1. Burn 13 th Lecture Electrical Burn

2. Definition An electrical injury can occur to the skin or internal organs when a person is directly exposed to an electrical current. Electrical burns occur when there is contact with an electricity, either alternating current (AC) or direct current (DC). Electrical injuries represent a special type of thermal injury, with a pathophysiology depending on the voltage, current flow and resistance of the skin. High-voltage electric current has irreversible localized and systemic consequences, with a high percentage of disability.. The effect of the electric current on the body is determined by the following seven factors: 1. type of current; 2. amount of current; 3. pathway of current; 4. duration of contact; 5. area of contact;

3. 6. resistance of the body; 7.voltage. the severity of an injury is proportional to the intensity of current that flows through the tissue. Considerations The outcome of an electric shock to an individual depends on 1-The intensity of the voltage to which the person was exposed, 2-The route of the current through the body, 3-The victim's state of health, and 4-The speed and adequacy of the treatment. Electric current can cause injury in three main ways: Cardiac arrest due to the electrical effect on the heart. Muscle, nerve, and tissue destruction from a current passing through the body.

4. Thermal burns from contact with the electrical source. Symptoms Symptoms may include: Skin burns Numbness, tingling Weakness Muscle contraction Muscular pain Bone fractures Headache Hearing impairment Seizures Heart arrhythmias Cardiac arrest Respiratory failure Unconsciousness First Aid 1. If safely possible, shut off the electrical current. 2. Call for medical help. 3. If the current can't be turned off, use a non-conducting object, such as a broom, chair, rug, or rubber doormat to push the victim away from the

5. source of the current. Don't use a wet or metal object. 4. Once the victim is free from the source of electricity, check the victim's airway, breathing, and pulse. If either has stopped or seems dangerously slow or shallow, initiate first aid (CPR).CPR 5. If the victim has a burn, remove any clothing that comes off easily, and rinse the burned area in cool running water until the pain subsides. Give first aid for burns. 6. If the victim is faint, pale, or shows other signs of shock, lay the victim down, with the head slightly lower than the trunk of the body and the legs elevated, and cover the person with a warm blanket or a coat.shock 7. Stay with the victim until medical help arrives. 8. Electrical injury is frequently associated with explosions or falls that can cause additional traumatic injuries, including both obvious external injuries and concealed internal injuries. Avoid moving the victim's head or neck if a spinal injury is

6. suspected. Administer appropriate first aid as needed for other wounds or fractures. Do Not DO NOT touch the victim with your bare hands while the person is still in contact with the source of electricity. DO NOT remove dead skin or break blisters if the victim has acquired burns. DO NOT apply ice, butter, ointments, medications, fluffy cotton dressings, or adhesive bandages to a burn. DO NOT touch the skin of someone who is being electrocuted. DO NOT get within 20 feet of someone who is being electrocuted by high-voltage electrical current until the power is turned off. DO NOT move a victim of electrical injury unless there is immediate danger. What are the symptoms of shock? The following are the most common symptoms of shock. However, each child may experience

7. symptoms differently. Symptoms of shock may include: Cold sweat Weakness Irregular breathing Chills Pale or blue-colored lips Pale or blue-colored fingernails A fast, but weak pulse Nausea Treatment The treatment of electric injuries has to be very careful because of the specific effect on nonviable tissue covered by healthy uninjured skin. Considerable alterations occur in the microcirculation, with the loss of endothelial integrity and the trapping of large volumes in the extravascular space, leading to massive oedema and decreased circulation in the injured limb. Immediate and adequate fluid resuscitation is therefore essential. The volume of resuscitation fluid may be very large and unpredictable.

8. Early necrectomy, extensive debridement and even amputation when the injury was massive were necessary. Fasciotomy and neural decompression were necessary on the dorsal and volar aspects of the arm or lateral aspects of the leg. Exposed nerves and tendons were covered with allografts until flap coverage was provided.