Electric shock: first aid, consequences afterelectric shock

Обновление: Октябрь 20one8

Electric shock means damage to organs and systems.
вследствие поражения электрическим токоm Main causes of death
with electric shock, this is respiratory arrest and cardiac arrest. After
a strong electric shock, if a person survives, development is possible
complications of the cardiovascular, central nervous
systems, impaired vision, hearing, etc.

Most often accidents occur when:

  • not knowing or not following the safety instructions
    electrical appliances
  • faulty household appliances in households, electrical equipment on
    enterprises
  • broken wires of high voltage lines

WITHтепень поражения организма человека зависит от способа
the passage of current through the body, on the strength and voltage, time
impact, health, age, and timeliness
first aid to the victim.

Types of Electricity

  • electric shock (shock) – effects on the entire body, it does not
    causes burns, and leads to paralysis of breathing and / or heart
  • electrical injury – damage to the outer parts of the body:
    electrical signs, burns, skin metallization.

The impact of electric currents on the body

  • Heat – due to resistance of body tissues
    electrical energy goes into heat, causing electrical
    burns in characteristic places of entry and exit of current, which are called
    current signs. With прохождении через ткани тепловая энергия изменяет и
    destroys them.
  • Electrochemical – leads to cell thickening and gluing
    blood, the movement of ions and changes in the charge of protein molecules,
    vapor and gas generation. Affected tissues acquire cellular
    view.
  • Biological – disrupted the skeletal muscles of the heart,
    нервной и других систеm

WITHимптомы electric shock

  • Unexpected man fall on the street or unnatural
    dropping an unseen power from the current source
  • Loss of consciousness, convulsions
  • Pronounced muscle contractions of an involuntary nature
  • Loss of neurological functions – memory loss, impairment
    understanding of speech and vision, violation of orientation in space,
    change in skin sensitivity, the reaction of the pupil to light.
  • Ventricular fibrillation and respiratory arrest – irregular pulse and
    uneven breathing
  • Burns on the body with sharply defined borders /

Signs of current on the skin

These are the areas of necrosis of the outer tissues at the entry and exit points.
current flow due to the transfer of energy from electrical to
heat Electric burns are rarely limited to marks on the skin,
deeper tissues are more often damaged: muscles, tendons, bones.
There are options when the defeat is localized under the outside
intact skin.

  • The shape is oval, rounded or linear. Along the edges of the affected
    skin can form a roller-like elevation, and the middle
    The label looks a bit hollow. Probably the detachment of the upper layer in
    the form of bubbles, inside which there is no liquid.
  • Color – most often pale, pale gray is lighter than the surrounding
    skin.
  • Sensitivity – pain in the places of the marks is absent due to
    lesions of nerve endings.
  • Withзнаки — отложения частичек металла на коже: при поражении
    low voltage currents on the surface of the skin, high – inside
    skin. Color depends on the metal in the conductor: copper – particles
    blue and yellow, iron brown. Hair rods twist in
    spirals, keeping the structure.

Afterдствия удара током

Nervous system

  • loss of consciousness of varying degrees and durations;
  • memory loss (retrograde amnesia);
  • convulsions;
  • weakness and weakness;
  • dizziness and headache;
  • violation of thermoregulation;
  • flickering in the eyes, blurred vision.

With поражении нервов изменяется чувствительность и двигательная
activity in the limbs, trophic disturbance,
pathological reflexes. The passage of current through the brain leads to
convulsions and loss of consciousness, in some cases, respiratory failure
center leads to cessation of breathing.

High current leads to deep disturbances.
деятельности ЦНWITH, торможению центра дыхания и регуляции сердечной
activities that lead to electric lethargy, imaginary death,
when it seems that breathing and heartbeat are missing, but in fact
business vital systems are reduced to a minimum.
Timely initiated resuscitation leads to successful
восстановлению работы систеm

WITHердечно-сосудистая система

In most cases, there are failures in cardiac activity.
functional character:

  • sinus arrhythmia;
  • tachycardia;
  • bradycardia;
  • extrasystole;
  • heart block.

Electrocution of the heart muscle may result in impairment.
contractile function, leading to fibrillation when fibers
myocardium begin to shrink in a scattered rhythm, and the heart does not
can pump blood, which in severity is tantamount to stopping
hearts. Повреждение сосудов приводит к кровотеченияm

Respiratory system

Торможение или остановка respiratory activity происходят
due to damage to the respiratory center in the brain.
The passage of current through the lung tissue causes bruising and breaking
lungs.

Sense organs

  • hearing loss;
  • noise in ears;
  • disorder of touch;
  • rupture of the eardrum;
  • middle ear injury;
  • keratitis;
  • choroiditis;
  • cataract.

Striated and smooth muscles

  • Spasm and contraction of muscle fibers can lead to
    cramps.
  • Strong skeletal muscle contraction can result in fractures.
    spine and tubular bones.
  • The spasm of the muscular layer of the vascular wall leads to an increase in
    pressure or myocardial infarction (in the case of a spasm of the heart
    arteries).

