11. First Aid for Electrical Shock


Today we will understand what electric injuries are, how they occur, how severe they are, electric shock and safety

measures when approaching the victim. We also will go over the first aid in such cases. Electric trauma is a sudden pathological condition caused by an electric current or an electric arc. In general, trauma statistics, electrical injuries are one of the most severe, accounting in 1-2.5 percent of all accidents. Up to 20-30 percent of electric shock injuries end in death. Electric injuries are widely observed in the industry, agriculture, transport, and household. Wires of telephone, radio, and television accidentally connected to power lines may also be sources of electric trauma. The most dangerous cause, atmospheric electricity or lightning also usually happens.

The negative factor is an electric current whose damage in properties are determined by force, voltage, type, and frequency. Most dangerous to humans is the voltage above 36 volts and current greater than 0.1 ampere. Fatal electric shocks occur at current strength greater than 0.1 ampere, voltage 110 volts. The frequency of 50 hertz is considered the most dangerous. At a voltage of 500 volts, alternating and direct currents are equally dangerous. In domestic networks, we use alternating current from 6-25 amperes with voltage 220 volts. These indicators are relatively high and can cause severe physiological violations up to clinical death. In everyday life, most often victims are children who have access to sockets, switches, and wiring. Electric shock occurs as a result of direct contact with the conductors. Furthermore, there is the chance of damage through an electric arc due to high voltage and the air's ionization between the person and the power source. At a current of 15 milli-amperes, an explosive contraction of muscles occurs. It bounces from the victim to the source of electrical energy. However, the chain and effect is also possible at lower current values. Fatal electric trauma typically occurs at a current of more than 100 milli-amperes.

Electricity spreading through the body's tissues from the entrance to the exit point forms the current loop. Less dangerous is the lower loop from leg to leg. More dangerous, the upper loop from hand to hand, and the most hazardous for life a full W-shaped loop passing a third of the whole body. In the latter case, the electric current passes through the heart, usually accompanied by severe heart activity disorders. Subjective sensations in electric trauma are quite diverse; a slight push, burning pain, convulsive muscle contraction, etc. After the current's termination, the victim usually feels a weakness, a feeling of gravity in the whole body, fear. There is an oppression of consciousness or excitement. Electric current acts locally damaging tissues in the places of passage and also has a general impact on the whole body. Local tissue lesions are manifested in different ways.

For example, they can be so-called current signs or marks; electrical burns, and electric metallization of the skin. Current marks are detected at the point of current input and output. Electric burns can be located on the skin in the place of electric shock due to exposure of high temperatures up to 2500 degrees Celsius. Also, there may be additional skin burns in the case of the victim's clothing that caught fire. Electric burns are almost always deep.

At first glance, it is difficult to determine the prevalence of electric shock because most of the damage is deep in the muscles. So all victims with electrical burns should be taken to the hospital. Skin metallization is also a local manifestation of electric trauma. It results from the introduction into the epidermis and dermis of the tiniest metal particles of an electric conductor molten under the current influence. Electric shock can do severe general damage to the organs. The electric shock can lead to seizures, affect heart rate, and breathing disorders. In extreme cases, the electric shock results in death. There are cases in literature, where the victim seems to be in good condition and within an hour after electric shock, they suddenly die most likely due to cardiac arrest.

In some cases, the so called imaginary death develops. A state in which there is no consciousness, heart contractions are rare, and difficult to determine, breathing is superficial and infrequent. There is extreme oppression of essential vital functions. Despite external similarities, such a state, is not a clinical death. The symptoms observed can be reversed even after a reasonably long time. Therefore, it is customary to assist an electric trauma, including CPR, up to the appearance of death or rigor mortis.

If CPR is correct, chances for rescue are relatively high even after a long period. Due to the most violent muscle contractions resulting from a current, you can observe muscle ruptures, fractures, or bone dislocations. Often electrical injury occurs during construction work leading to a fracture and other damage due to force after an electric shock. There are four degrees of electric trauma severity.

First degree, tonic contraction of the muscles prevails. Consciousness is present, after release from the current influence, there are retardation or excitation, pale skin, shortness of breath, tachycardia, increased blood pressure, and expressed pain syndrome. The skin may have current or burn marks.

