Burns from high voltage current

An electrical burn is a type of injury that occurs as a result of an electrical charge.. In 90% of cases, the causes of such injuries are contact with exposed wires or faulty electrical appliances. The remaining 10% are lightning strikes, being caught in an electric arc, and other causes.

Photo 1. Handling electrical appliances requires caution. Source: Flickr (Adien Saputra)

Features of electrical burns

An electrical burn is very different from a thermal . When coming into contact with hot objects, a person immediately feels severe pain. This triggers the body’s defense mechanism, which provokes an instinctive withdrawal of a body part from the source of the thermal threat.

An electrical burn is practically painless , however, the current that enters the body:

causes thermal burns to internal organs,
disrupts the electrolyte balance of all body fluids,
causes disruption of the electrical activity of neurons.

Note! The human body is 70% fluid (an excellent electrical conductor), so electrical discharge easily spreads throughout the body.

Human skin has electro-resistant characteristics, so at low voltage or low current, electricity can simply pass over the surface of the body without penetrating inside. In cases where the protective properties of the skin are not enough, electrical energy penetrates into the body. That is, the main part of the burn is inside the body , although there may be only a small burnt spot outside.

Degrees

In total, there are 4 degrees of electric shock strength. Each of them has its own differences, the nature of the damage to the body.

The first degree is characterized by damage to the upper layers of the skin, slight swelling, and a burning sensation. The burn area is small. This kind of damage is the most harmless, so after a visit to the doctor you can continue treatment at home.
In the second degree, deeper wounds appear, right down to the germ layer. The formation of blisters with exudate is typical at the entry and exit sites. The person feels severe pain and burning. If a small area is affected, you can treat it at home.
The third degree is characterized by the death of the inner layer of skin. The skin turns red, and with more severe injuries, it may even turn black and blisters appear. Blood clots can be observed in the clear exudate in the blisters. The skin on the affected area dies and cannot regenerate.
The fourth degree is considered the most dangerous. The injury is accompanied by damage to the skin, muscle tissue, and bones. Only a doctor can provide first aid. The skin does not regenerate, and restoration will require a transplant.

It is important to correctly determine the degree and area of the burn in order to provide first aid without causing harm. In case of incorrect identification, death is possible.

Types of electrical burns

There are many reasons for electrical injury: contact with bare wires or faulty equipment, touching electrical appliances with wet hands, lack of grounding or incorrect connection of electrical equipment, high-voltage wires caught in an electric arc, lightning strikes.

There are 3 types of electrical injuries:

Household (in contact with faulty equipment or exposed wires in everyday life),
Natural (when struck by lightning),
Industrial (in case of non-compliance with safety precautions in production where strong currents are used).

There are also instantaneous burns, with situational one-time contact with electricity, and chronic , when a person receives regular mild burns (which are asymptomatic), but there is a gradual accumulation of damage to internal organs.

Contact burn

The most common form of electrical burns is contact. The victim receives such an injury through direct interaction with a source of electricity. Depending on the voltage and current strength, a person can either get away with a slight fright or receive deep 3-4 degree burns.

Exposure to voltages greater than 380 V causes severe injuries to internal organs and often causes the death of the victim.

However, a powerful electric shock can throw a person away from the current source, and the body is capable of withstanding colossal loads, so there are cases where people survived and did not have any special injuries .

Voltage up to 380 V is dangerous because it quite often “magnetizes” a person to the source of electricity. When a person touches a bare cable with his hand, for example, under the influence of electrical voltage, the muscles contract and the fingers compress the wire. It is very difficult to escape from such a trap on your own, which is what causes most deaths from weak currents.

Arc burn

You don't have to touch an electrical source to get an electrical burn. In conditions of high humidity, an electrical discharge can form near high-voltage equipment (for example, electrical wires), which can reach an object up to a meter away through the humid air. With such a flash, a large amount of light and thermal energy is released. A person caught in an electric arc may have his clothes and hair catch fire, develop a large superficial burn, and develop electroophthalmia .