Long-term complications

  • CAS: impaired conduction of the heart, heart rate,
    obliterating endarteritis, arteriosclerosis;
  • Nervous system: neuritis, encephalopathy, trophic ulcers,
    vegetative changes;
  • Sense organs: катаракта, нарушение слуха и зрения;
  • Musculoskeletal system: contractures (amplitude limitation
    movements, impossibility to bend a limb), deformations.

Factors affecting the nature and severity of electrical injury

Kind and strength and voltage

  • More than one000 volts voltage leads to heavy
    damage up to death without even touching
    source, and being very close – in walking distance from
    current source (the so-called “volt arc”).
  • AC is more dangerous than DC
  • Low frequency current affects internal organs
  • High-frequency – the surface of the skin without leading to death.
Current strength (mA) The reaction of the body when exposed to the hand
0.9-one.2 Hardly noticeable impact
one.2-one.6 Goosebumps and skin tickling
one.6-2.8 Tension in the wrist
2.8-four.5 Forearm mobility impairment
four.5-5.0 Muscle cramps forearm
5.0-7.0 Muscle cramps
one5.0-20one5.0-20 The hand does not come off the current source
20-four0 Painful muscle cramps in the whole body
50-one00 Cardiac arrest
More than 200 Deep burns

Current path through the body – current loop

Injury current in everyday life

  • The most dangerous options are a complete loop that includes 2 hands and 2
    legs, hand-to-hand, as the current flows through the heart.
  • No less dangerous – hand-head when current flows through
    brain.

Tissue resistance and current density

Under the current density understand the amount of current passing through
unit area. The energy is concentrated when the current passes through
smaller area. For example, if an electric current passes through a hand,
current density increases in the area of ​​the joints.

Current duration

The longer the current, the stronger the lesions and the more
probability of death.

  • A high voltage current leads to a dramatic reduction in muscle,
    a person can even be forcefully discarded from a current source.
  • Low voltage current causes muscle spasm
    prolonged involuntary seizure of the conductor by hand. WITH
    over time, the skin’s resistance decreases, so
    interrupt the contact of the victim with the conductor as soon as possible.

External factors

The severity of damage increases in conditions of high humidity.
(baths, bathrooms), as well as in case of electric shock in water, and in
salty water damage is stronger than in fresh water (the more
dissolved salts in water, the better the conductivity of water).

WITHостояние организма

The danger of electric shock increases against exhaustion,
alcohol or drugs, chronic diseases,
senile and childhood.

Why are frequent deaths in the bath when in contact with household
appliances?

The fatal role is played by wet and wet skin. Such skin has
less resistance to electrical energy and, accordingly,
the damaging effect is always stronger even with the action of devices with
seemingly low voltage of oneone0 V, for example, from a hair dryer or
radio. In addition, a wet body almost guarantees the formation of
most dangerous current loop through vital organs.

WITHтепени поражения током — классификация

According to Frenkel By Polishchuk and Fistal
one Partial local seizures Easy Partial convulsions with stored consciousness
2 General cramp without the formation of prostration after an interruption
conductor contact
WITHредняя Loss of consciousness and convulsions without ECG abnormalities
3 Severe prostration with inability to flow, flowing with or
without losing consciousness
Heavy Loss of consciousness, accompanied by a violation of the heart and
respiratory activity
four Instant death or death after previous
prostration
Extremely heavy Clinical death

Algorithm of first aid in case of electric shock

All actions must be carried out very quickly, without delay,
unnecessary talk and reasoning. WITHвоевременное оказание помощи
allows you to save life and reduce the severity of electric shock.

Whatever the condition of the victim,
promptly call an ambulance or deliver a person to a medical
institution WITHмерть от удара током может наступить и через несколько
hours The external picture does not reflect the internal damage after
electric shock.

As soon as possible to stop the contact of the victim with
current conductor

  • You can approach the victim in rubber shoes or
    podlazhivaya under the feet of a rubber mat, dry boards, strictly on dry
    surfaces, wearing rubber gloves on his hands. These measures are more
    justified under stress тока более one000 Вольт, но оценить
    voltage in the electrical circuit is impossible, better
    be safe in order not to suffer yourself;
  • soak up the circuit with non-conducting objects (pull off
    wire with a wooden stick) or pull the device plug out of the spatula,
    turn off the current;
  • pull the victim away from the current source using objects
    not conducting current, and not touching the body: wooden sticks,
    деревянным стулом, веревкой, волоком на расстояние не менее one0
    m

To assess the state of the respiratory and cardiovascular systems and in
whether the person is conscious

Lightly pat on the cheek, ask basic questions. With
need for resuscitation:

  • check for breathing: see if there are breathing
    chest movements, bring a mirror / glass to the mouth and nose,
    which will mist up in the presence of breath, or a thin thread,
    which must be deflected when breathing;
  • determine the pulse on the carotid artery by pressing its area
    finger projections;
  • release airway for further
    salvation: put the palm of one hand on the victim’s forehead,
    lift the chin with two fingers of the other hand, push forward
    lower jaw and tilt your head back. With подозрении на
    spinal fracture these actions are prohibited when sticking the tongue
    it is permissible to fix it to the cheek with a pin.

