eMedicine Specialties > Emergency Medicine > Environmental

Electrical Injuries: Multimedia

Author: Tracy A Cushing, MD, MPH, Instructor in Medicine, Department of Emergency Medicine, Harvard Medical School; Attending Physician, Department of Emergency Medicine, Mount Auburn Hospital
Coauthor(s): Ronald K Wright, MD, JD, Associate Professor (Retired), Department of Pathology, University of Miami School of Medicine; Private Practice, Forensic Pathology
Contributor Information and Disclosures

Updated: Oct 7, 2009

Multimedia

Arcing electrical burns through the shoe around t...
(Enlarge Image)
Media file 1: Arcing electrical burns through the shoe around the rubber sole. High-voltage (7600 V) alternating current nominal. Note cratering.
[ CLOSE WINDOW ]
Arcing electrical burns through the shoe around t...

Arcing electrical burns through the shoe around the rubber sole. High-voltage (7600 V) alternating current nominal. Note cratering.

Contact electrical burn. This was the ground of a...
(Enlarge Image)
Media file 2: Contact electrical burn. This was the ground of a 120-V alternating current nominal circuit. Note vesicle with surrounding erythema. Note thermal and contact electrical burns cannot be distinguished easily.
[ CLOSE WINDOW ]
Contact electrical burn. This was the ground of a...

Contact electrical burn. This was the ground of a 120-V alternating current nominal circuit. Note vesicle with surrounding erythema. Note thermal and contact electrical burns cannot be distinguished easily.

Contact electrical burns, 120-V alternating curre...
(Enlarge Image)
Media file 3: Contact electrical burns, 120-V alternating current nominal. The right knee was the energized side, and the left was ground. These are contact burns and are difficult to distinguish from thermal burns. Note entrance and exit are not viable concepts in alternating current.
[ CLOSE WINDOW ]
Contact electrical burns, 120-V alternating curre...

Contact electrical burns, 120-V alternating current nominal. The right knee was the energized side, and the left was ground. These are contact burns and are difficult to distinguish from thermal burns. Note entrance and exit are not viable concepts in alternating current.

Electrical burns to the hand.
(Enlarge Image)
Media file 4: Electrical burns to the hand.
[ CLOSE WINDOW ]
Electrical burns to the hand.

Electrical burns to the hand.

Electrical burns to the foot.
(Enlarge Image)
Media file 5: Electrical burns to the foot.
[ CLOSE WINDOW ]
Electrical burns to the foot.

Electrical burns to the foot.

High-voltage electrical burns to the chest.
(Enlarge Image)
Media file 6: High-voltage electrical burns to the chest.
[ CLOSE WINDOW ]
High-voltage electrical burns to the chest.

High-voltage electrical burns to the chest.

Superficial electrical burns to the knees (flash/...
(Enlarge Image)
Media file 7: Superficial electrical burns to the knees (flash/ferning).
[ CLOSE WINDOW ]
Superficial electrical burns to the knees (flash/...

Superficial electrical burns to the knees (flash/ferning).

Energized site of low-voltage electrical burn in ...
(Enlarge Image)
Media file 8: Energized site of low-voltage electrical burn in a 50-year-old electrician.
[ CLOSE WINDOW ]
Energized site of low-voltage electrical burn in ...

Energized site of low-voltage electrical burn in a 50-year-old electrician.

Grounded sites of high-voltage injury on the ches...
(Enlarge Image)
Media file 9: Grounded sites of high-voltage injury on the chest of a 16-year-old boy who climbed up an electric pole.
[ CLOSE WINDOW ]
Grounded sites of high-voltage injury on the ches...

Grounded sites of high-voltage injury on the chest of a 16-year-old boy who climbed up an electric pole.

Energized site of the high-voltage injury depicte...
(Enlarge Image)
Media file 10: Energized site of the high-voltage injury depicted in Media File 9 (16-year-old boy who climbed up an electric pole).
[ CLOSE WINDOW ]
Energized site of the high-voltage injury depicte...

Energized site of the high-voltage injury depicted in Media File 9 (16-year-old boy who climbed up an electric pole).

Entrance site of a low-voltage injury.
(Enlarge Image)
Media file 11: Entrance site of a low-voltage injury.
[ CLOSE WINDOW ]
Entrance site of a low-voltage injury.

Entrance site of a low-voltage injury.

