About Electrical Burn Injuries

Overview

Electrical burns happen when electricity travels through the body, harming both the skin and deeper tissues underneath. They can be caused by things like household appliances, power lines, lightning, or accidents at work. These burns are grouped into types based on how they happen: either by directly touching an electric source, by contact with flames or equipment, or by heat from clothes catching fire.

The seriousness of electrical burns depends on things like the voltage, how long the person was in contact with it, and which body parts were affected. Electrical burns can damage not just the surface of the skin but also the layers underneath and even deeper tissues. They can also harm nerves and blood vessels, which may cause long-term problems, such as difficulty moving or using parts of the body.

Causes and Risk Factors

Causes of complications from electrical burns:

Electrical burns happen when an electric current travels through the body, creating heat that harms tissues.
How serious the burn is depending on the strength of the current, how long the contact lasts, and the path the electricity takes in the body.
These burns can damage both the surface and deeper layers of tissue, and in severe cases, they can lead to tissue death, known as necrosis.
The way electrical burns cause damage is complex and still not fully clear. It involves both heat damage and the body’s natural reaction to the burn, called an inflammatory response.

Non-modifiable risk factors of electrical burns cannot be changed or controlled. These include:

Gender: Electrical burn injuries primarily affect men, especially in work-related settings.
Age: Young children and older adults may be at higher risk due to their limited ability to recognize and avoid electrical hazards.

Modifiable risk factors of electrical burns can be influenced or changed. These include:

Lack of safety precautions: Failure to follow proper safety protocols when working with electricity increases the risk of electrical burns.
Inadequate training: Insufficient knowledge and training in electrical safety can lead to increased risk of accidents and burns.
Poor maintenance of electrical equipment: Neglecting routine maintenance or using faulty equipment can increase the likelihood of electrical accidents.
Occupation: Certain occupations, such as electricians or construction workers, have a higher risk of electrical burns due to frequent exposure to electrical equipment.

Remember, prevention is key in reducing the risk of electrical burns. Always prioritize safety measures and seek professional guidance when working with electricity.

Symptoms

Early symptoms of electrical burns:

Burns: Symptoms can range from mild to severe and burns may appear as redness, blistering, or charring of the skin.
Irregular heartbeat: Some individuals may experience an irregular heartbeat after an electrical burn.
Seizures: In certain cases, seizures may occur immediately following an electrical burn.
Tingling or prickling sensations: Some people may experience tingling or prickling sensations in the affected area.

Other symptoms that may occur with later stages, progression, or higher severity of electrical burns:

Loss of consciousness: In more severe cases, loss of consciousness can occur.
Headaches: Persistent headaches may develop after an electrical burn.
Coma: In extreme cases, a coma may result from an electrical burn.
Heart attack: Severe electrical burns can lead to a heart attack.
Respiratory arrest: In rare instances, respiratory arrest (where a person stops breathing) can occur as a result of electrical burns.

It is important to note that these symptoms can vary depending on the severity and location of the electrical burn. If you have experienced an electrical burn, it is recommended to seek medical advice for proper evaluation and treatment.

Diagnosis

To diagnose electrical burns, the following examinations, tests, and procedures are commonly performed:

Physical examination: The healthcare provider will assess the burn area, including its surface area and depth. They will also perform tests to look for signs of complications such as changes in heart rhythm (arrhythmias), limb swelling that can lead to high pressure (compartment syndrome), and muscle breakdown that can lead to kidney failure (rhabdomyolysis).
Burn area estimation: Different methods can help estimate how much of the body is burned. Wallace's rule of 9 divides the body into sections to quickly calculate the burned area, while the Lund and Browder chart is more detailed and adjusts for a person’s age. For burns that are scattered, the palm method can be used, where the size of the person’s palm represents about 1% of the body's total surface area (TBSA). Knowing the burn area is important for planning treatment and understanding how serious the burn is likely to be.
Assessment of limbs: It's important to check the arms and legs for deep burns, especially ones that go all the way around the limb (called circumferential burns), as these can block blood flow. A specific type of ultrasound can be used to see if blood is still flowing properly in these areas.
Wound dressing and coverage: After a detailed head-to-toe assessment, complete wound dressing and coverage should be done in consultation with a burn specialist.

To determine the stage or severity of electrical burns, additional examinations, tests, and procedures may include:

Electrocardiogram (ECG/EKG): Patients who experience electric shocks, whether from low or high voltage, may get an initial 12-lead ECG (also called EKG) to check if their heart has been damaged.
Lab tests: Specific blood tests may be recommended to assess electrolyte levels and screen for complications like heart and kidney damage.
Imaging studies: Depending on the symptoms and extent of injury, imaging studies like X-rays or CT scans may be done to check for internal damage or involvement of the muscles and bones.

It's important to note that these examinations, tests, and procedures should be conducted by healthcare professionals based on individual patient circumstances. Always consult with your healthcare provider for personalized advice.

Treatment Options

The goals of treatment for electrical burns are to promote healing, prevent infection, manage pain, and minimize scarring. To achieve these goals, various treatment approaches may be recommended:

Medication Types:

Pain relief medications: These can help manage the pain associated with electrical burns. Over-the-counter pain relievers or prescription medications may be used. Ask your doctor about the appropriate medication for your situation.

Therapies:

Topical treatments: Applying antibiotic ointments or creams can help prevent infection and promote wound healing.
Aloe vera: Aloe vera gel may have soothing properties and can be applied topically to help with healing and reducing pain. However, consult your doctor before using it.

Medical Procedures:

Skin grafting and negative pressure wound therapy (NPWT): NPWT uses a vacuum dressing on the wound to help promote new tissue growth and improve the success of skin grafts. Larger clinical trials are being conducted to determine its effectiveness.

Things you can do to help reduce complications:

Keeping the burn clean and dry: This helps prevent infection and promotes healing.
Seeking immediate medical attention for severe burns: Electrical burns should be treated as severe burns, and you should get medical help right away.

It's important to note that these recommendations may vary depending on the severity of the electrical burn and individual circumstances. Consult with your healthcare professional for personalized advice.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.