Sources of electrical injuries. Electrical injuries: severity of electrical burns, signs of lightning damage, first aid algorithm for a victim of electrical shock. Electric shock

Electrical trauma- damage to organs and body systems under the influence of electric current.

The first mention of death from electric shock was recorded in 1879 in France, Lyon, a carpenter died from an alternator.
In developed countries, the frequency of cases of electric shock is on average about 2-3 cases per hundred thousand of the population.
Most often, young people of working age suffer from electric shock.
The mortality rate of men from electrical injuries is 4 times higher than that of women.

The impact of electric current on the human body

Electric current has a thermal, electrochemical and biological effect on a person.

Thermal impact: electrical energy, meeting resistance from the tissues of the body, turns into heat energy and causes electrical burns. Mainly, burns occur at the point of entry and exit of the current, that is, in the places of greatest resistance. As a result, the so-called current marks or signs. Thermal energy converted from electrical energy destroys and changes tissues on its way.
Electrochemical effect:"Adhesion", thickening of blood cells (platelets and leukocytes), movement of ions, changes in the charges of proteins, the formation of steam and gas, giving the tissues a cellular appearance, etc.
Biological action: disruption of the nervous system, impaired conduction of the heart, contraction of the skeletal muscles of the heart, etc.

What determines the severity and nature of the electrical injury?

Electric shock factors:

Kind, power and voltage

Alternating current is more dangerous than direct current. In this case, low-frequency currents (about 50-60 Hz) are more dangerous than high-frequency ones. The frequency of the current used in everyday life is 60 Hz. With an increase in frequency, the current flows along the surface of the skin, causing burns, but does not lead to death.
The most significant is the strength and voltage of the electric current.

The body's response to the passage of alternating current
Current strength	How does the victim feel?
0.9-1.2 mA	The current is barely perceptible
1.2-1.6 mA	Feeling of chills or a whisper
1.6-2.8 mA	Feeling of heaviness in the wrist
2.8-4.5 mA	Stiffness in the forearm
4.5-5.0 mA	Convulsive contraction of the forearm
5.0-7.0 mA	Convulsive contraction of the shoulder muscles
15.0-20 mA	Impossible to take your hand off the wire
20-40 mA	Very painful muscle cramps
50-100 mA	Heart failure
More than 200 mA	Very deep burns

High voltage currents (over 1000 volts) cause more severe damage. High voltage electric shock can occur even when you are one step away from the current source ("volt arc"). As a rule, deaths occur precisely as a result of high-voltage injuries. Low voltage injuries are mainly domestic and, fortunately, the percentage of deaths from low voltage shock is lower than with high voltage injuries.

The path of the current through the body

The path that the current makes through the body is called the current loop. The most dangerous is a full loop (2 arms - 2 legs), with this option the current passes through the heart, causing it to malfunction until it stops completely. The following loops are also considered dangerous: hand-head, hand-hand.

Duration of current action

The longer the contact with the current source, the more the expression of the lesion and the higher the likelihood of death. Under the action of a high voltage current, due to a sharp muscle contraction, the victim can be immediately thrown away from the current source. At lower voltages, muscle spasm can cause prolonged hand grip on the conductor. With an increase in the time of exposure to the current, the resistance of the skin decreases, therefore, it is necessary, as soon as possible, to stop contact of the victim with the current source.

Environmental factors

The risk of electric shock increases in damp and damp rooms (bathrooms, baths, dugouts, etc.).

The outcome of electrical trauma also largely depends on age and condition of the body at the moment of defeat

Increase the severity of the lesion: childhood and old age, fatigue, exhaustion, chronic diseases, alcohol intoxication.

