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Electrocution Injury - Medical Negligence

An electrocution injury occurs when a person has received a severe injury due to exposed electricity such as a power line or other strong source of electricity. They can be categorized as low voltage injury or high voltage injury. The injuries themselves are a result of the current itself, from the conversion of the electricity to thermal energy or heat while the current is going through the body, and from effects considered secondary to the electricity. Severity of injury can be determined by the intensity of the current, the voltage passing through the individual and the type of current used. Severity can also be determined by the length of time the individual is exposed to the electricity, how resistant the tissues are, the degree of surface contact and the extent of body systems involved in the electrocution.

When a direct current electrocution happens (DC current), there is a muscle contraction that often throws the victim free of the electricity but increases the chances of the individual having blunt trauma to the body. Direct current injuries have a greater tendency to cause arrhythmias of the heart, depending on the phase of the heart going on when the electrical current happens. In a sense, the electricity acts like a defibrillator, altering the rhythm of the heart.

In low voltage alternating current electrocution (AC current), the electrocution is much more dangerous than DC current, given similar voltages. In fact, it is considered almost three times more dangerous than DC current. When AC current occurs, the muscle goes into tetany and the victim is not thrown clear from the source. In fact, they are compelled by muscle contractions to hold onto the source of the electricity. This increases the duration of the contact with the electricity and worsens the degree of injury.

More tissue damage occurs with greater contact duration, especially if the voltage is high. The current becomes concentrated at the ground points of the body and at the point of contact with the electricity. There can also be a great deal of tissue damage which occurs between the point of contact and the point of grounding.

Electrical injuries can occur because of direct contact with an electrical source or from indirect contact, such as when arcs occur, electrical flashes occur or when blunt trauma happens in a DC current injury. The arc is considered to be the worst of the injuries because it is very hot, up to 2500 degrees Celsius. Arcs can ignite clothing and results in severe burns. Flash burns from electricity often result in partial thickness burn injuries. In blunt trauma, bones can be fractured from being thrown from a source or from tetany in AC injuries. Central nervous system injuries are not uncommon as the victim can receive blunt force trauma to the head. You can get cataracts that occur right away or develop over several months because of the electrical injury. This happens in five percent of those who have had a significant electrical injury near the head. Burns to the cornea or other eye injuries are not uncommon.

Other areas involved in electrical trauma include the mouth (in infants who suck on electrical sources), lungs (rare), solid organs in the abdomen, kidneys (from rhabdomyolysis), fractures to the long bones, compression fractures to the vertebra, scapular fractures, and dislocation of the shoulder from tetany. A change to the mental status is common but is transient. There can be amnesia of the event. In rare cases, coma can ensue. Long term disability, if the brain is involved or if the peripheral nerves are involved, is common. There can be direct or indirect injury to the spinal cord, resulting in weakness and paralysis that occurs a few hours after the injury. The skin is usually involved as well but the extent of the exterior burn cannot predict the extent of internal injury.

Doctors usually treat electrocution beginning with an assessment of the airway, breathing and circulation. They should be assessed as patients who have suffered a trauma. Doctors should pay attention to the amount of myoglobin in the urine as myoglobin is what the muscles give off when they are severely injured. Broken bones must be managed in the usual fashion. The injuries should be addressed as crush injuries rather than burns because the muscle acts as if crushed and there are often blunt trauma injuries. Plenty of fluids need to be given so as to flush the kidneys free of myoglobin and other products of tissue loss. There should be a urine output of around 50-75 cc per hour or double that if blood is in the urine. Lasix is sometimes used to help flush out the kidneys.