The short-term and long-term effects of electric shock on the human body

Electric shock is a terrifying phenomenon that didn’t begin with Nikola Tesla or Thomas Edison. Electricity is all around us, all the time, and comes with the possibility and reality of electric shock. Electrical burns are some of the most complex and deadliest burn injuries treated across Burn and Reconstructive Centers of America’s (BRCA) national care system due to how electric currents travel through the body. These burns are rarely only surface-level injuries. Due to the body’s ability to conduct electricity, the body itself acts as a conduit for the current to move through, causing the current to travel and injure muscles, deep tissues, nerves, blood vessels and organs. Electrical burns are deadly, and survivors often face the possibility or reality of amputation.

What causes electric shock?

Electricity is defined as the flow of electrical power or charge. When you receive a “shock,” you’ve come into contact with an electrical current. You might have experienced this phenomenon at least once through static shock. While serious injuries are highly unlikely to occur from the average static shock, other potential causes of electrical shock are much more dangerous and numerous in our everyday lives. The most common ones include:

• Electrical wall outlets
• Faulty appliances
• Powerlines
• Lightning
• Frayed or damaged cords

The difference between electrical voltage, amperage and current—how much of each does it take to kill the average person?

What makes some electrical shock hazards more dangerous than others? Electrical amperage, current and voltage decide how a shock might affect a person.

Voltage

Electrical voltage is the measure of force it takes to move a charge between two points or through a conductor. Because Voltage = Current x Resistance, if the voltage goes up, then the current is probably also going up. Voltage behaves a lot like pressure in how we see and experience it, while the electrical current is like flow. So, what does voltage look like in everyday examples? The typical voltage of a car battery is 12 V of direct current (DC), while standard household outlets fall in the range of 110-120 V of alternating current (AC). Because the human body is a high conductor of electricity, the force it would take to move electrical current through the tissue is minimal. That means a minimum voltage of 50 V is enough to be lethal.

High voltage electric shock incidents, such as getting struck by lightning, are much rarer than low-voltage injuries. More people die of a low voltage such as outlets, or during home wiring jobs because low voltage shocks can cause deadly cardiac defibrillation or heart arrhythmias. In contrast, high voltage shocks can severely damage the organs.

While an electrical burn injury may not be as significant from a low-voltage shock, these electrical shocks can cause arrhythmia or abnormal heart rhythm.  The danger of low-voltage shock injuries is they can often lead to more severe complications and death due to cardiac defibrillation. Defibrillation, such as from a medical defibrillator or other sources of low voltage shock, stops your heart and acts as a restart, sometimes throwing the heart into and out of its natural rhythm. Therefore, it is common practice to administer cardiopulmonary resuscitation (CPR) on the scene of a low voltage shock to restart the heart or get the heart back into a natural rhythm.

Amperage

Between voltage and amperage, amperage poses the most significant risk. Voltage is the force it takes to move a charge; amperage measures the flow of charge through a conductor. It is measured in amperes or amps (A). So, what are amperes compared to volts? A typical car battery of 12V can be between 550 to 1,200A, while a home outlet of 110-120V is typically 15A. While care batteries have fewer volts than outlets, they have a higher amperage. However, the risk of electrocution from high amperage increases or decreases slightly depending on the type of electrical current: direct current (DC) or alternating current (AC).

Current

An alternating current (AC), invented by Nicola Tesla, is an electrical current that reverses the direction of electron flow multiple times a second. Most commercial applications use alternating current. Alternating current is the electrical current used to deliver electricity to households and businesses and high voltage electrical appliances. When under the same voltage or amperage, alternating current is considered the more dangerous of the two because it can cause tetany (spasms or seizing), cardiac fibrillation, respiratory muscle paralysis and cardiac dysrhythmia upon electrical shock. Alternating currents have contact points but no actual entrance or exit points. The inability to let go or release from an electric charge is more likely to occur with an alternating current than a direct current because an alternating current inhibits the let go response at a lower current.

