Electrical burn

An electrical burn is a burn that results from electricity passing through the body causing rapid injury. Approximately 1,000 deaths per year due to electrical injuries are reported in the United States, with a mortality rate of 3-5%. Electrical burns differ from thermal or chemical 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 to the brain, strain to the heart, and injury to other organs.
For a burn to be classified as electrical, electricity must be the direct cause. For example, burning a finger on a hot electric steam iron would be thermal, not electrical. According to Joule's first law: electricity passing through resistance creates heat, so there is no current entering the body in this type of burn. Likewise, a fire that is ruled to be "electrical" in origin, does not necessarily mean that any injuries or deaths are due to electrical burns. Unless someone was injured at the exact moment that the fire began, it is unlikely that any "electrical" burns would occur.
Causes.
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 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 than 50% of these injuries result from power line contact.
Electrical burns can be classified into six categories, and any combination of these categories may be present on an electrical burn victim:
Pathophysiology.
Four electrical factors determine the severity of the damage caused by electrical burns: voltage, current, resistance, and frequency. The severity of the burn also depends on the pathway the current takes through the body. Generally, the pathway of the current will follow the course of the least resistant tissues: firstly blood vessels, nerves, and 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 circuit. 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.
Prevention.
Basic electrical safety.
The following are some examples of unsafe practices which could lead to electric injury (this list is not exhaustive.):
Treatment.
First aid.
An electrically burned patient should not be touched or treated until the source of electricity has been removed. Electrical injuries often extend beyond burns and include cardiac arrhythmia, such as ventricular fibrillation. First aid treatments include assessment of consciousness of the victim, evaluation of pulse and circulation, and treatment of burns.
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 from dead tissue or loss of blood flow to limbs) and the damaged body parts may need to be amputated. Repeated removal of the damaged tissue and extensive rehabilitation are common, while limb amputation rates for victims who experience direct electrical contact can be as high as 75%. Burn treatment for severe wounds may require skin grafting, debridement, excision of dead tissue, and repair of damaged organs.
Rehabilitation.
Electrical burning has an effect on most vital body functions and is accompanied by several other electrical related injuries:
These injuries must be treated in addition to the burns themselves. In very rare instances, a high voltage electric shock can cause cataracts in the lens of the eyes, and detachment of the retina. This may be delayed for some days or weeks after the initial injury.