Trystan Casey
Electrical burns are a complex form of trauma that can lead to high morbidity and mortality. The severity of the injury depends on the type of current, voltage, and resistance. Electrical burns can be caused by touching electrical wiring, lightning strikes, or even falling into electrified water. Electrical burns can be classified into low-voltage and high-voltage burns. Low-voltage burns are caused by contact with 500 volts or less and usually only affect the epidermis. High-voltage burns, on the other hand, are much more severe and occur when a person comes into direct contact with high voltage, causing substantial internal damage. Other categories of electrical burns include arc burns, flame burns, flash burns, and oral burns.
| Characteristics | Values |
|---|---|
| Types | Electrical burns, arc burns, thermal contact burns, flash burns, flame burns, lightning burns, true electrical injuries, oral burns, low-voltage burns, high-voltage burns |
| Causes | Touching electrical wiring or equipment, arc blasts, electrical fires, lightning strikes, biting or sucking on electrical cords, short-circuiting, inserting fingers into electrical sockets, falling into electrified water |
| Severity | Varies depending on the voltage, current type, resistance, area of skin exposed, and type of clothing worn. High-voltage burns are more severe and cause substantial internal damage. |
| Symptoms | Skin burns, cardiac or respiratory arrest, altered mental status, seizures, loss of consciousness, focal neurologic deficits, muscle contractions, numbness, tingling, balance issues, red or red-black urine, shortness of breath, unconsciousness |
| Treatment | First aid: shut off the electrical current, call for emergency services, examine for bleeding. Medical treatment: pain medication, surgery, treatment for internal trauma, topical aloe vera or antibiotic ointments |
| Prevention | Stay away from downed power lines, use proper clothing and work distances, avoid electrical cords near water, teach children about electrical dangers, use outlet covers |
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What You'll Learn
Low-voltage electrical burns
Electrical burns are a complex form of trauma that is often associated with high morbidity and mortality. The severity of electrical burns depends on the voltage of the electricity, the amount that came into contact with the body, and how long the contact lasted.
Low-voltage electric currents that pass through the body usually have reversible effects. For a 1-second contact time, a current of 10-15 milliamps causes sustained muscular contraction, while 50-100 milliamps can result in respiratory paralysis and ventricular fibrillation. However, prolonged contact with a low-voltage source can lead to many devastating injuries, including cardiac or respiratory arrest, arrhythmias, and seizures.
The severity of low-voltage electrical burns also depends on the pathway the current takes through the body. The current will generally follow the course of the least resistant tissues, which include blood vessels, nerves, and muscles. As a result, low-voltage burns can cause small deep burns that may involve vessels, tendons, and nerves. These injuries often exhibit minimal external signs of thermal damage to the skin but demonstrate extensive muscle and nerve injury.
To prevent low-voltage electrical burns, it is important to use proper clothing, maintain safe work distances, and ensure overcurrent protection. Additionally, children should be kept away from electrical cords to prevent them from biting or chewing on them, as this can cause serious injuries.
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High-voltage electrical burns
High-voltage electrical injuries are a serious form of trauma that often leads to high morbidity and mortality. They are caused by contact with a live electrical source with a voltage greater than 500V to 1000V. The severity of these injuries depends on the voltage, the type of current (AC or DC), and the duration of contact. High-voltage shocks are more likely to result in death.
High-voltage electrical injuries can cause both external and internal damage. Externally, high-voltage electrical burns can cause deep, full-thickness burns that are indented and yellowish-grey in colour. These burns are often painless and may be accompanied by central necrosis. Flashing high-voltage injuries, caused by an electric arc or spark, can reach temperatures of up to 2500°C, leading to devastating full-thickness burns. Additionally, the pressure wave from a high-voltage arc blast can cause serious ear damage, memory loss, and physical injuries by throwing the victim away from the arc.
Internally, electrical burns can impact organs such as the heart, which may experience irregular rhythms or even cardiac arrest. Other potential symptoms include confusion, dizziness, headache, muscle contractions, numbness, tingling, balance issues, and red or red-black urine. In the case of a high-voltage injury, Creatinine kinase levels should be measured as they can predict the extent of muscle injury, amputation risk, mortality, and hospital stay duration.
High-voltage electrical injuries require immediate medical attention. If you encounter someone who has suffered an electrical burn, do not touch the victim or the electrical source to avoid injuring yourself. If possible, shut off the electrical current and call for emergency medical services. If you cannot turn off the power source, use a non-conductive object like dry wood to move the victim away from the circuit. Keep the victim warm and elevate their legs if they are showing signs of shock.
