Electrical burns result from contact with electrical currents and can cause significant internal damage, with about 1,000 deaths and 3,000 admissions to specialized burn centers annually. Injuries can be classified into true electrical injuries, flash injuries, and lightning injuries, with varied symptoms depending on the current path through the body. Management involves thorough investigation and monitoring of complications like cardiac arrhythmias, muscle damage, and respiratory distress.

1. ELECTRICAL BURNS

2. • An electrical injury is damage to the skin or internal organs when a
person comes into direct contact with an electrical current.
• Electrical injuries like electrocution have become a more common
form of trauma with high mortality.

3. Epidemiology
• Electrical injuries:
• 1000 deaths per year
• 3000 admisions to specialzed burn centers per year
• Lightening injury:
• 50-300 deaths per year

4. • 20% of all electrical injuries are in children
• At home with extension cords and wall outlets
• Adults most are occupational electrocutions resulting from power line
contact.
• Also result from using electrical tools or machines

5. Classes of Electrical Injuries
1. True electrical injuries: The person becomes part of the electrical
circuit and has an entrance and exit site
2. Flash injuries: These occurs when there is a sudden release of
electrical energy, causing a quick burst of heat that can burn the
skin
3. Lightening injuries: A unique type of injury that occurs at extremely
high voltages for the shortest duration, the majority of electrical
flow occurs over the body (Lichtenberg Figures (Fern-like Patterns)

6. • The current pathway affects the injury seen
• Through the chest: Myocardial problems
• Through the brain: respiratory arrest, seizures
• Through the orbits: cataracts

11. • Direct contact (high and low)
• Low voltage < 1000
• High voltage > 1000
• Domestic: low voltage causes small deep contact burns at exit and
entry points
• True high tension: Voltage > 1000 Extensive tissue damage and limb
loss. Muscle damage give rise to rhabdomyolysis and renal failure may
occur

13. Symptoms of Electrical Burns
- Entry and exit burns
- Pain
- Numbness
- Muscle damage
- Cardiac arrhythmias or cardiac arrest
- Respiratory distress

14. Electrical burns can be classified as:
• Direct current (DC): Tends to cause a single muscle spasm, throwing
the body away from the electrical source.
• Alternating current (AC): Three times more dangerous than DC
Continuous muscle tetany occurs between 40 and 110 HZ. This can
prevent the victim from releasing the electrical source

15. • Ohm’s Law
V = IxR
V is the voltage across the resistor in volts (V)
I is the current flowing through the resistor in amperes(A)
R is the resistance of the resistor in Ohms

16. Body Tissue Resistance
Least : Nerves, Blood, Mucous membranes, Muscle
Intermediate : Dry skin, Tendon, Fat
Most : Bone

17. • The longer the duration of contact with high-voltage current, the
greater the electro thermal heating and degree of tissue destruction

18. Route of Current
• The pathway that a current takes determines tissues at risk, the type
of injury seen
• Current passing through the heart or thorax can cause cardiac
dysrhythmias and myocardial damage
• Current passing through the brain can result in respiratory arrest,
seizures and paralysis
• Current in proximity to the eyes can cause cataracts

19. Jackson’s Burn Zones
• Zone of coagulation: Point of maximum damage. Irreversible tissue
loss due to coagulation of constituent proteins
• Zone of stasis: characterized by decreased perfusion. Tissue here is
potentially salvageable
• Zone of hyperemia: Outermost zone where perfusion is increased.
Tissues will invariably recover unless there is severe sepsis or
prolonged hyporperfusion

21. Investigations
• FBC
• BUE AND CR
• LFT
• CLOTTING PROFILE
• ABGs
• WOUND SWAB FOR C/S
• ECG
• OTHER IMAGING AS NECESSARY-RADIOGRAPHS, ULTRASOUND, FIBRE-
OPTIC BRONCHOSCOPY