Electric shock

Danger of electric shock or the consequences of an electric shock

System	Effects
Nervous system	Possible: loss of consciousness of varying duration and degree, loss of memory of the events that have occurred (retrograde amnesia), convulsions. In mild cases, the following are possible: weakness, flickering in the eyes, weakness, dizziness, headache. Sometimes nerve damage occurs, which lead to impaired motor activity in the limbs, impaired sensitivity and tissue nutrition. Perhaps a violation of thermoregulation, the disappearance of physiological and the appearance of pathological reflexes. The passage of electric current through the brain leads to loss of consciousness and the appearance of seizures. In some cases, the passage of current through the brain can lead to respiratory arrest, which often becomes the cause of death by electric shock. Under the action of a high voltage current on the body, a deep disorder of the central nervous system can develop with inhibition of the centers responsible for respiration and cardiovascular activity, leading to "imaginary death", the so-called "electrical lethargy". This is manifested by imperceptible respiratory and cardiac activity. If resuscitation actions in such cases are started on time, in most cases they are successful.
The cardiovascular system	Cardiac disorders in most cases are of a functional nature. Violations are manifested in the form of various heart rhythm failures (sinus arrhythmia, an increase in the number of heart contractions - tachycardia, a decrease in the number of heart contractions - bradycardia, heart block, extraordinary heart contractions - extrasystole;). The passage of current through the heart can disrupt its ability to contract as a whole, causing the phenomenon of fibrillation, in which the heart muscle fibers contract separately and the heart loses its ability to pump blood, which is equivalent to cardiac arrest. In some cases, the electric current can damage the vessel wall, leading to bleeding.
Respiratory system	The passage of an electric current through the respiratory center located in the central nervous system can cause inhibition or complete cessation of respiratory activity. If injured by high voltage current, bruises and ruptures of the lungs are possible.
Sense organs	Tinnitus, hearing loss, touch disorder. Ruptured eardrums, trauma to the middle ear, followed by deafness (in case of exposure to high voltage current) are possible. When exposed to bright light, damage to the visual apparatus can occur in the form of keratitis, choroiditis, cataracts.
Striated and smooth muscles	The passage of current through the muscle fibers leads to their spasm, which can manifest as seizures. Significant electrical contraction of skeletal muscle can lead to fractures of the spine and long bones. Spasm of the muscular layer of blood vessels can lead to an increase in blood pressure or the development of myocardial infarction due to spasm of the coronary vessels of the heart.
Causes of death: The main causes of death in electrotrauma are cardiac arrest and respiratory arrest as a result of damage to the respiratory center.
Long-term complications: The action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), the cardiovascular system (disturbances in the heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing impairment, etc. Electrical burns can heal with the development of deformities and contractures of the musculoskeletal system. Repeated exposure to electric current can lead to early arteriosclerosis, obliterating endarteritis and persistent vegetative changes.

Electric shock sign or electromark

Electric tag- areas of tissue necrosis at the points of entry and exit of electric current. They arise as a result of the transition of electrical energy to heat.
The form	Colour	Characteristic signs	Photo
Round or oval, but can also be linear. Often there is a ridge-like elevation along the edges of the damaged skin, while the middle of the mark seems to be a little sunken. Sometimes it is possible for the top layer of the skin to peel off in the form of blisters, but without liquid inside, unlike thermal burns.	Usually lighter than the surrounding tissue - pale yellow or grayish white.	Complete painlessness of the marks, due to damage to the nerve endings. Deposition of metal particles of the conductor on the skin (copper - blue-green, iron-brown, etc.). When exposed to a low voltage current, metal particles are located on the surface of the skin, and when a high voltage current is applied, they spread deep into the skin. The hair in the area of the marks is twisted in a spiral manner, retaining its structure.
Electric burns are not always limited to marks on the skin. Quite often, damage to deep-lying tissues occurs: muscles, tendons, bones. Sometimes the lesions are located under the apparently healthy skin.

Electric shock assistance

The consequences of electric shock largely depend on the provision of timely assistance.

Should I call an ambulance?

There are cases of sudden death a few hours after being electrocuted. Proceeding from this, any victim of an electric shock must necessarily be taken to a specialized hospital, where, if necessary, emergency assistance can be provided.

Electric shock relief steps

Stop the impact of the current on the victim observing the established rules. Open the electrical circuit by breaking the circuit or using a switch, or unplug the plug. Remove the power source from the victim using insulating objects (wooden stick, chair, clothing, rope, rubber gloves, dry towel, etc.). Approach the victim with rubber or leather shoes on a dry surface or placing a rubber mat or dry boards under your feet.

In the case of a current source above 1000 volts, special safety measures must be taken to save the victim. To do this, it is necessary to work in rubber shoes, rubber gloves, use insulating pliers for the appropriate voltage.
If necessary, drag the victim away from the “step voltage” zone of action (up to 10 m), holding him by the belt or dry clothes, while not touching open parts of the body.

Determine the presence of consciousness

Grab the shoulders, shake (if you suspect a spinal injury, do not do it), ask loudly: What's the matter with you? Do you need help?

Assess the state of cardiac and respiratory activity... And, if necessary, carry out resuscitation measures, according to the ABC algorithm (closed heart massage, artificial lung ventilation (mouth-to-mouth breathing)).