Direct current (DC), invented by Thomas Edison, is an electrical current that only flows in one direction. Direct current is associated with lightning, car batteries, medical appliances like defibrillators and other low voltage applications. The rapid rate car chargers for electric cars are usually direct current. Entrance and exit wounds are common injuries for those who’ve suffered electrical shocks from direct current sources. While alternating current sources are more dangerous than direct current sources, that is not to say that both cannot be fatal. Both direct and alternating currents can cause a person to lock on (tetany), but a direct current is easier to let go of. The difference is that the body can tolerate direct current more than alternating and may be able to take more of a charge for longer with fewer injuries than alternating current.

What happens when you get shocked?

Electricity’s goal is to ground itself. The biggest conductor we experience is earth, which is why you may have learned in school that lightning is always trying to get to the ground. The human body naturally conducts electricity as the earth does. That means electrical currents can readily travel through the body. The nerves, vessels, muscles and skin are the most accessible parts of the body for electrical current to travel through, but that isn’t a good thing. Trying to get to the ground, an electric current will go around or through you, traveling through the body part closest to the source and following the path of least resistance on its way out of the body. If you are wearing rubber shoes, the current won’t be able to get out, which is why wearing rubber products while working with electricity is encouraged to help prevent injuries. So, what other injuries can occur as a result of electric shock?

For minor shocks or shocks from low power sources, the electricity most likely won’t enter the body but will incur superficial damage to the skin, such as first- to second-degree burns.

The electrical current will enter the body via an entrance wound for more severe electrical shocks. The entrance wound is typically the place in contact with the electrical source. For example, if you grab a live electrical wire, the entrance wound would likely be on the hand. Once in your body, the electrical current will travel throughout the body via the tissues with the highest conductivity (nerves, vessels, muscles). These tissues may be severely damaged from the electrical current traveling through them, so you can wind up with deep damage from a high current source because, as it tries to go through the bones, they get superheated. If the bones have been damaged and heated enough to impact the surrounding tissue and nerves, it might result in a “dead limb” and amputation. If the person cannot disconnect from the source of electricity, the steady flow of electricity will need to find a way out of the body. This is what is called an exit wound. It is the place where electricity exits the body. Some common areas for exit wounds are the feet and the opposite hand. However, If the person becomes disconnected from the source of electricity, there may not be an exit wound.

While entrance and exit wounds can be severe, it’s essential to examine the whole patient. Since entrance and exit wounds aren’t particularly easy to identify and most internal damage is hidden, electric shock patients need to be observed for a few days to understand the prognosis fully. If the patient is having difficulty moving a particular body part after an electric shock and, after a few days, can move it a bit easier, that’s a good sign. If the patient can’t move it at all a couple of days later, that’s usually irreversible damage. Limitations and functions that improve over time typically result in a good prognosis, but deficits that get worse over time often become permanent.

Effects of electric current on the human body

Electrical injuries are some of the most complex cases treated across Burn and Reconstructive Centers of America’s (BRCA) care system. They are much more involved than what is visible on the outside.

Burns: Electrical injuries often involve burns. If it is a high-voltage electrical injury, the shock will cause burns anywhere from first-degree burns (minor burns) to fourth-degree burns (severe burns) on the body. Depending on the mechanism, however, electrical shocks can also cause a person’s clothes to catch fire, incurring thermal burns that way as well. The burns may appear:

• First-degree: red or pink skin with no blistering
• Second-degree: red and moist in appearance with blistering
• Third-degree: dry, tight and leathery, brown/tan/waxy or pearly white in appearance
• Fourth-degree: black and charred in appearance with possible muscle or bone involvement

Traumatic injuries: Traumatic injuries can happen depending on where and how the electrical injury occurs. A traumatic injury such as a spinal or cranial injury might occur due to an electrical shock if the shock is powerful enough to throw a person physically or if the shock happens at a great height. Spinal injuries may also occur after sudden extension from tetany (muscular spasms or seizing), which can cause vertebral fractures. If this is the case, traumatic injuries will take precedence over burns, and the person will be taken to a trauma unit before being transferred to a burn unit.

Compartment syndrome: Compartment syndrome occurs after a severe burn when the affected areas begin to swell. The swelling (edema) can cut off the blood supply and cause even more damage. Emergency medical intervention is necessary to restore the blood supply and save healthy tissue when this happens.

Amputation: In severe electrical shock where the person has suffered fourth-degree burns, amputation may be necessary. Fourth-degree burns affect the skin, tissues, vessels and muscles and bone. Typically, electrical shock amputations involve the areas with exit or entrance wounds.

