Electrical injury

What it is

Six factors set the type and extent of an electrical injury: the amount of current, the voltage, the resistance, which depends on the electrolyte and water content of the body tissue, the type of current, direct or alternating, the duration of contact, and the pathway of the current.

The harm comes by four mechanisms: the direct effect of electricity, thermal tissue damage, severe muscle contractions, and the fall after the shock.

Four types are named. True injury, where the individual becomes part of an electrical circuit. Flash, where the current arc strikes the skin but does not enter the body. Flame, from clothing catching fire in the presence of an electrical source. And lightning injuries, by ground current, contact injury, side splash or direct strike.

How it presents

The Lichtenberg figure is a red, branching electric discharge pattern on the skin of strike victims. It is usually on the upper body, appears within hours and disappears within days, and is formed when delicate capillaries beneath the skin rupture from the shock of the electrical discharge.

A 25 years old electrical worker who was thrown 3 meters away, had a brief LOC, has burn marks on both hands, and comes in 3 hours later conscious and able to give a full history, with a pulse and normal vital signs apart from mild tachycardia, but with headache, chest pain, pain at both hands and nausea, is the shape of the case. The skin is not the injury.