Algorithm ABC	What to do?	How to do?
A	Free up the airways	It is necessary to make a number of techniques to move the root of the tongue away from the back wall and thus remove the obstacle in the path of the air flow. The palm of one hand is placed on the forehead, with 2 fingers of the other hand, the chin is raised, pushing the lower jaw forward and upward, while throwing the head back. (if a spinal injury is suspected, the head should not be thrown back)
V	Check if there is breath	Bend over to the victim's chest and determine if there is a breathing movement of the chest. If it is visually difficult to determine whether there is breathing or not. To the mouth, to the nose, you can bring a mirror, which, in the presence of breath, will fog up, or you can bring a thin thread, which, in the presence of breath, will deviate.
WITH	Determine if the pulse	The pulse is determined on the carotid artery, with the fingers bent in the phalanges.
At the present stage of medicine, it is recommended to start resuscitation actions from point C - indirect heart massage, then A - release of the airways and B - artificial respiration.
If breathing and pulse are not detected, it is necessary to start resuscitation measures: Indirect heart massage, 100 clicks per minute on the chest (with an amplitude for adults of 5-6 cm and with full expansion of the chest after each pressing). To perform manipulations, the patient must lie on a flat, hard surface. The point of placing the hands during the massage should be on the chest between the nipples, the shoulders should be directly above the palms, and the elbows should be fully extended. Mouth-to-mouth breathing 2 breaths every 30 chest compressions. If it is impossible to perform mouth-to-mouth breathing, only indirect heart massage can be performed. Resuscitation should be continued until an ambulance arrives. The optimal time to start resuscitation is 2-3 minutes after cardiac arrest. The practical limit of resuscitation actions is 30 minutes, with the exception of victims who are in cold temperatures. The effectiveness of resuscitation actions is assessed by the color of the victim's skin (pinking of the face, disappearance of cyanosis).
Medication. If the measures are unsuccessful for 2-3 minutes, 1 ml of 0.1% adrenaline (intravenous, intramuscular or intracardiac), 10% calcium chloride solution - 10 ml, 0.05% strophanthin solution - 1 ml diluted in 20 ml 40% solution glucose.
In the presence of breathing, the victim must be given a stable lateral position and wait for the arrival of an ambulance.

4. Apply dry gauze or contour bandages to the burned surfaces. The imposition of ointment dressings is contraindicated.

5. If the victim is conscious, it is possible to give painkillers (analgin, ibuprofen, etc.) and / or a sedative (tincture of valerian, persen, ankylosing spondylitis, etc.).

6. The victim should be transported only in the supine position and warmly covered.

Hospital treatment

All victims with symptoms of shock are hospitalized in the intensive care unit.
Victims without signs of electrical or burn shock with limited electrical burns are hospitalized in surgical wards. According to the indications, they carry out a toilet of burn wounds, dressings, drug treatment (heart and antiarrhythmic drugs, vitamins, etc.). If necessary, complex surgical interventions are performed to restore the integrity and functional ability of damaged tissues and organs.
Victims without local lesions, even with a satisfactory condition, need hospitalization in the therapeutic department for further observation and examination. Since there are cases of belated complications from the cardiovascular system (cardiac arrest, heart rhythm disturbances, etc.), and from other systems (nervous, respiratory, etc.).
People who have suffered an electrical injury often require long-term rehabilitation. Since the action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), the cardiovascular system (violations of the heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing impairment, as well as impairment functions of other organs and systems.

Electric shock protection

The best protection against electric shock is head on shoulders. It is necessary to clearly know all the requirements and safety rules when working with electric current, use the necessary personal protective equipment and be extremely careful when performing any work on electrical installations.

Remedies:

Insulating pads and supports;
Dielectric carpets, gloves, galoshes, caps;
Portable grounding;
Insulating handles;
Use of screens, partitions, cameras for protection against electric current;
Use of special protective clothing (type Ep1-4);
Reduce the time spent in the hazardous area;
Safety posters and signs.

Safety requirements

Approaching live parts should only be at a distance equal to the length of the insulating part of electrical protective equipment.
It is imperative to use an individual shielding set of clothing when working in open switchgears with a voltage of 330 kV and above.
In electrical installations with voltages above 1000V, use a voltage indicator; it is necessary to use dielectric gloves when working in electrical devices over 1000V.
When a thunderstorm is approaching, all work on the switchgear must be stopped.

Electric trauma means a traumatic injury to the integrity, functions of tissues and organs, which appears under the influence of industrial, household or natural electric current. Various types of electrical injuries have different effects on the body, which can result in burns, violations of the physicochemical composition of the blood, tissue ruptures, fractures, dislocations, and violations of internal bioelectric processes.

Such injuries are often fatal.

Classification of electrical injuries

By the nature of the lesion, the following types of electrical injuries can be distinguished.

Local damage manifests itself in burn injuries of the skin, soft tissues, ligaments, electrophthalmia (damage to the outer membranes of the eye), metallization of the skin. Local electrical injuries are characterized by the appearance of electrical signs on the body - sharply outlined spots of gray or pale yellow color that appear in places of contact with current sources.

General injuries are accompanied by electric shock to muscle groups, manifested in convulsions, heart and respiratory paralysis.

Depending on the severity, all types of electrical injuries are divided into four degrees.

Grade I injuries are manifested by convulsions without loss of consciousness. There is also pale skin, general agitation, shortness of breath, headache, rise in blood pressure. After the end of the traumatic shock, the victim begins to experience pain.