Internal damage: Most of the damage from electrical shock cannot be seen on the outside. As the current travels through the body, internal organs and tissues can be damaged. Some internal damage that can be caused by electrical shock include:

• Vascular compromise: the blood vessels, arteries and veins are highly conductive to electricity. Electric shock may damage the blood vessels, arteries and veins by causing them to burst, cutting off the blood supply, causing painful varicose veins and more.
• Lethal dysrhythmias: the heart is a muscle that pumps using electrical pulses. Electric shock can disrupt or mask these pulses, throwing the heart out of rhythm and possibly causing cardiac arrest.
• Organ failure: electric shock can cause organ failure or multiple organ failure. This may include the heart (cardiac arrest), the kidneys (renal failure) and more.

Long-term effects of electric shock

Long-term effects of electric shock on the human body are hard to diagnose or track over time. However, some long-term effects have continuously presented in burn and trauma patients that most researchers and healthcare workers attribute to the electric shock that those patients survived.

Physical effects:

• Eye problems, specifically the rapid development of cataracts
• Generalized pain that many don’t receive satisfactory relief from
• Ghost pains or itches, specifically in those suffering from amputations
• Joint stiffness, arthritis and contracture due to muscle damage
• Muscle pain and spasms
• Permanent neurological injuries such as paralysis
• Itching, possibly as a side effect of the burns

Psychological effects:

• Reduced cognitive abilities, specifically verbal recall and attention span
• Post-traumatic stress disorder (PTSD)
• Anxiety
• Depression
• Development of a phobia
• Memory loss, especially around incident and recovery

Neurological effects:

• Numbness, tingling or pins and needles sensation (paresthesia) due to nerve damage
• Carpal tunnel syndrome due to median nerve damage
• Paralysis
• Seizure disorders
• Dizziness, loss of balance or fainting spells
• Ringing in the ears (tinnitus) or progressive hearing loss
• Tremors
• Migraines

While we cannot guarantee all of these are long-term effects of electric shock, we can trust what our patients go through during their recovery. Electrical shock and burn survivor Mary Calhoun said, “I have injuries that are longer-term that are popping up that we discovered are probably caused by [the shock]. I’ve lost a lot more of my hearing. I have cataracts now; I didn’t have them the year before, and they’re rapidly, rapidly growing.”

It is to examine electrical shock victims for cataracts during the initial phase of their care to document that the cataracts are not pre-existing conditions. Since cataracts and eye problems are known long-term effects of electrical shock, an ophthalmologist should be contacted to examine the eyes and ensure they are fine, so if later effects show up, they can be documented. Burn and Reconstructive Centers of America’s burn care teams work closely with our patients and the Joseph M. Still Research Foundation to track these symptoms and the long-term effects of electric shock for the present and future creation of individualized patient care plans.

Scene control is important. If you believe someone has been in contact with an electrical source, turn off the electrical source. You can die from trying to help someone being shocked since they are acting as a conductor for the current.  Shut off the electricity, if you can, before assisting the victim for the best chance of recovering them.

Further Information

Burns and electrical shock injuries are not “curable.” Instead, they are life-long conditions that require years of appointments, therapy, medications and surgeries. Our healthcare team at BRCA does what they can to limit the long-term effects of burn injuries and give our patients the best outcomes possible. For more information about BRCA locations and services, please visit our website at www.burncenters.com. If you have questions or would like to schedule an appointment, please call our burn information services at (855) 863-9595.

For more information about electrical burns, please click here .

To read stories about electrical burn survivors, please see the links below:

Mary Calhoun 

Wayne (Barry) Johnson 

Symptoms, First Aid Treatment, Long-Term Effects

An electric shock happens when an electric current passes through your body. This can burn both internal and external tissue and cause organ damage.

A range of things can cause an electric shock, including:

• power lines
• lightning
• electric machinery
• electric weapons, such as Tasers
• household appliances
• electrical outlets

While shocks from household appliances are usually less severe, they can quickly become more serious if a child chews on an electric cord our puts their mouth on an outlet.

