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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.
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.
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.
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 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.
The damage caused by an electrical burn can vary from mild to severe. Some of the areas that tend to suffer damage are the:
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.
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:
While waiting for emergency personnel to arrive, bystanders should:
The treatment of a burn injury depends on the type of burn and how severe it is. Mild burns can be treated by:
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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