An electrical burn is a burn that results from electricity passing through the body causing rapid injury. Approximately 1000 deaths per year due to electrical injuries are reported in the United States, with a mortality rate of 3-5%. [1] [2] Electrical burns differ from thermal or chemical burns in that they cause much more subdermal damage. [3] They can exclusively cause surface damage, but more often tissues deeper underneath the skin have been severely damaged. As a result, electrical burns are difficult to accurately diagnose, and many people underestimate the severity of their burn. In extreme cases, electricity can cause shock to the brain, strain to the heart, and injury to other organs. [4]
For a burn to be classified as electrical, electricity must be the direct cause. For example, burning a finger on a hot electric steam iron would be thermal, not electrical. According to Joule's first law: electricity passing through resistance creates heat, so there is no current entering the body in this type of burn. Likewise, a fire that is ruled to be "electrical" in origin, does not necessarily mean that any injuries or deaths are due to electrical burns. Unless someone was injured at the exact moment that the fire began, it is unlikely that any electrical burns would occur.
Electrical burns can be caused by a variety of ways such as touching or grasping electrically live objects, short-circuiting, inserting fingers into electrical sockets, and falling into electrified water. Lightning strikes are also a cause of electrical burns, but this is a less common event. [5] With the advances in technology, electrical injuries are becoming more common and are the fourth leading cause of work-related traumatic death. [6] One third of all electrical traumas and most high-voltage injuries are job related, and more than 50% of these injuries result from power line contact. [6]
Electrical burns can be classified into six categories, and any combination of these categories may be present on an electrical burn victim:
Four electrical factors determine the severity of the damage caused by electrical burns: voltage, current, resistance, and frequency. The severity of the burn also depends on the pathway the current takes through the body. [12] Generally, the pathway of the current will follow the course of the least resistant tissues: firstly blood vessels, nerves, and muscle, then skin, tendon, fat, and bone. [8] Most commonly, electric injuries primarily damage the outer limbs, but more critical portions of the body may be affected as well causing severe complications. [13]
As the body comes into contact with an electrical source, it becomes part of the electrical circuit. As such, the current has a point of entry and an exit at two different points on the body. The point of entry tends to be depressed and leathery whereas the exit wound is typically more extensive and explosive. [8] It is hard to accurately diagnose an electrical burn because only the entry and exit wounds are visible and the internal damage is not. [9]
The following are some examples of unsafe practices which could lead to electric injury (this list is not exhaustive.): [14]
An electrically burned patient should not be touched or treated until the source of electricity has been removed. [12] Electrical injuries often extend beyond burns and include cardiac arrhythmia, such as ventricular fibrillation. First aid treatments include assessment of consciousness of the victim, evaluation of pulse and circulation, and treatment of burns. [15]
Typically, an electrical burn patient has a lower affected body surface area than other burn patients, yet complication risks are much higher due to internal injury. [16] Often, the damaged internal tissue demands hospitalization. If not treated, this damaged tissue can cause complications (such as gaseous gangrene from dead tissue or loss of blood flow to limbs) and the damaged body parts may need to be amputated. [9] Repeated removal of the damaged tissue and extensive rehabilitation are common, while limb amputation rates for victims who experience direct electrical contact can be as high as 75%. [17] Burn treatment for severe wounds may require skin grafting, debridement, excision of dead tissue, and repair of damaged organs. [18]
Electrical burning has an effect on most vital body functions and is accompanied by several other electrical related injuries:
These injuries must be treated in addition to the burns themselves. In very rare instances, a high voltage electric shock can cause cataracts in the lens of the eyes, and detachment of the retina. This may be delayed for some days or weeks after the initial injury. [19]
Mains electricity or utility power, grid power, domestic power, and wall power, or, in some parts of Canada, hydro, is a general-purpose alternating-current (AC) electric power supply. It is the form of electrical power that is delivered to homes and businesses through the electrical grid in many parts of the world. People use this electricity to power everyday items by plugging them into a wall outlet.
An electrician is a tradesperson specializing in electrical wiring of buildings, transmission lines, stationary machines, and related equipment. Electricians may be employed in the installation of new electrical components or the maintenance and repair of existing electrical infrastructure. Electricians may also specialize in wiring ships, airplanes, and other mobile platforms, as well as data and cable lines.
An electrical injury, or electrical shock is damage sustained to the skin or internal organs on direct contact with an electric current.
A short circuit is an electrical circuit that allows a current to travel along an unintended path with no or very low electrical impedance. This results in an excessive current flowing through the circuit. The opposite of a short circuit is an open circuit, which is an infinite resistance between two nodes.
A circuit breaker is an electrical safety device designed to protect an electrical circuit from damage caused by current in excess of that which the equipment can safely carry (overcurrent). Its basic function is to interrupt current flow to protect equipment and to prevent fire. Unlike a fuse, which operates once and then must be replaced, a circuit breaker can be reset to resume normal operation.
