Electrical injury

Classically, electrical burns cause more damage than revealed upon surface inspection. Subsequent 'loss' of apparently normal tissue may result.

Important sequels of an electrical injury can include cardiac dysrhythmia and compartment syndrome within a limb.

An electrical injury represents a serious and a common form of trauma seen throughout the world.

• an electric current will travel through the body from one point (entry) to another (exit) damaging the tissue between these two points
• electrical injuries can be - electrocution, electrical shock, electrical burns, and electrical trauma
• the American Burn Association estimates that each year
  • 4400 people are injured by electrical accidents
  • 400 deaths occur due to electrocution – majority are work related e.g. – miners, electricians, construction works etc
  • up to 100 deaths occur due to lightning strikes (1,2,3)

Electrical accidents can be classified as:

• high voltage accidents - >1000 V
  • sources – high voltage lines (45 000 – 400 000 V), rail network lines (25 000 V), overhead lines (1500 V)
  • often caused as a result of occupational exposure to outside power lines
  • can be divided into
    • true high tension injuries - high voltage current passing through the body
    • flash injuries - tangential exposure to a high voltage current arc where no current actually flows through the body (3)
• low voltage accidents - <1000V
  • sources – mines (960V), subway electrical rails (750 V), workshops (380 V), domestic supplies (US 110V, Europe 220 V) (1)
• lightning injuries
  • caused by energy with high voltage and high amperage but extremely short duration
• other electrical injuries
  • e.g. - taser devices for rapid incapacitation, child and or spouse abuse, and torture (4)

Reference:

• (1) Waldmann V et al. Electrical injury. BMJ. 2017;357:j1418
• (2) M Ungureanu. Electrocutions – treatment strategy (case presentation). J Med Life. 2014; 7(4): 623–626.
• (3) Hettiaratchy S, Dziewulski P. ABC of burns: pathophysiology and types of burns. BMJ. 2004;328(7453):1427-9.
• (4) Dzhokic G et al. Electrical Injuries: Etiology, Pathophysiology and Mechanism of Injury. Macedonian Journal of Medical Sciences. 2008; 1(2):54-58