Electric Shock: Causes, Signs, Symptoms, Prevention, Treatment, Prognosis

A person experiences electric shock upon coming in contact with an electrical energy source. The electrical energy is transmitted from the source and passes through a part of our body resulting in shock. Depending on the type of current, a person who is exposed to the electrical energy may have zero injury, mild injury or can have extreme damage/injury and can even die. People commonly experience electric shocks from man-made objects like electrical appliances, electrical circuitry and electrical wires. Other than the man-made objects, a person can also experience an electric shock from natural sources, such as lightning strikes. The most common injuries a person experiences from electric shock and lightning strikes are burns.

Treatment depends on the amount of the surface area of the body affected and the severity of the shock.

Causes of Electric Shock are many. Children and adolescents are more to prone to suffering from high voltage electric shock resulting from harmful exploration. Adults can suffer from Electric Shock at workplaces from exposure to electrical items. Majority of the deaths occurring from electric shock are from job related injuries.

• Type of current; alternating current (AC) or direct current (DC).
• The amount or voltage of current and the affected tissues’ resistance.
• The pathway through which the electricity passes through the body.
• Low-voltage electricity, i.e. which is lesser than 500 volts, commonly does not cause serious injury.
• High voltage electricity, which is greater than 500 volts can cause serious damage to the tissues.
• Serious injuries from electrical shock commonly have an entrance and exit point on the body, as the person becomes a part of the electrical path.
• Children are at a higher risk for shocks from a low voltage (120 to 220 volts) which is commonly found in the household current from household appliances, extension cords, electrical cords etc. According to a study, these cause more than 65% of injuries whereas 20% of injuries are caused by electric shock from wall outlets.
• Injuries occurring from natural sources, such as lightning occur sporadically. Electric shock occurring from lightning may or may not cause external burns, but people can die from lightning due to injury or respiratory/cardiac arrest.
• Neurologic injury is often seen in individuals who are struck by lightning.
• Other injuries occur from severe contractions of the muscle triggered by electricity.

• Patient can either have no obvious external injury or any evidence of electric shock; or the patient can have severe external burns.
• Some patients can suffer from cardiac arrest after an electric shock/lightning strike.
• The burns which the patient experiences from electric shock are often severe at the site of contact with the electrical source and the ground. Common points of contact are hands, head and heels.
• Other than burns, injuries can occur from forceful muscular contraction due to which the patient is thrown clear from electrical source. In such cases, patient may have a spinal injury.
• If the patient is having shortness of breath, pain in the chest or abdomen, then it may indicate internal injuries.
• Pain with deformity of the hand or foot or other body part can indicate a possible fracture resulting from extreme muscle contraction from the electric shock.
• Children who suffer from electrical mouth burn, as a result of biting an electric cord, have a burn on the lip which has a red/dark, charred appearance.
• Patient who has experienced electric shock should be examined for entry and exit marks to help assess the extent of the electric shock.

• If the patient has suffered from a high-voltage shocks which is greater than 500 volts.
• If the patient has suffered from a lightning strike.

• If the burns are not healing properly.
• If the patient experiences increasing soreness, redness or drainage from the burns.
• If more than 5 years have passed since the patient’s last tetanus booster.
• If the patient suffering from electric shock is more than 20 weeks pregnant.
• If the patient has lost consciousness.
• If the patient experiences tingling, numbness, paralysis and problems with hearing, vision or speech.

Physical examination to assess for any significant or hidden/internal injuries. Electricity can cause injury to the muscles, heart, brain or bones and other organs from being jolted and thrown off or getting burned from the electric source.

• ECG and EKG (Electrocardiogram) to assess the heart.
• Complete blood count (CBC).
• Urine test to check the muscle enzymes, which can indicate serious injury to the muscles.
• X-rays are done to check for fractures or dislocations.
• CT scan.

If the electric shock is mild and the patient does not have any symptoms, then treatment is not needed. However, if the patient has experienced a high voltage electric shock or a lightning strike with burns/pain, then the patient needs immediate medical attention. Treatment depends on the degree of the burns and the extent of other injuries present, if any. Burns are treated according to their severity.

• Topical antibiotic ointments and dressings are applied for minor burns.
• For severe burns, surgery with skin grafting may be required.
• If the patient has severe burns on arms, hands, legs, then surgery is done to remove the damaged muscle and sometimes amputation may also be needed.
• Other injuries, such as eye injuries need examination and treatment by eye specialist (ophthalmologist).
• If there are any broken bones, then the patient requires splinting, casting or surgery.
• Patients who have experienced internal injuries need to be observed and surgery may be needed for them.

• Children who are younger than 10 years are more prone to suffer from electrical injuries from power cords. So families with children of that age group should take precautions by inspecting the power and extension cords and replacing any broken or cracked outer covering of the cords, which expose the internal wire.
• Never allow your children to play with electrical cords/appliances.
• Avoid using extension cords and make sure the cord indicates the current (displayed in amps) used by the device.
• Always use outlet covers over the electrical outlets to protect infants from harm.
• Upgrade/replace any old, ungrounded electrical outlets to grounded systems.
• Replace outlets present near any water sinks, tubs etc.
• Children aged more than 10 to 12 years, suffer from electrical injuries, which occur as a result from their exploring. These children or adolescents should be explained about the harm and danger, which can result from climbing the power towers, playing near the transformer systems or exploring electrified train tracks and other electrical systems.
• Adults should use their common sense to prevent electrical injuries, such as individuals who are working with electricity should ensure that the power is off before starting any work on electrical systems.
• Never use any electrical device located near the water.
• Never ever stand in water while working with/on electricity equipment.
• Be careful when outside during a thunderstorm and lightning. Seek shelter in a strong building or crouch low during lightning strikes. Also steer clear from trees and metal objects (metal baseball bats, golf clubs etc.) during lightning strikes.
• If you are swimming, fishing, surfing or just simply standing in water and a thunderstorm starts, then immediately get out of the water and seek adequate shelter.
• Occasionally there may be sudden weather changes and you can be caught unawares, as a normal sunny day or a simple rain shower can turn into a full blown thunderstorm and can produce a lightning strike. So, take proper precautions, as mentioned above, and save yourself from a lot of trouble.

Prognosis of electric shock depends on the severity and the nature of the injuries and other than that; the percentage of the body surface burned is the most vital factor in deciding prognosis. Patient who has suffered an electric shock, but does not experience immediate cardiac arrest and does not have serious burns has good chances of survival. The most common cause of death in people suffering from electrical injury is infection.

If the brain is affected or damaged from the electric shock, then it could result in a permanent seizure disorder, anxiety, depression and other changes in the personality of the patient.

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