Electrical Burns, Types, Management, Treatment Guidelines

They are burns which result when electricity passes through the body. Unlike other burns electrical burns cause more subdermal damage. They may cause surface damage but normally tissues underneath the skin experience severe damages. Due to the electric burns cannot be diagnosed accurately hence people may underestimate their severity. In the United States around 1000 deaths yearly are caused by electrical injuries. Extreme electrical burns cause brain shock, heart strain and severe injuries to other body parts.

For a burn to be classified as electrical, electricity must be the direct cause. Burns resulting from electrical appliances like an iron box, kettle are thermal burns. Also, burns caused by fire resulting from electric fault are not an electric one.

The severity of electrical burns is determined by; current, frequency, resistance and voltage. It also depends on pathway taken by the current through the body. Normally current in the body will flow though less resistant tissues. That is first blood vessels, nerves, muscle, skin, tendon fat and then bones.

When the body comes into contact with electric current, it becomes a part of the circuit. The current will have an entry and exit point on the body. The entry point tends to be more depressed whereas the exit is extensive and explosive. Due to this, it is only the two points which are visible hence hard to determine internal damage.

Electrical burns are determined by the following factors;

• The type of current,
• Amount of current,
• Pathway of current,
• Duration of contact,
• Area of contact,
• Resistance of the body

Electrical Burns Occur Principally Because of

Electrical burns can be caused by either grasping or touching electrical live objects. Examples are coming into contact with electrified water, short-circuiting and inserting fingers in in electrical sockets.  There are minimal cases where electrical burns are caused by lightning strikes. Advancement in the technology field has led to more electrical injuries. They have been ranked as fourth cause of traumatic deaths. Approximately 33% of electrical traumas and high-voltage injuries happen at workplaces. 50% of electrical burns are as a result of contact with a power line.

The following are categories of electrical burns; a victim could have any of the combinations

• Low-voltage, it is produced when one comes into contact with 500 or fewer volts. Current present in up to 500 volts cannot cause tissue damage. Low-voltage burns are normally superficial or mild. At times they may be severe depending on the time of contact with the source.
• High voltage, it is a very severe burn which occurs when one is in direct contact with the high voltage supply. Exterior injuries will often mislead because severe injuries are under the skin. This type of burn leads to severe damage of the tissues.
• Flash burns, they occur when electrical arcs pass over the skin. Electrical arcs have intense heat and light which can cause severe burns in a short time. The burns are shallow. The tissue beneath is not affected. Flash burns are caused by Alternating current frequency higher than 50 or 60 Hz used in land-based electrical circulation systems.
• Flame burns, they occur when one comes into contact with object ignited by an electrical source.
• Oral burns occur when one sucks or bites electrical cords. It usually affects kids. The current passes from one side of the kid’s mouth to the other causing defect.
• Arc burns. They occur when an electric current passes through high resistance area to low one. Arc burn does not require any contact. The electricity will ionize air particle to complete the circuit. This generates heat which may be as high as 4000⁰ This amount of heat is hot enough to vaporize a metal and catch the victim’s clothes fire. It can throw and cause severe injuries to the victim.

 Electrical Burns Treatment

Remove or stop the source of current- before any action. DO NOT touch the victim while he/she is in contact with the source as it can affect other people.

First aid treatments for the patient include valuation of consciousness, pulse, and circulation among others. Due to the fact that the patient may have severe internal injuries it is advisable to take him/her to the hospital for recognition.

In most cases, patients with electrical burns show minimal effects on the skin with internal injuries being severe. Damaged tissues require hospitalization of the patients. Failure may lead to more complications making the parts require amputation. The treatment may require debridement, excision of dead tissues, and repair of damaged organs or skin grafting.

Effects of Electrical Burns

As discussed above there are a number of factors that determine electrical burns hence the effects will differ. Depending on the time of contact and current effects will vary from muscular contraction to respiratory paralysis and ventricular fibrillation. Example, a current more than 1000mA causes myocardial contractions. Respiratory and ventricular fibrillation are caused by current between 50-100mA.The skin offers great resistance to direct than alternating current.

Electric injuries, burns, are as a result of abnormal electrons flow through the body and may have one of two effects:

• Depolarization of nerves and muscles causing abnormal electrical pulses in the heart and brain
• The production of an internal or external electrical burn both by heating and by producing holes in cell membranes

Health complications due to the above-named effects are numerous. They affect many body systems and range in severity.

Cardiovascular (Heart) Complications

• Abnormal irregular heart beat due to fast, uncoordinated fluttering contractions of the ventricles may result to inadequate pumping of blood; this can lead to heart arrest and death.
• Heart complications occurs with low voltage alternating current or lightning
• Direct myocardial lesion by joule effect, a rise in tissue temperature, can be visible. It commonly leads to damage to myocardial contusion by the shock waves
• Blood clotting, or thrombosis, in the coronary or minor arteries may occur.

Nervous Effects

• Labyrinth damage and tympanic membrane rupture can lead to balance impairment. Electrical burn causes an inner ear dysfunction called Labyrinth damage. Eardrum puncture is the most common complication.
• Retinal detachment and potential cataracts
• Low voltage and lightning might also lead to loss of consciousness.

Other effects include;

• Limb fractures and involuntary contraction of muscles,
• Damage to blood vessels,
• Forceful propulsion of body
• Detachment of the retina and
• Cataracts in the eye lenses.

Days or weeks after the injury, one may have cataracts or detachment of the retina.

How to Prevent Electrical Burns

There are a number of ways on how to prevent electrical burns. However, they cannot cover all possible scenarios.

• Avoid coming into contact with electricity or using appliances with wet hands.
• Using safety plugs and keeping kids away from electrical cords.
• Cover all mains outlet to avoid any accidental touching.
• Switching off electricity source before repairing any faulty areas
• Disconnecting electrical appliances from the source before you start repairing them,
• Installation of circuit breakers,
• Allowing qualified electricians repair connections and appliances,
• Replacing high-risk appliances with ones that are less riskier.
• Use of appliances with insulators.

Those are some of the precautions to observe so as to avoid electrical burns. It is important to be careful every time we handle electricity connections and appliances.  Seeking medical help immediately after electrical burns is very important.