Aside from the source of the shock, several other factors affect how serious an electric shock is, including:

• voltage
• length of time in contact with the source
• overall health
• electricity’s path through your body
• type of current (an alternating current is often more harmful than a direct current because it causes muscle spasms that make it harder to drop the source of electricity)

If you or someone else has been shocked, you may not need emergency treatment, but you should still see a doctor as soon as possible. Internal damage from electric shocks is often hard to detect without a thorough medical exam.

Read on to learn more about electric shocks, including when it’s a medical emergency.

The symptoms of an electric shock depend on how severe it is.

Potential symptoms of an electric shock include:

• loss of consciousness
• muscle spasms
• numbness or tingling
• breathing problems
• headache
• problems with vision or hearing
• burns
• seizures
• irregular heartbeat

Electric shocks can also cause compartment syndrome. This happens when muscle damage causes your limbs to swell. In turn, this can compress arteries, leading to serious health problems. Compartment syndrome might not be noticeable immediately after the shock, so keep an eye on your arms and legs following a shock.

If you or someone else has been shocked, your immediate response can have a big impact on minimizing the effects of an electric shock.

If you’ve been shocked

If you receive an electric shock, it might be difficult for you to do anything. But try to start with the following if you think you’ve been severely shocked:

• Let go of the electric source as soon as you can.
• If you can, call 911 or local emergency services. If you can’t, yell for someone else around you to call.
• Don’t move, unless you need to move away from the electric source.

If the shock feels minor:

• See a doctor as soon as you can, even if you don’t have any noticeable symptoms. Remember, some internal injuries are hard to detect at first.
• In the meantime, cover any burns with sterile gauze. Don’t use adhesive bandages or anything else that might stick to the burn.

If someone else has been shocked

If someone else receives a shock, keep several things in mind to both help them and keep yourself safe:

• Don’t touch someone who has been shocked if they’re still in contact with the source of electricity.
• Don’t move someone who has been shocked, unless they’re in danger of further shock.
• Turn off the flow of electricity if possible. If you can’t, move the source of electricity away from the person using a non-conducting object. Wood and rubber are both good options. Just make sure you don’t use anything that’s wet or metal based.
• Stay at least 20 feet away if they’ve been shocked by high-voltage power lines that are still on.
• Call 911 or local emergency services if the person was struck by lightning or if they came into contact with high-voltage electricity, such as power lines.
• Call 911 or local emergency services if the person has trouble breathing, loses consciousness, has seizures, has muscle pain or numbness, or is feeling symptoms of a heart issue, including a fast heartbeat.
• Check the person’s breathing and pulse. If necessary, start CPR until emergency help arrives.
• If the person is showing signs of shock, such as vomiting or becoming faint or very pale, elevate their legs and feet slightly, unless this causes too much pain.
• Cover burns with sterile gauze if you can. Don’t use Band-Aids or anything else that might stick to the burn.
• Keep the person warm.

Even if the injuries seem minor, it’s crucial to see a doctor after an electric shock to check for internal injuries.

Depending on the injuries, potential electric shock treatments include:

• burn treatment, including the application of antibiotic ointment and sterile dressings
• pain medication
• intravenous fluids
• a tetanus shot, depending on the source of the shock and how it occurred

For severe shocks, a doctor may recommend staying in the hospital for a day or two so they can monitor you for any heart issues or severe injuries.

Some electric shocks can have a lasting impact on your health. For example, serious burns can leave permanent scars. And if the electrical current goes through your eyes, you may be left with cataracts.

Some shocks can also cause ongoing pain, tingling, numbness, and muscle weakness due to internal injuries.

If a child sustains a lip injury or burn from chewing on a cord, they may also have some heavy bleeding when the scab eventually falls off. This is normal, due to the number of arteries in the lip.

Electric shocks can be very serious, so it’s important to seek help as soon as possible. If the shock seems severe, call 911 or your local emergency number. Even if the shock seems minor, it’s best to follow up with a doctor to make sure there aren’t any less visible injuries.

Emotional shock definition, stages, consequences, what to do?

Emotional shock: definition, stages, consequences, what to do?

Emotional shock, also called psychological shock, is our body’s response to a traumatic situation. If left untreated, it can develop into a psychiatric pathology. What are the symptoms? What are the steps? What to do to get out of this? Explains Dr. Gerard Mackeron, a psychiatrist from Paris.