Primary resuscitation of the victim (in the absence of a pulse and
breathing

  • Indirect cardiac massage – most effective for the first 3
    minutes after cardiac arrest. The patient lies on his back on level
    the surface, straightened in the elbows
    in the middle of the chest between the nipples. Производят по one00
    ритмичных нажатий в течение one минуты на грудную клетку с амплитудой
    pressing 5-6 cm and until the chest is completely unfolded after
    pressing.
  • Mouth to mouth breathing – two full breaths every 30
    clicking on the projection of the heart. With невозможности данного способа
    It is permissible to use only indirect heart massage.
  • The duration of resuscitation – prior to arrival
    ambulance or until signs of life appear (pink skin,
    появление пульса и breathing. Victim in such a case
    turn on its side and expect an ambulance. Maximum
    duration – 30 minutes, further actions are impractical
    except for those patients who are in cold
    temperatures.
  • Drug treatment (conducted by the resuscitation team
    ambulance). With безуспешности приведенных выше мероприятий в течение
    2-3 минут вводится one мл адреналина 0,one% (внутримышечно, внутривенно
    or intracardiac); а также кальций хлорид one0% — one0 мл,
    строфантина 0,05% — oneмл, разведенный в 20 мл four0% растворе
    glucose.
  • The primary treatment of burns is to impose a dry
    gauze bandage.
  • Painkillers – while maintaining consciousness before the ambulance arrives
    a person can be given pain reliever and soothing.
  • Transportation of the victim to the hospital is carried out in
    лежачем положении и укрытом теплым одеялоm

WITHтационарное лечение после удара током

  • It is carried out in reanimation, and in the absence of signs
    burn or electric shock – in the surgical department.
  • The treatment complex depends on the indications: from a simple toilet and
    ligation of burn wounds to complex surgical interventions
    restoration of damaged organs and tissues.
  • Even in the absence of local damage and satisfactory
    condition the patient is in the ward under observation for
    prevention of remote reactions from systems and organs.
  • WITHерьезные электротравмы требуют длительной реабилитации.

Features of lightning

Striking factors: electric current, sound and light
energy, shock wave. Impact of lightning is like defeat.
high voltage electrical current.

  • Symmetrical damages are characteristic: paresis of two extremities,
    paraplegia.
  • The signs of the current have a strange twisted shape and are distinguished by a large
    lasting.

If the thunderstorm found on the street, you can not hide under the trees,
lean against metal objects and even more so be in
water.

Some facts

  • The first officially registered death from electric shock
    произошла во Франции, в one879 г – жертвой действия переменного тока
    became a carpenter.
  • Частота электротравм в развитых странах – 2-3 случая на one00
    Thousands of people.
  • Группу риска составляют молодые люди 25-four0 лет, причем мужчины
    в four раза чаще умирают вследствие электротравм, нежели женщины.

Electric shock protection

  • Never try to pick up, remove the wire from the road,
    lying on the ground do not touch the wires on the street, sticking out of
    ground transformer systems hanging from pillars:

    • to the wires sagging low above the ground
    • to the wire laying on the ground
    • to trees, buildings, cars, which touches ragged
      the wire.
  • Count off 8 meters (bus size) from the touch point of the wire
    land and walk out of the “defeat zone” in goose step, in this case
    when walking, both legs are almost at the same point with one
    electrical potential, so the voltage between them is not
    will arise. Do not lose balance and do not touch other items
    people, land.
  • If you see the victim next to the broken wire,
    assistance can be provided only after a power outage
    high-voltage, so call for help and do not approach
    to the victim. Try to free the victim from stress
    можно лишь при one00% уверенности, что провод низкого (до oneкВ)
    voltage and only using means of electrical protection.
  • Do not use faulty electrical appliances.
  • Do not plug in appliances with wet hands.
  • WITHоблюдать правила безопасности при обращении с электрическими
    instrumentation.
  • With необходимости работы с электроприборами использовать
    means of protection.

WITHредства защиты от electric shock:

  • Insulating plates and supports;
  • Gloves, caps, galoshes and rugs, dielectric;
  • Portable grounding;
  • Tools with insulated handles;
  • WITHпециальная защитная одежда;
  • Safety screens, partitions, cameras for protection against current;
  • Warning signs and posters.

Rules of work:

  • Minimize the time spent in the danger zone near the action
    appliances;
  • Withближаться к источниками тока следует только на расстояние,
    which is equal to the length of the insulating part of the protective equipment.
  • With работе с устройствами напряжением от 330 кВ обязательно
    the use of workwear.
  • In the conditions of rain and thunderstorms all work must be
    suspended.

Автор: врач-гигиенист, эпидемиолог

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