Grade II injuries are also accompanied by loss of consciousness. With the second degree of electrical injury, the victims have a decrease in blood pressure, minor disturbances in work.Cardiac arrhythmia and shock are often observed.

III degree of severity is characterized by severe respiratory disorders, convulsions, rupture of the vessels of the lungs, disruption of the heart and all blood circulation, a sharp decrease in blood pressure, heart rhythm disturbances, retinal detachment, cerebral and lung edema. Necrotic foci may appear in the lungs, liver, spleen, thyroid and pancreas. A coma can be a consequence of a third-degree injury.

For IV degree, respiratory arrest is characteristic as a result of paralysis of the respiratory center and fibrillation of the ventricles of the heart. Often occurs when an electric current passes through a person's head.

By the nature of the effect of electric current, the following types of electrical injuries can be distinguished:

Instant, received in a few seconds;

Chronic, obtained through constant and prolonged contact with a source of strong current.

Reasons for receiving electrical injuries

You can get injured from electric current when interacting with a source at home, at work, or when struck by lightning. A direct lightning strike is a spontaneous, force majeure factor against which a person cannot insure himself.

In other cases, the reasons are as follows.

Psychophysiological nature. That is, trauma can be the result of weakened attention, a stressful situation, excessive fatigue, a state of health, a person being under the influence of drugs, alcoholic beverages.

Technical nature. Such reasons include a malfunction of electrical equipment, as a result of which voltage may arise in the metal parts of the device; the use of electrical appliances not for their intended purpose; power outages; violation of the rules for the operation of devices.

Organizational nature. The reasons for electrical injuries of an organizational nature may lie in negligence when working with devices connected to the mains, neglecting elementary ones at work and at home.

Electrical injuries account for only 2-2.5% of all injuries, and most of them are received by people whose profession is directly related to electricity, that is, electricians, high-voltage constructions fitters, builders.

Electrical injuries can occur in the presence of a dangerous for humans or current, due to the characteristics of the body and the state of human health, environmental conditions.

Electric shock symptoms

Immediately at the moment of electric shock, a person can feel a jolt, spasm, muscles, a burning blow. After the current ceases to act, the main symptoms are observed on the part of the central nervous system. Signs of electric shock trauma have a lot in common with the clinical picture of a concussion. There is lethargy, lethargy, indifference to the environment, dizziness.

The cardiovascular system reacts to electrical injuries in the following way:

An initial increase and then a sharp decrease in blood pressure;

Increased heart rate;

Arrhythmia;

Expanding the boundaries of the heart.

Moist wheezing may appear in the lungs, foci of emphysema are found on radiographs, and a cough occurs. In some cases, acute respiratory failure is found. Some victims suffer from vomiting, diarrhea, nausea.

Burns with electrical injuries

An electrical burn occurs at the point of entry and exit of electric current.

But the absence of current marks should not be taken as an excuse to exclude electrical injury. Many victims (more than 30%) have no tags.

Electrical burns also have several degrees of severity.

The first degree appears to be small foci of epidermal coagulation without blistering.

Second-degree burns provide total damage to the skin with the formation of blisters.

The third degree is accompanied by lesions of the entire thickness of the skin and dermis. Superficial necrosis is observed.

With the fourth degree of severity, not only the skin is affected, but also the underlying tissues, deep necrosis develops.

Superficial burns with electrical injuries are less common than deep burns. In some cases, electrical trauma can be accompanied by damage to large areas of tissue or even charring of the extremities.

Diagnosis of lightning injuries

In case of an injury sustained by a lightning strike, the following is observed:

Temporary blindness;

Temporary dumbness and deafness;

Pathological feeling of fear;

Fear of light;

Paralysis of the respiratory and cardiac systems;

Headache.

The intensity of these specific symptoms depends on the severity of the injury.

First aid for electrical injury

In order to be able to help an injured person, you must first of all protect yourself. De-energize the voltage source, pull the wire out of the victim's hands. If this is not possible, then it is necessary to isolate the victim from the power source. To do this, you must use protective equipment such as a board, a wooden stick, an insulated tool, rubberized gloves, insulating stands, rubberized shoes. If there are no such safety devices nearby, then you can protect yourself by moving to the victim with small "duck steps". At the same time, the soles of the feet should not come off the ground. The toe of one foot should always be in line with the heel of the other foot.

It is necessary to pull the injured person away from the injury site at a distance of 10-15 meters. At the same time, it is necessary to hold it by the edges of the clothes, without touching the bare parts of the body. First aid for electrical injury should be started when the victim is in a safe place. Breath and pulse are checked. If they are not palpable, then it is worth starting to do artificial respiration and If the person has not lost consciousness, he should be given any sedative, given as much drink as possible while waiting for the arrival of an ambulance.

