Electrical Injury

Aka: Electrical Injury, Electrical Burn

1. Epidemiology
   1. Electrical injuries cause 1000 deaths in U.S. per year
2. Pathophysiology
   1. Electricity travels a path until meets resistance
      1. Carbonized tissue resists continued current
   2. Electrical Injury results in thermal Burn Injury
   3. Most common injury sites
      1. Deep Skin injury
      2. Neurologic injury
         1. Spinal cord injury (e.g. motor or sensory deficit)
         2. CNS injury (e.g. Altered Level of Consciousness)
      3. Eye Injury
         1. Cataracts
         2. Corneal burn
         3. Retinal Detachment
      4. Cardiovascular injury
         1. Cardiac Arrest
         2. Arrhythmia
3. Types
   1. Alternating Current (AC): Low voltage home injury
      1. AC is 3 times more dangerous than DC at same voltage
      2. May result in muscle Tetany
         1. Patient involuntarily holds source
         2. Prolongs duration of contact and increases injury
   2. Direct Current (DC): High voltage Occupational Injury
      1. May throw patient from jolt of energy
      2. May result in blunt injury in addition to burns
   3. Arc Injury
      1. Patient part of arc of current between 2 objects
      2. Most serious Electrical Injury
         1. Severe blunt Trauma may result
         2. Temperature may exceed 2500 C (4532 F)
4. Management
   1. See Burn Management
   2. Indications for outpatient management (all criteria)
      1. Low-voltage exposure
      2. Normal physical
      3. Normal laboratory examination (No Myoglobinuria)
      4. Electrocardiogram (EKG) normal
5. References
   1. Martinez (2000) South Med J 93:1165-8 [PubMed]