First aid for electric burns

The article was professionally consulted by Specialist Doctor II Tran Van Trong - Specialist in Pediatric Surgery, Plastic Surgery - Aesthetics - Department of General Surgery - Vinmec Danang International Hospital.

Electric burns are a type of severe burns, if fire burns and boiling water burns cause damage to the skin from the outside to the inside, then electric burns cause deep burns from the inside out. When the body is transmitted by an electric current, it will cause systemic or local pathological lesions.

There are two types of injury when electrical burns, including:
Burns caused by electric sparks: sparks usually have a very high temperature, ranging from 3200-48000C, the re-effect time is very short, only about 0.2-1 ,5 seconds. 80% of the radiant heat and light of an electric spark is an infrared beam, which is capable of causing superficial burns, body burns directed towards the spark, or burns to open parts of the body. If burned by high voltage over 1000 volts can cause deep burns or dermal burns.
Burns caused by conduction currents into the body: when being conducted by electrical currents into the body, it can cause local injuries (burns), or systemic damage such as respiratory arrest, cardiac arrest and electric shock. One of the phenomena of electrical burns with a high voltage of millions of volts is a burn caused by lightning.

Some of the main causes of electrical burns include:
Contact or close proximity to high-voltage power lines Exposure to broken power lines, downed power poles Listening to the phone next to high-voltage lines Being struck by lightning

Unlike other types of burns, electrical burns do not cause red patches of skin burning or blisters, instead, black spots of skin at the site of the passage of electricity. After only a few days, the area of ​​​​the skin that has passed the current will slowly die off.

The extent of electrical burns will depend on several factors:
Direct current or alternating current Voltage of current: high or low Amperage as it flows through the body Resistance of body tissues Time electric current through the body line through the body electric current passing through the brain and heart is often dangerous to life high voltage electric current: 1000-50000 volts. When an electrical current passes through the body, it will follow the path with the least resistance. When an electrical current passes through the body, it encounters parts with high resistance such as skin or bone, the electrical energy will then turn into heat (according to the law of Joule-Lenz).

Injury to the whole body: The greater the electric power, the stronger the stimulation to the centers that regulate the respiratory circulation, the autonomic nervous system and the central nervous system. This leads to strong inhibition and causes acute disturbances to vital organs in the body. There are 4 levels of acute pathological disorders, including:
Mild: consciousness is intact but muscles have been contracted Moderate: muscles are strongly spastic. If the location where the electric current passes through the person is far from the ground, the victim can be shot by electric shock and fall to the ground, causing injury and loss of consciousness Severe: in addition to losing consciousness, the person with electric burns can have a heart rhythm disorder (ventricular fibrillation) or a breathing disorder (respiratory arrest). Very severe: the victim may fall into a state of clinical death. Even death from ventricular fibrillation, cardiac arrest or respiratory arrest. If the person with an electrical burn is given first aid in time and the extent of the bodily injury is not too serious, the victim will be able to get rid of the above conditions and enter the period of burn disease with the following general characteristics: :
Burn shock, acute renal failure, urine containing hemoglobin and myoglobin. Toxic, severe infection Bleeding secondary to anemia Acute gastrointestinal ulceration Burn deterioration Rapidly developing Movement, sensory or mental disorders following a burn Local injury: Local injury from electrical burns usually manifests at the entry and exit points of the electrical current. Common sites such as feet and hands. Children can get electric burns to their lips, mouth or tongue from sucking on the electrodes. The higher the resistance, the stronger the amperage, in addition, the longer the duration of the current with the body, the deeper and wider the local damage.
Local lesions from electric burns are usually round, oval-shaped necrotic patches of yellow opaque or charred, dark gray skin. In the early stages of an electrical burn, it is difficult to accurately diagnose the depth of the burn.

In addition, the fascia, muscle, and tendon layers may also become necrotic. For areas of the frontal bone or skull bone can be perforated and bone necrosis, leading to meningitis. Vascular damage to the extremities causes secondary bleeding and nerve damage causes paralysis. Even more seriously, the entire limb is charred or necrotic, which may require early amputation.
Electrical burns can also cause secondary necrosis of tissues arising from thrombus formation in the lumen of vessels, occlusion of blood vessels and damage to the vessel wall. In the first time, the burn will have a certain limit, a few days later, the damaged area is at risk of ischemia, and the muscles and tendons are secondary necrosis.
Electrical burns often have local complications and when cured can leave disabling sequelae.

Do not touch the victim while they are still exposed to the electric current: First, you need to turn off all electrical appliances or the main power in the house to prevent the current from continuing to pass through the victim's body. In the event that the power cannot be cut off immediately, you should stand on a dry surface and use a wooden stick to push the victim away from the power source. Never use metal objects or wet objects, as they are easily electrified, making you also susceptible to electric shock.
Do not move the victim unnecessarily: After separating the victim from the current, try not to move them to another location unless absolutely necessary.
Check if the victim is responsive: after being electrocuted, the victim may become unconscious, or not respond at all when you touch or talk to them. In case the victim stops breathing, you need to perform CPR and CPR immediately.
Call for emergency: when the victim does not respond, or is burned by high-voltage power lines, due to lightning strikes. Or the person in distress has signs of severe burns, heart palpitations, cardiac arrest, convulsions, is still awake but has difficulty moving or balancing, has problems with vision, hearing, muscle cramps , shortness of breath.
Ways to treat an electrical burn while waiting for medical help: you should use a dry and sterile dressing to cover the electrical burn. In the event of a severe electrical burn victim, do not attempt to remove the pieces of clothing that are stuck to the victim's skin, instead, you can use scissors to gently cut off the clothing that is not attached to the burned skin. You should also not use a towel or blanket to cover the burn because the fibers can come off and stick to the wound, making the burned area worse. Never try to cool an electrically burned area with ice cold water and do not apply grease on it.
Monitor victim's symptoms: symptoms after an electrical burn may include chills, pale skin, rapid pulse. You should monitor continuously if the victim shows any symptoms, this is very helpful in the healing process of the burn.
Keep the victim warm: you should try to keep the victim warm while you wait for help, as it can make the symptoms of shock worse. You can cover the victim with a blanket or shirt, but be careful not to cover the burn.
Dr. Trong has over 10 years of experience in Pediatric Surgery and Plastic Surgery - Aesthetic, and soon became one of the leading doctors in the field of Children's Surgery, especially Laparoscopic Surgery. and Plastic Surgery - Aesthetic.

Reference source: Mayoclimiv.org