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Electrical Burns

Definition

Electrical burns occur when a person is directly exposed to an electrical current. Although some electrical burns look minor on the skin, they can cause extensive internal damage, especially to the heart, muscles, or brain. This is a potentially serious condition that requires care from a doctor.
Classification of Skin Burns
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Causes

Electrical burns result from accidental contact with exposed parts of electrical appliances or wiring, such as:
  • Children biting on electrical cords
  • Poking utensils or other metal objects into electrical outlets or appliances, like a plugged-in toaster
  • Failing to shut the power supply before making home repairs or installation
  • Dropping a plugged-in appliance into water
  • Occupational accidents due to, for example, electric arcs from high-voltage power lines. (Electric arcs occur when a burst of electricity jumps from one electrical conductor to another, such as flashes of electricity from the wheels of an electrically powered train or where a trolley car connects to an overhead power line.)
  • Lightening strikes

Risk Factors

Any exposure to an electrical current is a risk factor for electrical burns.

Symptoms

Electrical burns may cause:
  • Visible burns on the skin
  • Muscle contraction or pain
  • Numbness or tingling
  • Weakness
  • Bone fractures
  • Headache
  • Feeling disoriented
  • Low blood pressure
  • Seizures
  • Heart arrhythmias
Electricity can also cause cardiac arrest, respiratory failure, and/or unconsciousness.

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam.
Like other burns, electrical burns have 3 degrees of severity, each with distinctive symptoms:
  • First-degree burns—Injury is only to the outer layer of skin. They are red and painful, and may cause some swelling. The skin turns white when touched.
  • Second-degree burns—These burns are deeper and more severe. They cause blisters and the skin is very red or splotchy. There may be more significant swelling.
  • Third-degree burns—These cause damage to all layers of the skin down to the tissue underneath. The burned skin looks white or charred. These burns may cause little or no pain because the nerves in the skin are destroyed.
It may be more difficult to diagnosis damage under the skin caused by electricity. Tests may include:
  • Electrocardiogram (EKG)—to detect rhythm disturbances of the heart
  • Urine or blood tests—to check for severe damage to muscles

Treatment

Electrical burns require an immediate call to emergency medical services. If possible, shut off the electrical current from its source (such as unplugging a cord or turning off the circuit breaker). Often, simply turning off the appliance itself will not stop the flow of electricity.
If the current can't be turned off, use a nonconducting object, like a wooden broom, chair, rug, or rubber doormat to push the victim away from the source of the current. Don't use a wet or metal object. If possible, stand on something dry and non-conducting, such as a mat or folded newspapers.
Do not attempt to rescue a victim near active high-voltage lines.
Once the victim is free from the source of electricity, check airway, breathing, and pulse and, if needed, start cardiopulmonary resuscitation (CPR) efforts. The victim is covered with a blanket to maintain body heat and feet are raised above the head.
Ice, butter, or ointments, should not be applied.
Anyone with an electrical burn should be taken to the hospital for further evaluation. Treatment will depend on the severity of the burn and any other associated complications.

Prevention

To help reduce your chances of an electric burn, take the following steps:
  • Use child safety plugs in all outlets.
  • Keep electrical cords out of children's reach.
  • Avoid electrical hazards by following manufacturer's safety instructions when using electrical appliances. Always turn off circuit breakers before making repairs to wiring.
  • Avoid using electrical appliances while showering or wet.
  • Never touch electrical appliances while touching faucets or cold water pipes.
  • Avoid being out in lightening storms.

RESOURCES

Burn Prevention Network http://www.burnprevention.org

Safe Kids Worldwide http://www.safekids.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Healthy Alberta http://www.healthyalberta.com

References

Browne BJ, Gaasch WR. Electrical injuries and lightning. Emerg Med Clin North Am. 1992;10:211.

Cawley JC, Homce GT. Occupational electrical injuries in the United States, 1992-1998, and recommendations for safety research. J Safety Res. 2003;34:241.

Cooper MA. Electrical and lightning injuries. Emerg Med Clin North Am. 1984; 2:489.

Electrical injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 26, 2013. Accessed November 3, 2014.

Fire safety. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/firstaid%5Fsafe/home/fire.html. Updated July 2011. Accessed November 3, 2014.

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