Electrical accident - Electrocution

When lesions are caused by electricity, we speak of electrical accidents. Electrical lesions are caused by the direct effect of electric current on tissues and its conversion into thermal energy. We distinguish three types of current according to their origin: domestic current (alternating, low voltage), industrial current (high voltage direct current) and lightning. It is called electrocution when electrical lesions are produced by domestic or industrial current, as opposed to fulguration when they are produced by lightning.

Depending on the type of exposure, the path of the current and the time of assistance, we will have more or less symptoms and sequelae. The lesions are usually serious with symptoms that vary between asphyxia, cardiac arrhythmias including arrest, burns, alteration of the nervous system and alteration of internal organs; secondary lesions caused by the electric shock may also appear, with falls from height and blows. Cognitive defects, pain syndromes and damage to the sympathetic nervous system are the most common long-term sequelae.

The diagnosis is clinical, and a blood test with determination of cardiac enzymes and an ECG will be performed to complete the study. Patients with altered mental status will require a CT or MRI of the skull.

Treatment is based on interrupting the current, removing the victim from the electrical circuit using non-conductive material, rapidly initiating CPR and treating burn lesions, and will require emergency medical assistance for fluid therapy. In high voltage lesions, most of the treatment is surgical with a high rate of amputations and resection of necrotic areas, i.e. dead skin.