ELECTRICAL BURNS
Written by Rhiana Devadasan
Electrical injuries = cellular damage due to electrical current.
How?
The passage of current through a solid conductor results in conversion of electrical energy to heat, thus resulting in burns. (NB: Exposure to electricity is only harmful if there is a contact point of entry & a discharge point through which the current leaves the body)
Determinants:
- The voltage
- The resistance of the tissues in the pathway of the current
TYPES:
- High-voltage electrical injuries vs. Low-voltage electrical injuries
- Local vs. General
TREATMENT:
- DO NOT touch the patient if they’re still in contact with electrical current source.
- Immobilize any fractures
- Conduct an ECG & keep monitoring
- Perform a chest x-ray
- Perform a neurological examination
Effects:
- CV effects
- Direct necrosis of the myocardium
- Cardiac dysrhythmias
- Lead to cardiac standstill and ventricular fibrillation, sinus tachycardia
- Cutaneous effects
- Kissing burns – occur at the flexor creases as the electrical currentmarcs causing arc burns on both flexor surfaces.
- Extensive underlying tissue damage often present.
- CNS effects
ACUTE CNS EFFECTS
- Respiratory arrest, seizures, mental status changes, coma, amnesia, quadriplegia and localized paresis.
- Current through skull → coagulation of brain parenchyma, epidural and subdural hematomas and intraventricular haemorrhages.
LATE CNS EFFECTS
- Paralysis, transverse myelitis, amyotrophic lateral sclerosis.
- Compartment syndrome
- Loss of intravascular fluid leading to increased interstitial pressure of the compartment
- Signs: pain, pallor, paresis and weak pulse.