Electrical burn
Encyclopedia
An electrical burn is a burn
Burn
A burn is an injury to flesh caused by heat, electricity, chemicals, light, radiation, or friction.Burn may also refer to:*Combustion*Burn , type of watercourses so named in Scotland and north-eastern England...

 that results from electricity
Electricity
Electricity is a general term encompassing a variety of phenomena resulting from the presence and flow of electric charge. These include many easily recognizable phenomena, such as lightning, static electricity, and the flow of electrical current in an electrical wire...

 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%. Electrical burns differ from thermal
Burn
A burn is an injury to flesh caused by heat, electricity, chemicals, light, radiation, or friction.Burn may also refer to:*Combustion*Burn , type of watercourses so named in Scotland and north-eastern England...

 or chemical
Chemical burn
A chemical burn occurs when living tissue is exposed to a corrosive substance such as a strong acid or base. Chemical burns follow standard burn classification and may cause extensive tissue damage. The main types of irritant and/or corrosive products are: acids, bases, oxidizers, solvents,...

 burns in that they cause much more subdermal damage. 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
Electric shock
Electric Shock of a body with any source of electricity that causes a sufficient current through the skin, muscles or hair. Typically, the expression is used to denote an unwanted exposure to electricity, hence the effects are considered undesirable....

 to the brain, strain to the heart, and injury to other organs.

Pathophysiology

There are three electrical factors that determine the severity of the damage caused by electrical burns: voltage
Voltage
Voltage, otherwise known as electrical potential difference or electric tension is the difference in electric potential between two points — or the difference in electric potential energy per unit charge between two points...

, amperage, and resistance
Electrical resistance
The electrical resistance of an electrical element is the opposition to the passage of an electric current through that element; the inverse quantity is electrical conductance, the ease at which an electric current passes. Electrical resistance shares some conceptual parallels with the mechanical...

. The severity of the burn also depends on the pathway the current
Current
- Science and Mathematics :* Electric current* Current , including** Ocean currents** Air currents** Current - currents in rivers and streams* Current density, mathematical concept unifying electric current, fluid current, and others...

 takes through the body. Generally, the pathway of the current will follow the pathway of least resistance in the human body - these being firstly blood vessels, nerves, muscle, then skin, tendon, fat, and bone. Most commonly, electric injuries primarily damage the outer limbs, but more critical portions of the body may be affected as well causing severe complications.

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..

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
Lightning strike
Lightning strikes are electrical discharges caused by lightning, typically during thunderstorms.Humans can be hit by lightning directly when outdoors. Contrary to popular notion, there is no 'safe' location outdoors. People have been struck in sheds and makeshift shelters...

 are also a cause of electrical burns, but this is a less common event.
With the advances in technology, electrical injuries are becoming more common and are the fourth leading cause of work-related traumatic death. One third of all electrical traumas and most high-voltage injuries are job related, and more the 50% of these injures result from power line contact.

Electrical Burns can be classified into 6 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.
  • 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
    Electric arc
    An electric arc is an electrical breakdown of a gas which produces an ongoing plasma discharge, resulting from a current flowing through normally nonconductive media such as air. A synonym is arc discharge. An arc discharge is characterized by a lower voltage than a glow discharge, and relies on...

     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 victim’s 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 of pressure. This can throw the victim and cause severe injuries.
  • 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. Electrical current typically passes from one side of the child’s mouth to the other, possibly causing deformity.

First Aid

An electrically burned patient should not be touched or treated until the source of electricity has been removed. Next, the stability of the patient should be determined. Electrical injuries often extend beyond burns and may have induced electric shock
Electric shock
Electric Shock of a body with any source of electricity that causes a sufficient current through the skin, muscles or hair. Typically, the expression is used to denote an unwanted exposure to electricity, hence the effects are considered undesirable....

, which can potentially stop the heart. Once the patient has been stabilized, the burned skin should be soaked in cold water for about 10 minutes. Apply lotions or ointments that will protect the damaged tissue and soothe the pain, and then loosely wrap a sterile gauze bandage
Gauze
Gauze is a thin, translucent fabric with a loose open weave.-Uses and types:Gauze was originally made of silk and was used for clothing. It is now used for many different things, including gauze sponges for medical purposes. When used as a medical dressing, gauze is generally made of cotton...

 around the burn.. Regularly replace the bandages with new ones and apply prescribed medicine as appropriate.

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. Often, the damaged internal tissue demands hospitalization. If not treated, this damaged tissue can cause complications (such as gaseous gangrene
Gangrene
Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies . This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood...

 from dead tissue or loss of blood flow to limbs) and the damaged body parts may need to be amputated.
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
    Necrosis
    Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

    .
  • 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
    Cardiac arrest
    Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...

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


These injuries must be treated in addition to the burns themselves. Burn treatment for severe wounds may require skin grafting
Skin grafting
Skin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft.Skin grafting is often used to treat:*Extensive wounding or trauma*Burns...

, debridement
Debridement
Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue...

, excision of dead tissue, and repair of damaged organs.

Prevention

The following are some basic safety rules for preventing electric injury:
  • Avoid using electrical equipment and appliances while showering or wet.
  • Use child safety plugs in all outlets.
  • Keep children away from electrical cords.
  • Follow manufacturer safety instructions when using electrical appliances.
  • Turn off circuit breakers before making repairs to wiring.
  • Never touch electrical appliances while touching faucets or cold water pipes..

In addition, electricians, power-line repair men, and other industry workers should always follow proper safety procedures.
The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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