Proper Treatment for Burns Sustained From Electric Shock

When you receive a serious electrical shock, there are actually three burns: the spot of skin where the electricity entered , the spot on the skin where the electricity exited and the internal body tissue through which the electrical current traveled. While first aid can help prevent circulatory shock and encourage the healing process, electrical burns demand professional medical help to address potentially life-threatening organ damage.

Determining Whether To Call 911

• While you want to err on the side of caution, not every electrical burn warrants a ride in an ambulance. It mainly depends on observed symptoms. If you find the victim unconscious or in the middle of a seizure, call 911. If the victim is conscious, but complains of numbness, tingling, muscle pain or involuntary muscle contractions, call 911.

  After calling 911, don't touch the victim until you've assessed the situation. Make sure that he is no longer in contact with the power source and, if possible, turn the electricity off. Next, check for breathing and pulse. If they're absent, have someone perform CPR on the victim until the paramedics arrive.

  If there is breathing, lay the victim on his back, elevate his legs and cover his torso with a blanket to help prevent circulatory shock. Don't bother attending to the burn at this point; just try to avoid moving him until the ambulance gets there.

Non-Emergency Treatment

• If the victim doesn't exhibit any of the aforementioned life-threatening symptoms, he should still be driven to a hospital that day, so a doctor can examine the extent of his internal injuries. The victim will need a series of blood tests and possibly an MRI, so choose either the hospital emergency room or a physician's office that connects directly to a hospital.

  One of the most dangerous complications from an electrical shock that can occur is a super-heating of bones. Just like the heating coils in an electric oven, bone absorbs a portion of the electricity running through it and converts it to heat. Depending on the voltage level and the length of the shock, the bone could absorb enough energy to start vaporizing the fluid in the surrounding tissue. A blood test will show increased levels of compounds associated with this thermal destruction.

  Before leaving for the hospital, run the burn under cold, clean water for about three minutes. Next, pat the surface dry with a clean towel and cover the burn with a sterile bandage pad.

Low-Voltage Burns

• Most low-voltage burns doctors see occur in the mouths and hands of children under the age of 5. To treat a hand burn, the site is cleansed and covered with poloxamer 188, a chemical that seals and repairs cell membranes damaged by electric shock and increases the chances of tissue survival. This gel, which also contains three different antibiotics, is reapplied twice daily. Meanwhile, a split helps immobilize the hand and keep the young patient from disturbing the burn dressing.

  Due to the extensive damage caused, electrical burns in the oral cavity do not really have a standard, long-term treatment plan. When a baby sucks on an exposed wire or extension cord socket, electricity readily flows through the electrolyte-rich saliva where it can generate temperatures of up to 2,500 degrees Fahrenheit. If the current flows through saliva on the face (i.e., "drool"), the burn can range from partial-thickness (i.e., a blistering, second-degree burn) all the way to destruction of a significant portion of the lips. If the current flows into the mouth, the high electrical resistance of bone can cause teeth and other skeletal tissue to heat up and destroy surrounding soft tissue.

  While physicians differ on how to treat deformities caused by oral electrical burns, the primary treatment generally consists of rinsing the burn with liquefied poloxamer 188, followed by applying a petroleum-based, antibiotic-containing ointment four times each day. Because the patient is so young, the doctor will likely fit both arms with splits to keep him from touching the burn site.

High-Voltage Burns

• Whether caused by a lightning strike or a utility-line accident, high-voltage electrical burns create a cascade of life-threatening conditions by turning the victim's bones into the physical equivalent of industrial heating coils.

  Burns from a high-voltage shocks often have a tell-tale black charring, caused by vaporized metal getting electroplated onto the skin's surface. This coating is gently removed with a stream of saline solution.

  Once the doctors can get a clear look at the burn, they must determine whether the tissue can even recover. If so, the burn will be cleansed with a poloxamer 188 and coated with antibiotic ointment.

  If the burn appears to be full-thickness (i.e., one that has penetrated or destroyed all three layers of the skin), an MRI will be ordered to assess the extent of the surrounding vascular damage. For local damage, the doctors will most likely order a skin graft. Should the vascular damage extend to the greater part of an appendage, the doctors will move to amputate.