In psychology, an emotional shock occurs as a result of a traumatic event that inhibits a person’s ability to cope with emotions, and that he experiences when they occur. The psychological trauma experienced in this way can lead to significant consequences in a more or less long term. You should know that emotional shock is one of the factors contributing to the onset of depression. It can be caused by a bereavement, disappointment in love, family problems, an accident. In most cases, the shock is caused by a negative event.

Symptoms: what are the stages of emotional shock?

Normally, the stress response kicks in when we have to deal with a threatening situation. “This reaction is expressed in physiological changes that prepare us for action (flight or attack). When we are faced with a traumatic situation, this stress response becomes outdated and inadequate. Schematically, this leads to 3 main types of reactions,” explains Dr. Gerard Mackeron. The presence of these symptoms should be alert, as they indicate a transition to a post-traumatic state”

Mental shock : the victim is in shock, stunned, immobile, unable to act and reason – she seems to freeze.

Random vanity: a person fusses inefficiently, shouts, runs aimlessly.

Psychic dissociation: Subject appears to act in an adaptive manner, but actually operates in automatic mode without any thought. It’s like he’s physically present but mentally absent.

What are the causes of emotional shock?

These are often events that lead to death threats, as well as sexual violence, which can cause emotional shock. “However, there is no connection between the objective severity of an event and the consequences of this event for the mental balance of a person,” the psychiatrist clarifies. What matters is not so much what actually happened, but how the person felt. This explains that witnesses, guardians or relatives can also be traumatized,” explains our interlocutor.

What are the health effects?

Emotional shock usually resolves within hours or even days. When these symptoms persist one month after the event, it is called post-traumatic stress disorder. “Without treatment, this condition can become chronic and be complicated by the appearance of other pathologies, such as mood disorders, depression, personality changes, alcoholism or drug addiction,” the specialist clarifies.

What to do and who to consult?

The way out of emotional shock is based on different principles: “in addition to the environment, it is important to put into words what was experienced, as well as to sleep well and calm down,” says Dr. Gerard Mackeron. In parallel, a psychiatrist or trauma psychologist should be consulted using methods such as EMDR, cognitive and behavioral therapy (CBT), or even hypnosis.” Depending on the emotional state of the patient, antidepressants may be prescribed.

Original article

Hemorrhagic shock – article from the Innovative Vascular Center

Hemorrhagic shock (HS) is a critical condition of the body associated with acute blood loss, resulting in a crisis of macro- and microcirculation, a syndrome of multiple organ and polysystemic insufficiency. From a pathophysiological point of view, this is a microcirculation crisis, its inability to provide adequate tissue metabolism, satisfy the tissue need for oxygen, energy products, and remove toxic metabolic products.

The body of a healthy person can restore blood loss up to 20% of BCC (approximately 1000 ml) due to autohemodilution and redistribution of blood in the vascular bed. With blood loss of more than 20-25%, these mechanisms can eliminate the BCC deficiency. With massive blood loss, persistent vasoconstriction remains the leading “protective” reaction of the body, in connection with which normal or close to normal blood pressure is maintained, blood supply to the brain and heart is carried out (centralization of blood circulation), but due to weakening of blood flow in the muscles of internal organs, including kidneys, lungs, liver.

Long-term stable vasoconstriction, as a protective reaction of the body, initially maintains blood pressure within certain limits for some time, later, with the progression of shock and in the absence of adequate therapy, it contributes to the consistent development of severe microcirculation disorders, the formation of “shock” organs and the development of acute renal failure and other pathological conditions.

The severity and speed of disorders in HS depends on the duration of arterial hypotension, the ascending state of organs and systems. With ascending hypovolemia, short-term hypoxia during childbirth leads to shock, as it is a trigger for impaired hemostasis.

Hemorrhagic shock clinic

Hemorrhagic shock is manifested by weakness, dizziness, nausea, dry mouth, darkening of the eyes, with increased blood loss – loss of consciousness. In connection with the compensatory redistribution of blood, its amount decreases in the muscles, the skin is manifested by pallor of the skin with a gray tint; the limbs are cold, wet. A decrease in renal blood flow is manifested by a decrease in diuresis, subsequently with impaired microcirculation in the kidneys, with the development of ischemia, hypoxia, and tubular necrosis. With an increase in blood loss, symptoms of respiratory failure increase: shortness of breath, respiratory rhythm disturbance, agitation, peripheral cyanosis.

