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Electrical Burns

Electrical Burns

An electric burn is an injury to the skin that occurs when the body comes into contact with electricity. These burns can be caused by several sources of electricity, such as current in the home, lighting, and stun guns. Electrical burn injuries can be due to clothing that catches fire, current flowing through the body, or arc flash – the heat produced by a certain type of electrical explosion or discharge. With current and arc flash, the body changes electricity into heat, and this results in a thermal burn.  The appearance of an electrical burn doesn’t always indicate the full extent of the injury. Internal organs or tissues may be more badly affected than the skin.

Incidence of Electrical Burns

Four to five percent of all burns seen in medical settings in the United States are electrical. Around 400 deaths each year are due to accidental high voltage electrical injuries, while approximately 1,000 annual deaths in total occur due to electricity. Children usually suffer electrical burns at home, while adults tend to sustain them at work. Furthermore, males are more often injured by electricity than females.

Types of Current and How They Affect the Body

Low-frequency alternating current (AC) results in more extensive tissue damage than high-frequency AC or direct current (DC) do. That’s because low-frequency AC causes ongoing muscle contraction at the site of contact with the source of electricity. The victim is often unable to let go of the object that’s burning them. Since AC is used to power buildings, AC injuries are much more common.

Meanwhile, DC causes one strong muscle contraction that tends to throw the individual away from the source of energy.  The most common examples of this are lightning strikes and making contact with a car battery. The severity of injuries resulting from lightning strikes depends on several factors, including whether the strike was direct or the lightning hit a tree, structure, or something else before it went to the individual’s body.

Voltage

Burns can be either low or high voltage. Voltages higher than 500 to 1000 Volts result in deep burn injuries and extensive damage to organs and deep tissues. On the other hand, exposure to low voltages usually causes less serious injuries. Homes in the US have voltages between 110 and 220. Since the patient often cannot let go, there’s prolonged exposure to the source.  Just 60 to 100 milliamps of low-frequency AC or 300 to 500 milliamps of DC can cause ventricular fibrillation. This is when the heart beats with fast, erratic electrical impulses.

Resistance

Resistance is another factor that affects the nature and severity of an electrical burn. The tissues with the least amount of resistance sustain the most injuries. In the human body, skin has the most resistance, followed by bone, while blood, muscles, and nerves have the least amount of resistance. Since muscles are made up of moist tissues, they have much lower resistance than skin, which is made up of dry tissues.

That being said, skin can have higher or lower resistance based on keratinization, dryness, and thickness. High skin resistance causes more energy to dissipate at the level of the skin. Therefore, the skin burns, and there is less internal damage. Conversely, there may be less noticeable skin injury or no injury at all if the skin has low resistance. More of the electrical energy is transferred to the inside of the body.

Parts of the Body Commonly Damaged by Electricity

The damage caused by an electrical burn can vary from mild to severe. Some of the areas that tend to suffer damage are the:

  • Victims can experience abnormal heart rhythms or go into cardiac arrest.
  • In severe cases, substances from inside the damaged muscle can seep out into the blood in a condition called rhabdomyolysis. Other organs can sustain injuries because of this. Another possibility is that the victim experiences an abnormal build-up of pressure in a muscle group. This is known as acute compartment syndrome.
  • These organs can cease to function normally.
  • Nervous system. Some victims experience muscle weakness or eye or ear damage.

Symptoms of An Electrical Burn

The symptoms associated with an electrical burn depend on how much electricity the body came into contact with and how long that contact lasted. The burn injury also varies depending on which layers of the skin are affected. Superficial burns result in red, dry, and painful skin, and when the burn is pressed, it turns white. These burns affect only the skin’s top layer.

Meanwhile, partial-thickness burns affect the two top layers of the skin. The skin appears red, and it can form blisters or leak fluid. Full-thickness burns affect all the skin’s layers, and the skin can be gray, white, or black. Since the nerve endings are damaged, the victim doesn’t feel any pain. If the internal organs suffered damage, there would be other symptoms.

When to Seek Emergency Attention for An Electrical Burn

Anyone who suffers an electrical burn should seek medical attention right away. As noted previously, sometimes skin damage is minor, while internal injuries are severe. It is especially important to seek emergency care in the case of:

  • Severe burns
  • Difficulty breathing
  • Confusion
  • Seizures
  • Arrhythmia
  • Cardiac arrest
  • Loss of consciousness

While waiting for emergency personnel to arrive, bystanders should:

  • Switch off the source of electricity, if possible, or move the source away using a dry object made from wood, plastic, or cardboard.
  • Start CPR if the person isn’t breathing, coughing, or moving.
  • Try to keep the injured person from becoming too cold.
  • Cover the burned areas with a clean cloth or a sterile gauze bandage. Blankets, towels, and other materials with loose fibers should not be used since they can stick to the burn.

Treating Electrical Burns

 

The treatment of a burn injury depends on the type of burn and how severe it is. Mild burns can be treated by:

  • Cooling the burn by applying a cool cloth or soaking it in water.
  • Covering the burn with a clean bandage and using a cream or ointment to prevent infection and soothe the skin.
  • Treating the pain by raising the injured part above the level of the heart and taking over-the-counter pain medication.
  • Getting a tetanus shot if it has been several years since the last one.

Severe electrical burns are treated with:

  • Special bandages
  • Strong, prescription pain medications
  • Topical antibiotics
  • Surgery
  • Specific interventions based on internal damage

Prognosis

Several factors affect prognosis. These include the direction that the electricity went through the body, the type of current, the duration of exposure, and the voltage and amperage of the electrical source. The resistance of the affected tissues also plays a role here. Deep full-thickness or partial-thickness wounds typically cause scarring. In some cases, other long-term complications include neurological challenges, pinched nerves, and abnormal bone growth in non-skeletal tissues.

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