Another type of non-contact electrical injury is the effect of “step voltage”. If a bare live electrical cable touches the ground, the current can spread around the point of contact for a distance of up to 80 cm.

Photo 2. “Don’t get involved, he’ll kill you” is not a “horror story”, but a truthful warning. Source: Flickr (George).

Mixed burn

More than half of cases of electric shocks result in a mixed electrical burn, which combines tissue damage directly from electric current , as well as injuries resulting from exposure to high temperatures (when clothing burns).

Combined electrical trauma is also common, when in addition to electrical and thermal burns, the patient also receives mechanical injuries (soft tissue ruptures, bone fractures).

Types of Electrical Injuries

Several types of electrical injuries are considered. Electrical injuries may include:

Burns due to electric shock . This is the most common injury. Burns are considered to be a consequence of self-short circuits in electrical installations. Considering what causes electrical burns, depending on the conditions of occurrence, three types of burns are noted: current, arc, mixed. In the first case, injury occurs when current directly passes through the body due to human contact with a conductive part, that is, electrical burns occur when an electric shock occurs. In the second case, an electric arc is applied, but without current passing through the body. And in the latter case, both factors act simultaneously. In terms of severity, burns from electric shock can be of any degree.
Metallization of leather . This injury refers to the penetration of small particles of melting metal into the skin under the influence of an electric arc. Damage can occur when switches and disconnectors are turned off under load or during short circuits. Usually, after a certain period of time, the damaged epidermis disappears, and the skin takes on a normal appearance. Only if the eyes are affected, treatment will be difficult and lengthy.
Electrical signs . Such signs appear due to exposure to chemical or thermal, or the combined effects of electric current. The signs are characterized by a shape with clear contours and have a gray or pale yellow tint. Typically the signs are round or oval in shape. The damaged area becomes harder and cell death is observed. Typically, electrical signs do not cause pain and treatment is quick and successful. Over a certain period of time, the epidermis comes off and the skin becomes healthy.
Electroophthalmia . This is exposure of the eyes to a source of strong radiation of ultraviolet rays, which appears when an electric arc occurs. A person experiences inflammation of the outer membranes of the eyes.
Mechanical damage . These are dangerous injuries that occur as a result of a person being under voltage for a long time in installations up to 380 V. Mechanical injuries accompany electric shocks, as they are provoked by current passing through the body.
Electric shock . Excitation of living tissues, provoked by an electric current passing through the body, and accompanied by spontaneous spasmodic muscle contractions.

Any injury associated with electrical contact is life-threatening.

Degrees and symptoms of electrical burns

The severity of an electrical injury depends on the voltage, current and duration of exposure to electricity on the body. The main signs of an electric shock are:

severe weakness, headache, nausea;
temporary paralysis of a limb that interacted with electricity;
breathing and heart problems (increased frequency or interruptions);
loss of consciousness;
the presence of burned areas where electricity enters and/or exits the body;
if the exit point is not found, then the electrical discharge has dissipated inside the body, and this is fraught with severe and deadly consequences;
the appearance of “electric patterns” on the skin;
with very strong stress, mechanical injuries are possible, including bone fractures.

There may not be any pain from the burn itself at the time of injury, but over time the skin will turn red, may become covered with burn blisters with serous contents, and the affected deep soft tissues will look “boiled.”