There are four degrees of severity of hemorrhagic shock:

• I degree of severity is observed with a BCC deficit of 15%. The general condition is satisfactory, the skin is pale, slight tachycardia (up to 80-90 beats / min), blood pressure within 100 mm Hg, hemoglobin 90g / l, central venous pressure is normal.
• II degree severity – BCC deficiency up to 30%. General condition of moderate severity, complaints of weakness, dizziness, darkening of the eyes, nausea, skin is pale, cold. Blood pressure 80-90 mm Hg, central venous pressure below 60 mm wg, tachycardia up to 100-120 beats/min, reduced diuresis, hemoglobin 80 g/l and below.
• III degree severity occurs with a BCC deficiency of 30-40%. The general condition is severe. There is a sharp lethargy, dizziness, pale skin, acrocyanosis, blood pressure below 60-70 mm Hg, CVP drops (20-30 mm water column and below). There is hypothermia, frequent pulse (130-140 beats / min), oliguria.
• IV degree severity is observed with a BCC deficiency of more than 40%. The condition is very serious, consciousness is absent. Arterial pressure and central venous pressure are not determined, the pulse is noted only on the carotid arteries. Breathing is superficial, rapid, with an abnormal rhythm, mobile excitation, hyporeflexia, anuria are noted.

Treatment of hemorrhagic shock

• Fast and reliable bleeding control.
• Replenishment of BCC and maintenance of macro-, microcirculation and adequate tissue perfusion using controlled hemodilution, blood transfusion, rheocorrectors, glucocorticoids, etc.;
• Artificial ventilation of the lungs in the mode of moderate hyperventilation with positive end-expiratory pressure (prevention of “shock lungs”)
• Treatment of the syndrome of disseminated intravascular coagulation, disorders of the acid-base state, protein and water-electrolyte metabolism, correction of metabolic acidosis;
• Anesthesia, therapeutic anesthesia, antihypoxic protection of the brain;
• Maintain adequate urine output at 50-60 ml/hour;
• Maintaining the activity of the heart, liver;

Elimination of the cause of bleeding is the main point in the treatment of hemorrhagic shock. The choice of method to stop bleeding depends on its cause. In the treatment of great importance is the speed of compensation for blood loss and timely surgical treatment. At the II degree of severity, hemorrhagic shock is an absolute indication for the operational stop of bleeding.

Infusion therapy for hemorrhagic shock should be carried out in 2-3 veins: with blood pressure in the range of 40-50 mm Hg. the volumetric infusion rate should be 300 ml/min at a blood pressure of 70-80 mm Hg. – 150-200 ml / min with stabilization of blood pressure up to 100-110 mm Hg. infusion is carried out drip under the control of blood pressure and hourly diuresis.

The ratio of colloids and crystalloids should be 2:1. Infusion therapy includes: rheopolyglucin, volecam, erythromass, native or fresh frozen plasma (5-6 vials), albumin, Ringer-Locke solution, glucose, panangin, prednisolone, corglicon, for the correction of metabolic acidosis – 4% sodium bicarbonate solution, trisamine . In hypotensive syndrome – the introduction of dopamine or dopamine. The volume of infusion should exceed the estimated blood loss by 60-80%, at the same time, blood transfusion is carried out in the amount of not more than 75% of blood loss with its simultaneous replacement, then delayed blood transfusion in smaller doses.

To eliminate vasospasm after eliminating bleeding and eliminating BCC deficiency, ganglionic blockers are used with drugs that improve the rheological properties of blood (rheopolyglucin, trental, complamin, chimes). It is necessary to use high doses of glucocorticoids (30-50mg/kg of hydrocortisone or 10-30mg/kg of prednisone), diuretics, mechanical ventilation.

For the treatment of DIC in HS, fresh frozen plasma is used, protease inhibitors – contrical (trasylol) 60-80000 OD, Gordox 500-600000 OD. Dicynon, etamzilat, androxon reduce capillary fragility, enhance the functional activity of platelets. Cardiac glycosides, immunocorrectors, vitamins are used, according to indications – antibacterial therapy, anabolics (nerobol, retabolil), Essentiale.