Electrocution is death or severe injury caused by electric shock from electric current passing through the body. The word is derived from "electro" and "execution", but it is also used for accidental death.
Electrical wiring in North America follows the regulations and standards applicable at the installation location. It is also designed to provide proper function, and is also influenced by history and traditions of the location installation.
A residual-current device (RCD), residual-current circuit breaker (RCCB) or ground fault circuit interrupter (GFCI) is an electrical safety device that interrupts an electrical circuit when the current passing through a conductor is not equal and opposite in both directions, therefore indicating leakage current to ground or current flowing to another powered conductor. The device's purpose is to reduce the severity of injury caused by an electric shock. This type of circuit interrupter cannot protect a person who touches both circuit conductors at the same time, since it then cannot distinguish normal current from that passing through a person.
The National Electrical Code (NEC), or NFPA 70, is a regionally adoptable standard for the safe installation of electrical wiring and equipment in the United States. It is part of the National Fire Code series published by the National Fire Protection Association (NFPA), a private trade association. Despite the use of the term "national," it is not a federal law. It is typically adopted by states and municipalities in an effort to standardize their enforcement of safe electrical practices. In some cases, the NEC is amended, altered and may even be rejected in lieu of regional regulations as voted on by local governing bodies.
Erotic electrostimulation is a sexual practice involving the application of electrical stimulation to the nerves of the body, with particular emphasis on the genitals, using a power source for purposes of sexual stimulation. Electrostimulation has been associated with BDSM activities, and erotic electrostimulation is an evolution of that practice.
High voltage electricity refers to electrical potential large enough to cause injury or damage. In certain industries, high voltage refers to voltage above a certain threshold. Equipment and conductors that carry high voltage warrant special safety requirements and procedures.
A contactor is an electrically controlled switch used for switching an electrical power circuit. A contactor is typically controlled by a circuit which has a much lower power level than the switched circuit, such as a 24-volt coil electromagnet controlling a 230-volt motor switch.
Electrosurgery is the application of a high-frequency alternating polarity, electrical current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. Its benefits include the ability to make precise cuts with limited blood loss. Electrosurgical devices are frequently used during surgical operations helping to prevent blood loss in hospital operating rooms or in outpatient procedures.
An arc flash is the light and heat produced as part of an arc fault, a type of electrical explosion or discharge that results from a connection through air to ground or another voltage phase in an electrical system.
NEMA connectors are power plugs and sockets used for AC mains electricity in North America and other countries that use the standards set by the US National Electrical Manufacturers Association. NEMA wiring devices are made in current ratings from 15 to 60 amperes (A), with voltage ratings from 125 to 600 volts (V). Different combinations of contact blade widths, shapes, orientations, and dimensions create non-interchangeable connectors that are unique for each combination of voltage, electric current carrying capacity, and grounding system.
Stray voltage is the occurrence of electrical potential between two objects that ideally should not have any voltage difference between them. Small voltages often exist between two grounded objects in separate locations by the normal current flow in the power system. Contact voltage is a better defined term when large voltage appear as a result of a fault. Contact voltage on the enclosure of electrical equipment can appear from a fault in the electrical power system, such as a failure of insulation.
Macroshock is a medical term for the effects of body exposed to electrical current, which can lead to severe injury or death by electrocution. It is used most often in the medical field, but is also commonly used in the fields of electrophysiology and bioengineering. Definitions of the term are inconsistent; there are three most commonly accepted definitions. Depending upon the medical text used, a macroshock is either:
In building wiring installed with separate neutral and protective ground bonding conductors, a bootleg ground is a connection between the neutral side of a receptacle or light fixture and the ground lug or enclosure of the wiring device.
Electric shock drowning is a term used in the US to describe a cause of death that occurs when swimmers are exposed to electric currents in the water. In some cases the shock itself is fatal, since the person will suffocate when their diaphragm is paralyzed, while in others it incapacitates the swimmer causing them to drown. The main cause of electric shock drownings is faulty electrical wiring on boats or piers that causes electric current to leak into the water. Electric shock drownings occur most often in fresh water, which is conductive due to dissolved minerals and impurities. The increased conductivity of saltwater reduces the fraction of the electric current that flows through a submerged person, whose body has a much smaller conductivity than the saltwater. In this case, the current to cause electric shock drowning would be so great that current-limiting circuit breakers would trip and shut off the current, thereby protecting against electric shock drowning in saltwater.
Fractal burning, Lichtenberg burning or wood fracking refers to a technique where a Lichtenberg figure is burnt into wood using high voltage electricity. It has gained notoriety due to numerous incidents of death or severe injuries when people have attempted it at home, with at least 33 people having died between 2017 and 2022.