Depending on the depth of damage from electric current, there are 4 degrees of electrical burns:

First degree. Slight redness of the skin, slight burning sensation. It goes away without special treatment in 3-7 days.
Second degree. Greater depth of skin damage, the appearance of burn blisters, and the pain is quite intense. Treatment is carried out at home and takes up to 2 weeks. It is important not to puncture the bladder, so as not to introduce infection into the open wound underneath.
Third degree. Deep soft tissue damage. Huge burn blisters with bloody contents may form on the surface. If the wound under the blisters is pink and the pain is intense, this indicates that the stratum corneum of the epidermis is alive and over time the tissue will be able to recover. If the skin is painless and acquires a brown, grayish or black tint, independent recovery is no longer possible and a skin transplant will be required.
Fourth degree. Occurs when exposed to very high current. Leads to charring not only of the skin, but also of muscles and even bones. Sometimes all fluids in the body are brought to a boiling point. This phenomenon is undoubtedly fatal.

Types of burns

Deadly danger.

Based on the type of contact, electrical burns are divided into:

contact - occurs in direct contact with a current source;
arc - without direct contact with the electrode, the victim is exposed to an arc in the air;
mixed - combined action of the arc and direct contact.

By type of injury
Type	Description
Household	Obtained by a person in everyday conditions. Such injuries are considered the most harmless, but they can also cause death.
Production	An injury sustained by a person while performing work duties. Quite dangerous damage because a person can come into contact with high voltage.
Natural	Injuries of this type have the highest mortality rate and can be sustained by the patient after contact with lightning.

Type of impact
Type	Description
Chronic	People who work with electricity often encounter such damage. Characterized by prolonged exposure to low voltage current on the human body.
Instant	They appear as a result of exposure to high voltage current and can lead to instant death of the victim.

Injury can occur at home.

The main classification depending on the degree of damage is presented in the table.

Degrees of electric shock
Degree	Description
1	It affects the top layer of the skin. At the site of the lesion, redness appears and swelling is possible. This type of electrical burn can be treated at home. The doctor will explain the basic rules to the patient. The prognosis is favorable.
2	The germ layer of the skin is injured. Bubbles filled with content appear on the surface. After the blow, the patient feels acute pain. If the lesion is single and covers insignificant volumes, treatment can be performed on an outpatient basis. The prognosis for recovery can be determined after identifying the site of contact.
3	The inner layers of the skin are affected. Bubbles with blood masses appear on the surface, which open on their own. An unprotected surface of the skin is formed, which can have a bright scarlet or black color. Blackening of the skin indicates necrosis of the germ layer and disruption of the possibility of natural regeneration.
4	The lesion covers not only the skin, but also muscle tissue and bones. The prognosis is unfavorable. If such an electrical burn is detected, treatment should be carried out exclusively surgically.

Burn.

First aid to the victim

An electrical burn is an extremely dangerous injury, which often causes a deterioration in the patient’s quality of life or death. The statistics are frightening - about 40% of deaths from this cause can be avoided. The reason for the high mortality rates is the adult population’s ignorance of the basics of first aid.

First of all, you need to call an ambulance to the scene of the incident.

If you find a person who has lost consciousness near power sources, you should call an emergency team and carry out a series of actions that constitute the standards for first-aid care. The main goal is to neutralize the effect of the discharge.

Attention! It is possible to recognize a dangerous injury by the condition of the victim. Severe injuries with a violation of tissue integrity are characterized by impaired breathing and heartbeat, and an increase in swelling. The person calling the ambulance must inform the dispatcher that help is required for a person who has received an electric shock.

First aid for electrical burns is to follow this algorithm:

the victim must be disconnected from the voltage source; this can be done by turning off the current supply;
in the case when it is impossible to turn off the current supply, you should try to pull away the source of danger using a wooden object;
after eliminating the danger, it is worth checking the breathing and measuring the victim’s pulse - if there are no signs of life, you should immediately begin resuscitation procedures, perform chest compressions and artificial respiration;
the victim’s torso should be located above the level of the head;
it is important to inspect for fractures;
If there are burns on the patient's body, they can be covered with a sterile cloth; materials with lint should not be used.

Electrical burns are extremely dangerous. Such lesions can not only provoke an abnormal heart rhythm and loss of consciousness.

Electrical discharge can cause cardiac arrest. That is why timely resuscitation procedures can save a person’s life. The price of knowing simple rules is human life.