If burns are clearly visible on the skin, they should be bandaged with clean bandages or cloth. If there is a suspicion of a fracture, then a splint should be applied to the limb.

Follow-up treatment of burns

Follow-up care for first-degree electrical injury is not always necessary. A person with injuries of the 2nd, 3rd and 4th degree of severity, after receiving the first necessary aid, should be taken to a trauma or surgical center, where he will be provided with a qualified

The first thing to do is a tetanus shot. Further, local treatment of burns and general treatment begins, aimed at restoring disturbed systems, body functions.

As an anti-burn measure, sterile dressings with a disinfectant are applied to the places of the marks. Burned areas of the skin can be exposed to ultraviolet radiation, which facilitates the process of cell death and accelerates the formation and restoration of healthy epithelium.

In parallel with local treatment of damaged areas of the body, it is necessary to carry out intensive infusion therapy, which restores cardiac activity, as well as the work of the central and peripheral nervous system.

The main types of complications after electrical injury

Injuries from electric current are dangerous both in themselves and the consequences that can develop immediately and subsequently, after undergoing rehabilitation and full recovery from the injury. Complications can manifest themselves:

Disturbances in the work of the vestibular apparatus;

Hearing impairment;

Retrograde amnesia;

Paresis of the limbs;

Damage to the kidneys, liver, the formation of stones in the organs;

Damage to blood vessels, spinal cord, brain;

Psychosis and disorder of the sympathetic and parasympathetic nervous system;

Coma;

Massive bleeding.

If an electric current has passed through the head, then trauma to the organs of vision with retinal detachment, clouding of the lens, pathological changes in the intraocular environment, and the development of glaucoma are inevitable.

Prevention of electrical injuries

The main prevention of injuries from electric current is to observe safety precautions at the time of operation, installation and repair of electrical equipment. People working with electric current must be well instructed and must have personal protective equipment. People servicing existing electrical installations must periodically, twice a year, undergo a medical examination. In this case, it is imperative to go through a therapist, surgeon, neuropathologist, ophthalmologist, otolaryngologist if indicated.

By following basic safety precautions, many electrical injuries can be avoided.

Electrical trauma is a violation of the integrity and functions of tissues and organs as a result of the action of an electric current. Depending on the strength, voltage and duration of exposure to the current, the state of the body, environmental factors, the location of the current loop and other factors, different types of electrical injuries may occur. Passing through the body, the electric current causes a number of effects - burns of certain parts of the body and internal tissues, disruption of the physicochemical composition of the blood, rupture of tissues and bone fractures, disruption of internal bioelectric processes. Various types of electrical injuries account for more than 2% of injuries worldwide, and many of them are fatal.

Causes of electrical injuries

Injury can result from direct contact with the power source or from arcing contact in the immediate vicinity of the power source. The most common causes of electrical injuries are accidents associated with the professional activities of electricians, representatives of construction specialties, and general laborers. By following electrical safety techniques, most injuries could be avoided.

What is the immediate cause of electrical injury? For the occurrence of injury, certain conditions are needed - life-threatening voltage and current strength, the state of health of the victim, environmental parameters.

There is no consensus regarding the magnitude of the "safe" voltage or current. For example, in France it is considered to be a "safe" voltage of 24 V for alternating current and 50 V for direct current; in Russia, a voltage of 50 V alternating current is considered to be a probable cause of electrical injury. But it is known that even a voltage of 12 V can be fatal. As for the current strength, an indicator of up to 10 mA with alternating current and up to 50 mA with constant current is considered dangerous.

If we are dealing with an alternating current with a frequency of 50-60 Hz, then with a current of 0.6-1.5 mA, the victim experiences only a slight tremor of the hands, with a current of 2-3 mA - strong tremors, at 5-7 mA - convulsions , at 8-10 mA, hands can still be torn off the electrodes, but such a current strength can already cause electrical injury. At 20-25 mA, it is impossible to tear off the hands from the electrodes, at 50-80 mA, respiratory paralysis occurs, and at 90-100 mA, cardiac paralysis.

At a constant current of 0.6-3 mA, contact with the electrodes does not cause any sensations, at 5-7 mA itching occurs, at 8-10 mA - heating, at 20-25 mA - a slight muscle contraction. The cause of electrical injury is the current strength of 50-80 mA, when convulsions and difficulty breathing occur, at 90-100 mA respiratory paralysis may occur.

The degree of damage largely depends on the resistance of the human body, and it is determined by a number of features. For example, in women, body resistance is less than in men, this is due to the thickness of the skin, therefore, if the current strength of 11-12 mA is considered "non-letting" in men, then for women it is only 7-8 mA. In children, skin resistance is lower than in adults and the elderly.

External factors can also aggravate the severity of injury, for example, the higher the ambient temperature, the higher the risk of electrical injury. The higher the partial oxygen content in the air, the lower the body's sensitivity to current. The higher the air humidity, the more likely arc injury is.

