This PPT is prepared for learning purpose for First BPTh.

1. Department of
Electrotherapy
and
Electrodiagnosis
Datta Meghe College of
Physiotherapy

2. SHOCK
Dr.Shailesh D. Patil
M.P.Th (Cardio-respi)
Associate Professor
Department of Cardiovascular and respiratory
Physiotherapy
Datta Meghe College of Physiotherapy
Wanadongari, Nagpur.

3. SHOCK

5. DEFINATION:
Ashock is a painful stimulation of sensory nerves caused by
a sudden flow, cessation or variation in the current passing
through the body.
Shock is a life threatening condition that occurs when the
body is not getting enough blood flow.
Damage multiple organs.

6. SEVERITY:
It depends upon path taken by the current , and
strong current through head, neck, might prove fatal .
Greater the current which passes through the body,
the more severe is the shock.
According to ohms law I=E/R high EMF large
current.
Most apparatus used in department is plugged into
the mains supply of 240 volts and frequency of 50
Hz. There fore represents a hazard of shock.

7. High resistance reduces intensity of current so if exposed
parts of circuit are touched with damp hands ,shock will be
more severe. lower the skin resistance greater the current
passage.
Type of current used: Shocks are more severe with AC current
when compared with DC.
Intensity of AC current is continually changing and so it
provides stronger stimulation. It may also produce tetanic
muscular contractions, which makes it impossible for the
victim to let go of the conductor.

8. EFFECTS OF ELECTRIC SHOCK:

9. Patient may be distressed and frightened but not loss
consciousness.
After a severe shock there is decreased the BP and may loss
consciousness.
In some cases there is cessation of respiration which leads to
the cardiac arrest due to ventricular fibrillation and absence of
pulse in carotid artery.
Cessation of respiration is recognized by lack of respiratory
movements and cyanosis, cardiac arrest by absence or
abnormality of respiratory movements, absence of pulse in
carotid artery and fully dilated pupils.

10. CAUSES
1. Poorly designed or badly serviced electro-medical
apparatus.
2. Patient receives shock if a low-frequency current is
switched on with the controls turned up, or insufficient time is
allowed for the apparatus to warm up.
3. If intensity control is turned up unduly during the intervals in
the flow of an interrupted or surged current

11. PRECAUTIONS:
All apparatus should checked before use and check
connection.
Intensity should check they must to zero.
Adequate time should give to warming up and increase
intensity slowly.
Patients should never touch the machine
Apparatus should be disconnected from the source of
supply before faults investigate.
.

12. Treatment of Electric Shock:

13. Firstly, disconnect the victim from source of supply.
Current should be switched off at once.
If there is no switch in the circuit the victim must be removed
from contact with the conductor.
But rescuer must take care not to receive a shock himself
from touching the affected person, contact should be made
only through a thick layer of insulating material.

14. Following a minor shock the patient is reassured and is
allowed to rest.
Water is given to drink but hot drinks should be avoided,
as they causes vasodilatation and sweating and
consequently further fall in BP.
In all the cases it is advisable to consult medical officer.
If the shock is severe, the victim is laid flat, in such a
position that respiratory passage are clear.
Tight clothing is loosened and plenty of air is allowed.

15. Undue warmth is avoided as it causes vasodilatation,
sweating and fall in BP and also external heat increases
metabolism and so the demand for oxygen, of which there is
already a dearth in the tissues.
If the patient is unconscious nothing is given by mouth and a
medical officer is summoned with out delay.
If respiration has ceased, airway is cleared and artificial
respiration is commenced immediately by mouth-mouth or
mouth-nose method or oxygen administered by a bag or a
mask.

17. In the event of cardiac arrest, external cardiac massage is
applied in addition to above protocol.

18. 2. EARTH SHOCK:

19. Due to a connection between the live wire of the main and
earth is called earth shock.
Earth circuit=electric power is transmitted by one live
cable and one neutral cable connected to earth.
.

20. The earth forms part of the conducting pathway and any
connection the live wire of the main and earth completes a
circuit through which current passes.
If any person forms part of the circuit he receives a shock.
So, earth shock is liable to occur if any person makes
contact with live wire of the main while connected to earth

21. Connection to live cable :
Patient receiving treatment with a current which is not earth
free connected to live cable.
It can be made by touching an exposed part of circuit and if
switch breaks only the neutral wire the connection can be
made even switch is turned off.
If the insulation on the live wire is faulty and the wire comes
in contact with some metal part of the apparatus, such as
the casing or the reflector of an IR lamp.

23. Connection to earth:

24. Made by touching any conductor connected to the earth. such as
gas or pipes ,
radiators, stone floors if they are damp.
Ametal bed on such a floor or one which is in contact with a pipe
or radiator, forms an earth connection.
So does the casing of apparatus if it is correctly connected to
earth.

25. Precautions against earth shock:

26. Arrange department so that there is minimum danger of anyone
making an earth connection while in contact with apparatus .
Water and gas pipe should out of the apparatus and patient
receiving treatment.
Floor should be of the insulating material and should be kept dry-
as water seeping through cracks in lionlem to a stone floor
beneath can from an earth connection.

27. If floor is not insulating material a non-conducting mat should
be placed under the patients foot during the treatment .
Switches must break the live wire and fuses must be on the
live wire so if earth circuit is made and a large current passes
the fuse blows and stops the current flow.
The metal causing of all apparatus must be connected to
earth.
Patients should not be permitted to touch the apparatus.

28. When currents are administered in the bath special care
must be taken i.e. the bath must be of insulating material
and leaking must be avoided.
The bath should have no fixed taps or waste pipe and if a
rubber hose id used for filing the bath it must be removed
before treatment is begun, as when it is damp current can
pass through it.
During the treatment the water should not be added.
Current used for the treatment should be always earth free.
The current obtained from the batteries are always earth-
free and that from a.c main can be rendered so by a static
transformer.

29. THANK YOU