Rules for providing emergency assistance.

Important! The person providing assistance to the victim must also take care of his own safety. Help should be provided without risking your own health.

Treatment of electrical burns

Treatment should be carried out in a hospital setting.

For electrical burns, complex treatment is indicated. If the result of a burn is poor circulation and severe cerebral edema, dehydration therapy is carried out. It is important to ensure cooling of the head; if the patient is in an excited state, he is given sedatives. Infusion therapy and donor blood transfusion are indicated.

To achieve better results, general treatment should be combined with the use of local agents. Such drugs can be used only after the patient has been removed from a serious condition and the threat to his life has been eliminated. Your doctor will tell you how to treat an electrical burn.

The main purpose of the funds:

cleansing wound surfaces from necrosis;
reducing pain intensity;
prevention of purulent complications.

If the wound is wet and a scab is present, dressings are carried out daily using antibacterial solutions and ointments, and sorbents are used.

First aid for electrical burns

In the event of an electrical injury, the first step is to take the person away from the source of electricity . If objectively a person has been subjected to a mild electric shock, it is enough to give him a drink of clean water,, if necessary, lubricate the burn site with Panthenol and ensure peace. If after 2 days the patient does not return to the same state of health, it is necessary to consult a doctor.

A severe electric shock has serious consequences and requires an immediate call to the ambulance. If the victim has no signs of vital activity, chest compressions and artificial ventilation must be performed before doctors arrive . In this case, the torso should be higher than the head.

If an electric shock causes a person to be thrown to the side or a strong muscle contraction occurs, skin tears and bone fractures may occur. If fractures are suspected, there is no need to move the victim so as not to cause additional bleeding or bone displacement. In the case of an open fracture or soft tissue tear, you can cover the wounds with a clean cloth to avoid severe blood loss and the risk of infection.

Note! If the victim is “magnetized” to an electrical appliance or wires, under no circumstances should you touch them with your bare hands. A person needs to be pushed away from the source of electricity using objects that do not conduct electricity well: wooden or rubber, but in no case metal.

Providing first aid to the victim

Absolutely every person should be able to provide first aid in case of electric shock or burns. The first step is to immediately call an ambulance. Further, first aid for electric shock and burns consists of:

Stop human contact with electrical current as soon as possible. To do this, turn off the switch by cutting the wire with an ax with a wooden handle, throwing the wire away with a wooden stick.
If a person is at a height, then before turning off the current, protect the person from falling.
Place the patient on a horizontal surface, but in such a way that the lower limbs are higher than the head.
After disconnecting the person from the power source, it is necessary to begin resuscitation measures. It is necessary to perform artificial respiration and chest compressions.
If the patient nevertheless fell from a height and injured his limbs, then immobilize them.

Do not take any further action, but wait for an ambulance.

Diagnosis and treatment of electrical burns

Electrical injuries have very characteristic symptoms , so the main direction of diagnosis is to determine the extent of the damage. This can be determined by indirect signs: the condition of the skin at the site of contact with electricity, the source of electrical injury, the duration of exposure to current, etc. For grade 3-4 lesions, an ultrasound or MRI of soft tissue may be prescribed.

Therapeutic treatment

Treatment of electrical burns in most cases is carried out using therapeutic methods. Exposure to electricity causes 4 types of damage:

Thermal : high temperature effects on tissues with disruption of their structure and function.
Mechanical : soft tissue ruptures, bone fractures.
Biological : disruption of metabolic processes and electrical activity in the body.
Electrolytic : changes in the composition and balance in the blood and other body fluids.

Therapeutic treatment aims to restore lost balance and heal wounds and has much in common with the treatment of thermal burns. An infusion of saline solutions is carried out to restore water balance and lost blood, dopamine to relieve shock, diazepam against seizures, blood thinners (heparin), antiarrhythmic drugs (beta blockers, cardiac glycosides), diuretics, painkillers, vitamins, immunomodulators, etc. An important step is the prevention of infections.