Damage can also vary depending on the path of the current loop. The most probable paths of passage: right arm - legs, left arm - legs, both arms - legs, head - legs, arm - arm. These "large" or "full" loops are dangerous because the current captures the heart area. The "small" current loop leg - leg, which occurs when a person comes under a step voltage, is considered less dangerous; the current path is not dangerous in itself, but if a person falls under its influence, the current can pass through life-threatening zones.

Types of electrical injuries

All electrical injuries are conventionally divided into two types of electrical injuries: local and general.

Local electrical injuries are severe damage to the skin, soft tissues, ligaments, bones. These include contact and arc electrical burns of varying severity, sharply outlined spots of gray or pale yellow color that appear in places of contact with the current source (the so-called electrical signs). Local types of electrical injuries also include metallization of the skin (a phenomenon in which the smallest metal particles, various mechanical damage penetrate into the upper layers of the skin) and electrophthalmia (inflammation of the outer membranes of the eye under the influence of a powerful stream of UV rays).

General electrical injuries are the so-called electrical shocks, which are accompanied by convulsive muscle contractions. It is customary to distinguish four degrees of damage:

General electrical injuries of the 1st degree. They are characterized by muscle cramps without loss of consciousness;
General electrical injuries of the II degree. Are accompanied by convulsions and loss of consciousness;
General electrical injuries of the III degree. Loss of consciousness with impaired cardiac or respiratory function;
General electrical injuries of the IV degree. Clinical death.

First aid for electrical injury

In order to help the victim, you must take care of your own safety. Otherwise, you yourself will fall under voltage, and then you will have to provide first aid in case of electrical injury. De-energize the source of injury - turn off the device, try to pull the electrical wires out of the victim's hands. If this is not possible, you need to tear the victim away from the power source using protective equipment - a board or wooden stick, insulated tools, rubber gloves, insulating supports, rubber-soled shoes, etc.

First aid for electrical injury should be provided as soon as the victim is in a safe place. If he is unconscious, it is necessary to check the pulse and respiration, and in their absence, perform an indirect heart massage in combination with artificial respiration. If the pulse and breathing are stable, lay the victim on his stomach, turning his head to one side - this will allow him to breathe freely and not choke on vomit.

Situations are different, but if there is a first-aid kit at hand, and burn marks are clearly visible on the victim's skin, you can provide assistance in case of electrical injury before the arrival of doctors. Dry and clean bandages are applied to the burns, and if the feet or hands are injured, cotton swabs or rolled bandages are placed between the fingers. Remember that the victim needs plenty of fluids, if he is conscious - give him as much liquid as possible to drink and immediately send him to the emergency room.

Among the most common electrical injuries are household or industrial electric shock or lightning. Depending on the degree of injury, chaotic muscle contractions and other disruptions in the work of the central nervous system can be recorded. If the electric shocks do not stop, neuropathy develops, followed by asystole. Almost always, with electrical injuries, they cause loss of consciousness.

Electrical trauma is damage or pathological condition caused by exposure of the victim to an electric current of great strength and voltage. Mortality when exposed to electric current reaches 10%.

In case of electrical injury, there are:

the general reaction of the body - firstly, a reflex effect through the nervous system, leading to a disorder of blood circulation and respiration, and secondly, the depth of local changes;
the depth of local changes under direct influence on the body of thermal, electrochemical and electrodynamic factors.

Degree of injury in case of electrical injuries

The degree of injury in case of electrical injury depends on the strength and parameters of the current, the direction and duration of exposure, the physiological state of the body and the characteristics of the external environment. Low voltage current (127-220 V) is more dangerous than high voltage current, as it more often causes ventricular fibrillation of the heart. The danger of electrical injury increases with overheating of the body, and high air humidity contributes to the occurrence of arc contact, which occurs at a voltage of more than 1000 V. A burn can destroy not only the skin, but also the underlying tissues, up to their charring. The severity and outcome of the lesion depends on internal and external factors. When exposed to a high voltage current, ruptures of all layers of tissues are possible, sometimes with complete separation of limbs and other organs (dissecting electrical trauma).

Depending on the general condition of the victims, four degrees of severity of electrical injury are distinguished:

I - convulsive muscle contraction without loss of consciousness;
II - muscle contraction with loss of consciousness;
III - convulsive muscle contraction with loss of consciousness and cardiac or pulmonary disorders;
IV - clinical death.

Subjective sensations with an electrical injury of any degree are varied - from a slight push to burning pain, convulsive muscle contraction, tremors. These lesions can appear immediately upon lesion, but sometimes even after several hours or even days.