Second degree, blood pressure is unstable, a tendency to arterial hypertension. In other cases, there is an oppression of consciousness, but no more than 15-20 seconds. Respiratory and cardiac activity is not impaired.

Third degree, manifested by cardiac dysfunction in the form of arrhythmias, decreased blood pressure, respiratory failure due to laryngospasm. Laryngospasm is a condition that occurs in compression, spasm of the larynx muscle which results in a narrowing or complete closure of the vocal opening.

Fourth degree, ventricular fibrillation or clinical death. Local injuries at the point of current input and output, different degrees of burns. When providing first aid resulting from an electrical injury, the timeliness and compliance with mandatory but straightforward rules, are of great importance.

For now, let's start from the first aid in case of electric shock, in domestic conditions at home, or at work, where the voltage is 220, 380 volts. If you see the victim, check your safety. Before touching the victim, you have to disconnect the current. The most reasonable thing, is to quickly drop wires from the victim's body with any non-conductive object. For this purpose, a dry board or stick, dry cotton cloth, a glass bottle, a few paper sheets, such as a raw magazine, are suitable. After the victim can be pulled away from a dangerous source. However, you need to hold the dry cloth with one hand without touching his skin, and avoiding touching metal zippers, reverts, and clasps. Sometimes it is easier and more reasonable to cut the power.—But remember, if you’re in the dark and can’t see, this may cause additional problems. Suppose the victim is under stress, and is in a puddle of water, or on the wet ground. In that case, it is necessary to approach the victim in a particular way, not to create “step tension”.

It is essential to walk in small steps, and rearrange the feet, not to break away from the other, so that no electric arc is created between the legs. In case of wire ignition, do not put out a fire with water. Use sand, or cover with a thick cloth to extinguish the fire. Remember, you can touch and assist the victim only after removing him from an electrical current. If the victim is unconscious, open the airway and check his breathing. If there is no consciousness and breathing, immediately begin CPR. If consciousness is absent, and breathing is maintained, it is necessary to put the victim into a stable lateral position and call an ambulance. Electrical trouble may also cause damage to soft tissues and develop bleeding. In this case, you have to determine the type of bleeding and stop it as learned in previous videos.

If the electrical injury resulted in a burn, apply dry sterile bandages to current marks area. Do not peel off sticky cloth. In fractures and sprains, your main aim is to create the damaged limbs immobility, if you plan to transport the victim yourself. In all cases of electrical injuries, with the cardiac dysfunction and loss of consciousness, there is a possibility of repeated cardiac arrest. In that case, the urgent hospitalization of the victim is required. Electric shock can occur during working with high-voltage wires, which is a significant risk to life. Special training, knowledge and equipment, are required to handle such cases. Do not touch or remove the wires with homemade equipment. Even objects that are usually considered safe, branches, wooden sticks, hemp ropes can carry electric current. Even firefighter gloves and boots will not be able to protect in such situation.

Therefore, in the event of a high voltage electric shock, immediately call special services and an ambulance. Your safety is a priority. Lightning strikes are also common. Many people die every year as a result of these natural phenomenon. Lightning strike brings short-term less than 100 milliseconds formation of electric discharge, or for very high voltage, more than 10 million volts and current, more than 2,000 Amperes. Damage may occur even if the lightning strike did not get directly to the person. It can strike a nearby object or a ground and injure a person. A lightning strike forms when the typical skin burns resembling a fern, tree branches and hyperemia strips on the skin. These are lightning science.

The more severe complication is breathing and circulation stops. Lightning discharge plays a defibrillators role, resulting in short-term cardiac arrest. If the heart activity has been preserved or has recovered itself, transfer the victim to a stable lateral position and call an ambulance. If the victim has no cardiac activity, do not waste time and immediately start CPR. Contrary to popular belief, it is unacceptable to cover the victim with soil. It is not only a threat of infection, but also the loss of precious time and consequently the life of the victim.

To sum up, today we have learned what electric injuries are. Now you also know the safety measures and first aid algorithms in various electric shocks to consolidate the material.

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