Surgical intervention

Surgical intervention is prescribed for electrical burns of 3-4 degrees . With deep tissue necrosis, resection of organs and tissues or amputation of limbs may be indicated. In case of extensive damage to the skin, skin grafting and plastic surgery are performed. Surgical treatment is also prescribed for mechanical injuries accompanying the electric shock: deep ruptures of soft tissue, open fractures or displaced fractures.

Treatment with folk remedies

After first aid for electrical burns has been provided and the incident has been briefly described to emergency doctors, the degree of damage has already been determined and the method of treatment has been determined. For minor injuries, treatment can be carried out using folk remedies. The most effective options:

applying grated potato pulp to injured skin;
using chilled cabbage leaves;
washing burns with a decoction of linden blossom;
rubbing the burn with an ointment prepared from 2 small spoons of Vaseline and 1 small spoon of calendula tincture;
lotions with oak bark;
using a mixture of sauerkraut and egg whites to speed up the healing of small blisters;
using lotions with dill juice diluted with water in a ratio of 1 to 2.

Vitamins A and E are usually prescribed orally, which promotes rapid regeneration of the epidermis and prevents the formation of scars.

Complications and consequences

Electric shock can manifest itself in different ways. The most common option is a household one: a person touches a faulty electrical appliance with wet hands and receives a small electric shock, which the victim himself feels like a shock. With such an injury, the current usually does not penetrate the body.

When exposed to high current, electricity penetrates the skin. When a person simultaneously holds onto a metal object with his other hand, he himself becomes a conductor and electricity passes through his internal organs. It is especially dangerous if the current passes through the upper limbs - in most cases this leads to disruption of the heart and some centers in the brain. With such an injury, the victim has points of entry and exit of the electrical discharge. Sometimes only the current entry point is detected in the patient. This means that electricity continues to wander through the tissues of the body, causing thermal damage to internal organs.

The most common complications after electric shock:

disruption of the cardiovascular, nervous and respiratory systems due to changes in electrical activity;
disruption of the functioning of internal organs due to the thermal effects of electricity;
seizures;
loss of skin sensitivity at the site of the lesion;
paresis and paralysis of the limbs;
eye diseases, including cataracts, with electroophthalmia;
the appearance of electrical signs (changes in the structure of the skin in places through which the current has passed);
metallization of the skin (molten metal particles entering the skin);
development of infection in the wound;
necrotic tissue damage and gangrene, possibility of amputation;
muscle atrophy;
impaired motor function due to fractures or traumatic scars;
psychological changes, including self-isolation and depression.

To avoid the development of complications, it is necessary to begin rehabilitation measures as quickly as possible.

Clinical manifestations of burns

Burns from electric shock usually have clearly defined forms on the epidermis, even when the electric current passes into deeper layers. The following manifestations of burns due to electric shock are possible:

spontaneous contractions of muscle tissue;
spasms;
arrhythmia;
breathing problems due to effects on the central nervous system.

Babies who put exposed wires in their mouths can get burns to their mouths and lips. Also, electric shock and burns can contribute to cosmetic deformation and have a negative impact on tooth growth.

Electric shock can provoke muscle contractions and falls, which lead to dislocations, fractures of the spine and bones, and injuries to internal organs. Difficult to identify or invisible psychological and neurological abnormalities can begin to develop 1-5 years after the injury.

In case of a slight burn due to electric shock, the patient indicates pain at the point of contact with the current source. The general condition is satisfactory, but headaches, nausea, and dizziness may appear.

With a more severe injury, the patient is inhibited and the risk of loss of consciousness increases. Temperature and pain sensitivity decrease, heart rhythm is disturbed. This condition may be accompanied by speech excitation.

