrongly, which could lead to serious injury or even death. It’s crucial to pay attention to and follow these warnings. Also, it’s important to obey safety rules at work, especially in jobs where there’s a high risk of electrical injuries. The goal of these rules is to prevent workplace accidents and keep everyone safe.