Symptoms: locally small (up to 3 cm) areas of dry necrosis of an oblong or rounded shape with retractions in the center appear. Characterized by a large depth of lesion due to circulatory disorders, edema and hyposthesia of the surrounding tissues. There is no hyperemia around the site. Changes in peripheral nerves of the type of ascending neuritis with paresis, sensory and trophic disorders are often observed. When a high current passes through the body, a convulsive contraction of the muscles occurs, which can cause avulsion and compression fractures, fracture-dislocations and dislocations. General changes are associated with the action of current on the central nervous and respiratory systems.

Common symptoms of electrical injury include:

weakness, dizziness, fatigue, fright, heaviness in the whole body, depression or agitation;
paresis, paralysis, spastic lesion of the muscles of the larynx and respiratory muscles, asphyxia, bradycardia.

Heart sounds are muffled, pulse is tense, heart rhythm disturbance, ventricular fibrillation, cardiac arrest.

Disorder of consciousness - from lethargy and fainting to prolonged loss of consciousness, from convulsive contractions of a muscle group, respiratory distress - to its complete stop.

The degree of burns with electrical injuries

Depending on the depth of the lesion, four degrees of electrical burns are distinguished.

To the I degree include the so-called signs of current, formed under the action of a small amount of thermal energy with damage to only the epidermis.

Electric burns II degree in case of electrical injury, they are characterized by a detachment of the epidermis with the formation of burn wounds at the entry and exit site of the current, having dense edges of a gray-yellow color, sometimes penetrating to the bone. At the same time, in the bone tissue, you can see formations resembling pearl beads, arising from the melting of bone tissue with the release of calcium phosphate.

With electric burns of the III degree coagulation of the skin occurs throughout its entire thickness.

For IV degree burns not only the dermis is affected, but also the underlying tissues, often tendons, muscles, bones, blood vessels, and nerves.

Signs of being struck by lightning

Lightning is a special type of electrical injury from atmospheric electricity.

More often people are affected who are during a thunderstorm near electrical equipment, a working TV and radio, talking on the phone, etc.

In the victims, the so-called lightning marks are determined on the skin, which are tree-like branches, stripes of light pink or red. The appearance of these signs of lightning damage is explained by the expansion of capillaries in the area of contact of atmospheric electricity with the body.

Electric current spreads in the human body from the place of entry to the place of exit (Kirgoff's law), forming a so-called current loop. There are 12 such loops in total. The lower loop (from foot to foot) is less dangerous than the upper loop (from hand to hand, from hand to head); a complete loop that captures two arms and two legs is considered dangerous, since the current will surely pass through heart and can disrupt its activity.

First aid for household electrical injury and lightning

The algorithm for helping a victim with an electrical injury is as follows:

quick release of the victim from the action of the current - opening the electrical circuit with a switch or switch. Cutting the wire (each separately) with tools with a dry wooden handle. When providing assistance to a victim from an electrical injury by exposure to an electric current with a voltage of more than 1000 V, you must first put on rubber shoes, gloves and act with an insulating bar;
isolation of the victim from the ground with dry boards, rubber products, etc .;
providing first aid in case of electrical injury, it is necessary to create rest, use pain relievers - sedatives, transport it to a medical institution;
aseptic dressings on the burn area;
help with electrical injury includes resuscitation. In the absence of breathing and cardiac activity, artificial ventilation of the lungs and chest compressions are performed. If there is no effect within 3-5 minutes, a defibrillator is used by the ambulance team, tracheal intubation is performed with the transfer of the patient to controlled breathing.

After providing assistance with a household electrical injury or lightning strike, urgent hospitalization of the victim in an intensive care unit or a burn center is necessary. It is important to remember that the patient's condition can deteriorate sharply several hours after the injury.

The combination of injuries resulting from exposure to technical or natural electricity is called electrical injury in medicine. This is a rare damage to tissues and internal organs, accounting for just over 2% of the total number of injuries. Electric shock or arc injury can occur in everyday life, but most often it is associated with industrial electrical injuries.

When an electric current is applied to soft tissues and organs of a person, complex physical processes occur in the body - the conversion of electrical energy into thermal, mechanical, etc. This is the reason for the appearance of electric burns at the site of contact with human skin. In addition, an electric shock or the effect of an electric arc disrupts the work of internal organs, vital systems in the human body - cardiovascular, endocrine, digestive, etc.

The classification and types of electrical injuries are associated with the power of the acting current, the duration of contact, the general condition of the body, the place of passage of the electric arc, and additionally influencing external factors. Based on this, there is a change in the formula of human blood, rupture of soft tissues, bone injuries, disruptions in the processes of vital activity of the body, etc.

Causes

Electrical injuries are caused by improper or inept use of electrical appliances, malfunctioning equipment, they are the result of the impact of a lightning discharge. This is a direct contact with the conductive components of electrical installations, carrying out work without first disconnecting the voltage.