Rehabilitation after electric burns

The rehabilitation period after an electrical burn depends on the degree of injury, but on average takes from 3 months to 1 year . During this period, in addition to medication support, the patient is treated with physiotherapeutic procedures, massages, and physical therapy classes.

Photo 3. Massage is one of the effective methods of rehabilitation. Source: Flickr (Chiropractors Gold Coast).

A set of rehabilitation measures is aimed at improving blood circulation and rapid regeneration of damaged tissues, as well as preventing:

disturbances in the functioning of internal organs and systems,
trophic disorders in tissues,
development of secondary infection in the wound.

During the rehabilitation period, motor function is restored, for example, excision of keloid scars that interfere with normal motor activity. If external aesthetic defects occur, plastic surgery is indicated. Also, in case of severe injuries, it is recommended to visit a psychologist to restore psychological health and learn to accept your new appearance.

How to understand that a person has suffered from an electric shock

You can find out about an electrical burn by looking at the marks from the electric arc. The skin of the affected area changes color. It turns red or purple-gray. With severe injuries, blackening or even charring may occur. There is no clear location of the pain; it spreads throughout the body. Electric shock is indicated by muscle spasms and convulsions.

The main signs of electrical injuries include:

Weak breathing, shallow. Sometimes asphyxia may occur.
Cardiopalmus.
Muscle cramps.
Impaired consciousness, memory loss.
Disorientation in space.
Loss of sensation in a limb.
Unstable vision, inability to focus.
A clear outline of the burn on the skin.
Unintelligible speech.
The victim may complain of nausea and dizziness.

Prevention of electrical injuries

Prevention of electrical burns consists solely of following safety precautions:

do not use faulty electrical appliances,
do not touch wires and electrical equipment with wet hands,
do not touch exposed electrical wires,
stay away from high-voltage wires and other objects with high voltage to avoid being caught in an arc,
do not come close to broken electrical wires, so as not to receive an electric shock from the step voltage,
Do not be in open areas during a thunderstorm to avoid being struck by lightning.

Treatment

If the injury occurs at home, it is most likely minor. Small areas of skin can be treated independently. The wound heals within a couple of weeks.

The affected area should not be treated with iodine or brilliant green, as they will aggravate the burn. It is better to use creams and ointments for healing burns, which include an antibacterial and antiseptic component. Preparations with sodium fusidine help avoid tissue rotting.

In the first week, you need to take especially careful care of the wound:

daily smear the injury with an antiseptic solution, anti-burn creams, as prescribed by your doctor;
carry out dressings regularly;
for pain, use painkillers;
antihistamines are required.

For treatment in a hospital setting, 2 treatment methods are used: medication and surgery.

Drug treatment

If a person suffers from high voltage, then most likely he will lose consciousness. In this case, a disruption of the heart rhythm and disruption of the cardiovascular system are possible. In this case, doctors send the patient to the intensive care unit. He is prescribed infusion therapy with anti-inflammatory and painkillers. In some cases, a blood transfusion may be required.

After stabilizing the victim’s condition, therapy is supplemented with local treatment for a speedy recovery. All creams and ointments that can be used to treat burns with blisters prescribed by doctors have an antibacterial effect and stimulate regenerative processes.

If the nervous system is disrupted as a result of an electric shock, the patient is prescribed sedatives and sometimes antidepressants. To stabilize the functioning of the cardiovascular system - stimulants. If circulatory disorders or cerebral edema are detected, then taking dehydration medications is recommended.

Surgical intervention

Surgical intervention is necessary only for the 3rd or 4th degree of severity of the injury. Surgeons clean the affected area and transplant healthy skin.

In particularly severe situations, amputation may be required. It is recommended for those patients whose injury is not amenable to conservative treatment methods and skin grafting.

The decision is made individually, based on the patient’s condition. In some cases, surgery is required immediately when there is a real threat to life or health. Sometimes doctors decide to postpone intervention until the patient has partially recovered, that is, they give time to recover from the shock.