High-voltage electrical injuries are often the result of contact with overhead high-voltage power lines or lightning strikes. In the United States, approximately 400 deaths per year are attributed to high-voltage electrical injuries, with lightning causing 50 to 300 of these fatalities. These injuries are a significant concern, particularly in occupational settings and for children at home.
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Arc burns
Arc blasts, a form of arc burn, can produce a considerable pressure wave blast, which can throw the victim away from the arc blast and cause severe physical injury. The pressure wave can also propel large objects over great distances and has enough force to snap off the heads of steel bolts and knock over walls. Additionally, a high-voltage arc can cause copper and aluminium components in electrical equipment to melt, and these molten metal droplets can be blasted by the pressure wave, causing serious burns or igniting clothing.
Flash burns are a specific type of arc burn caused by electrical arcs that pass over the skin. While these burns can cover a large area, they are typically superficial and do not penetrate underlying tissues. However, the intense heat and light of an arc flash can cause severe burns in a fraction of a second.
If someone has sustained an arc burn, it is crucial to prioritise their safety and well-being. Call for emergency medical assistance and ensure that the electrical current is no longer flowing through the victim before approaching them. If they are conscious, instruct them not to move, as they may have sustained serious injuries without realising it. Examine the victim for signs of major bleeding, and if present, apply pressure to the wound using a cloth or elevate the injured area if it is an arm or leg. It is important to stay with the victim and keep them warm while waiting for emergency services to arrive.
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Flame burns
The severity of flame burns depends on the voltage of the electricity, the amount of contact with the body, and the duration of contact. High-voltage electrical injuries, caused by contact with overhead high-voltage power lines, can result in severe internal damage and organ failure. On the other hand, low-voltage electrical injuries, often caused by children biting into electrical cords, usually result in milder external burns.
Proper clothing, work distances, and overcurrent protection can help reduce the risk of flame burns. It is important to remember that the outward appearance of an electrical burn may not reflect the true extent of the injury, as internal tissues and organs may be more severely affected. Therefore, it is recommended to seek medical attention and consult a professional for treatment.
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Oral burns
Electrical burns are a complex form of trauma that is often associated with high morbidity and mortality. The severity of the injuries depends on the type of current, the voltage, and the resistance. Electrical burns are the most common type of burn caused by electricity, along with arc burns and thermal contact burns.
Oral electrical burns are the most common electrical injury in children and can have serious long-term functional and aesthetic consequences. These burns can occur when children bite into electrical cords, resulting in lip, face, and tongue injuries. In such cases, a multidisciplinary approach is required, involving pediatric dentistry, plastic/burn surgery, and oral and maxillofacial surgery. The use of a microstomia prevention device is critical to achieving superior functional and aesthetic results. The proper timing and sequencing of treatment are also crucial in managing oral electrical burns.
Oral electrical burns can also occur in adults, although they are less common. These burns can result from contact with high-voltage power lines or accidental exposure to electrical currents in the workplace. In adults, oral electrical burns are often associated with significant trauma and complications.
The treatment of oral electrical burns involves addressing both the burn itself and any underlying electrical injury. It is important to shut off the electrical current if the victim is still in contact with it and to call for emergency medical services. Once the current is shut off, it is safe to approach the victim and assess their condition. If the burn is deeper than the top layer of skin, topical treatments such as aloe vera, petroleum jelly, or antibiotics may be applied to prevent infection. However, it is important to avoid using home remedies such as butter, egg whites, or toothpaste, as these may cause infection.
The severity of oral electrical burns can vary depending on the voltage, the duration of contact, and the resistance of the tissues involved. High-voltage electrical injuries can cause serious damage, including memory loss, ear damage, and physical injuries due to the pressure wave blast. Low-voltage electrical injuries, on the other hand, may produce less severe burns but can still result in nerve damage and long-term complications.
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Frequently asked questions
Electrical burns are burns sustained when a person comes into contact with an open current of electricity. Electrical burns can be caused by touching electrical wiring or equipment that is used or maintained improperly.
There are three types of electrical burns: electrical burns, arc burns, and thermal contact burns.
Arc burns occur when an electrical current passes from a high-resistance area to a low-resistance area. No actual contact is needed with the person or object for an arc burn to occur.
Thermal contact burns occur when electricity starts a fire, including when explosive materials are in the air.
Other types of electrical burns include flash burns, flame burns, lightning burns, oral burns, and high-voltage and low-voltage burns.