Most often, the cause of an electrical injury is a careless and inattentive attitude to the preparatory stage when performing electrical work - an erroneous supply of voltage, not turning off the current source, an unacceptable state of insulation.

The most dangerous for human health and life is the current over 0.15A, alternating and direct voltage from 36 to 220V. Injury is common among professional electricians and electricians.

The danger of electrical injury is a high percentage of deaths and a significant degree of severity of injuries.

Types of injuries

What is electrical injury? By the nature of the impact, they are divided into:

instant;
chronic.

Instantaneous injury is exposure to excessive electrical current for a short period of time. This injury is considered the most dangerous and has serious consequences. It often leads to the need to apply resuscitation procedures to the patient and emergency surgery.

Chronic trauma occurs as a result of long-term work at a source of high power electric current, its negative and gradual impact on a person. Rapid fatigue, disturbed sleep rhythms, increased blood pressure, pain in the head become a sign.

The action of the current on a person depending on the time of the lesion

Electrical injury, depending on the site of damage, is:

local;
general.

Local injuries are expressed in violation of the integrity of the area of direct contact with electric current. General - this is the passage of an electric discharge through the entire body, affecting and affecting the internal organs of a person.

Depending on the reasons that led to the exposure to current, the following types of electrical injuries are distinguished:

current - occurs when a current is emitted and its effect on the body in contact with the conductive components of electrical installations;
arc - occurs when exposed to an electric arc.

A current burn has 4 degrees of severity. At low voltage, these are burns of 1 and 2 degrees, characterized by the appearance of redness and blisters, at 380V, as a rule, burns of 3 and 4 degrees with necrosis of the superficial skin layers and carbonization of tissues are diagnosed.

Arc burn occurs:

when approaching the conductive components of electrical installations under voltage, at a distance at which a breakdown of the air gap between them occurs;
in case of damage to insulating materials on live elements that are energized, to which a person touches;
in case of incorrect operations with electrical appliances, when the arc is thrown onto a person.

Diagnosis and first aid

Symptoms of electrical trauma help diagnose them. It occurs on the basis of a medical history and visible signs of an electric burn. A more accurate study of internal organs is revealed using computed tomography, radiography, ECG, etc.

The result of an injury is contact with working electrical installations, which must be disconnected immediately and the injured person must be treated immediately. To do this, you need to turn off devices, plugs, switches, etc., while you need to take care of your own safety.

remove wires from the victim without the help of insulated tools, while using rubber gloves.
touch the victim, if the power source is not disconnected.

The person who has received an electrical injury must be laid on a smooth and hard surface, call an ambulance and take some measures:

as a rule, trauma leads to loss of consciousness, in some cases to cardiac arrest. For this, the patient's pulse and respiration must be strictly controlled;
if necessary, cardiac massage and artificial respiration are performed. For this, the victim is laid on his stomach, while his head is turned on its side. This gives him the opportunity to breathe freely and not to choke on the natural fluids and vomit that appear in the oral cavity;
sterile dressings soaked in special solutions and means are applied to burn wounds;
the victim must be examined for the presence of additional damage to the soft and bone tissues when falling from a strong current wave. Take measures to prevent complications associated with them;
the traumatized patient needs plenty of fluids.

It is important to transfer the victim into the safe hands of doctors in a timely manner. These can be surgeons, traumatologists, or, depending on the severity of electrical injuries, burn surgeons (combustiologists) who receive patients in specialized burn centers.

Treatment

Treatment of electrical injuries while in the hospital is carried out in accordance with generally accepted standards. They involve strict monitoring of the general condition of the victim's body, intensive therapy, and the appointment of drugs to resume the normal functioning of organs and body systems. Treatment is usually conservative.

With pronounced muscle spasm and circulatory disorders of the limb, pain relievers and case blockade are performed. In this case, obligatory dressings are carried out, with the removal of dead tissue. In the case of small areas of damage, independent natural healing occurs, regardless of the depth of the burn.

With a significant size of the burn wound and carbonization of soft tissues, surgical intervention is necessary. Charred limbs are amputated immediately after injury in a medical facility, along the line of bleeding, living muscles. With deep and extensive burns, after the formation of a clear contour of the necrosis zone and healthy tissue, the removal of non-viable cells (necrectomy) is carried out. Subsequently, plastic surgery, operations to restore skin tissues, tendons, etc.

The patient's rehabilitation period is long and depends on the severity and nature of the injury. We must not forget that for the patient, during the period of injury, the skillful and timely assistance of a specialist is important. Therefore, when providing assistance, the victim cannot be left; it is necessary to organize his delivery to the hospital, where all the measures for additional examination, diagnosis and professional assistance will be carried out. It is important to do this, despite the fact that the external lesions seem small to you. Electrical trauma is so insidious that the victim's condition can change at any time.