Grounded sites of a low-voltage injury in a 33-ye...
(Enlarge Image)
Media file 12: Grounded sites of a low-voltage injury in a 33-year-old male suicide patient.
[ CLOSE WINDOW ]
Grounded sites of a low-voltage injury in a 33-ye...

Grounded sites of a low-voltage injury in a 33-year-old male suicide patient.

Grounded site of a low-voltage injury in the same...
(Enlarge Image)
Media file 13: Grounded site of a low-voltage injury in the same 33-year-old male patient depicted in Media File 12.
[ CLOSE WINDOW ]
Grounded site of a low-voltage injury in the same...

Grounded site of a low-voltage injury in the same 33-year-old male patient depicted in Media File 12.

Grounded sites of low-voltage injury on the feet.
(Enlarge Image)
Media file 14: Grounded sites of low-voltage injury on the feet.
[ CLOSE WINDOW ]
Grounded sites of low-voltage injury on the feet.

Grounded sites of low-voltage injury on the feet.

A histologic picture of an electrical burn showin...
(Enlarge Image)
Media file 15: A histologic picture of an electrical burn showing elongated pyknotic keratinocyte nuclei with vertical streaming and homogenization of the dermal collagen (40X). Courtesy of Elizabeth Satter, MD.
[ CLOSE WINDOW ]
A histologic picture of an electrical burn showin...

A histologic picture of an electrical burn showing elongated pyknotic keratinocyte nuclei with vertical streaming and homogenization of the dermal collagen (40X). Courtesy of Elizabeth Satter, MD.

More on Electrical Injuries

Overview: Electrical Injuries
Differential Diagnoses & Workup: Electrical Injuries
Treatment & Medication: Electrical Injuries
Follow-up: Electrical Injuries
Multimedia: Electrical Injuries
References
[ CLOSE WINDOW ]

References

  1. Lee RC. Injury by electrical forces: pathophysiology, manifestations, and therapy. Curr Probl Surg. Sep 1997;34(9):677-764. [Medline].

  2. Rabban J, Adler J, Rosen C, Blair J, Sheridan R. Electrical injury from subway third rails: serious injury associated with intermediate voltage contact. Burns. Sep 1997;23(6):515-8. [Medline].

  3. Spies C, Trohman RG. Narrative review: Electrocution and life-threatening electrical injuries. Ann Intern Med. Oct 3 2006;145(7):531-7. [Medline].

  4. Koumbourlis AC. Electrical injuries. Crit Care Med. Nov 2002;30(11 Suppl):S424-30. [Medline].

  5. Price T, Cooper MA. Electrical and Lighting Injuries. In: Marx J, Hockberger R, Walls R. Rosen's Emergency Medicine. 3. 5th. Mosby; 2002:2010-2020.

  6. Rai J, Jeschke MG, Barrow RE, Herndon DN. Electrical injuries: a 30-year review. J Trauma. May 1999;46(5):933-6. [Medline].

  7. Casini V. Worker Deaths by Electrocution: A summary of NIOSH Surveillance and Investigative Findings. Washington DC: Department of Health and Human Services (NIOSH); May 1998. 5-8.

  8. Luz DP, Millan LS, Alessi MS, et al. Electrical burns: A retrospective analysis across a 5-year period. Burns. Jun 5 2009;[Medline].

  9. Thomas SS. Electrical burns of the mouth: still searching for an answer. Burns. Mar 1996;22(2):137-40. [Medline].

  10. Ferreiro I, Melendez J, Regalado J, Bejar FJ, Gabilondo FJ. Factors influencing the sequelae of high tension electrical injuries. Burns. Nov 1998;24(7):649-53. [Medline].

  11. Kopp J, Loos B, Spilker G, Horch RE. Correlation between serum creatinine kinase levels and extent of muscle damage in electrical burns. Burns. Nov 2004;30(7):680-3. [Medline].

  12. Hussmann J, Kucan JO, Russell RC, Bradley T, Zamboni WA. Electrical injuries--morbidity, outcome and treatment rationale. Burns. Nov 1995;21(7):530-5. [Medline].

  13. Baker MD, Chiaviello C. Household electrical injuries in children. Epidemiology and identification of avoidable hazards. Am J Dis Child. Jan 1989;143(1):59-62. [Medline].

  14. Rabban JT, Blair JA, Rosen CL, Adler JN, Sheridan RL. Mechanisms of pediatric electrical injury. New implications for product safety and injury prevention. Arch Pediatr Adolesc Med. Jul 1997;151(7):696-700. [Medline].

  15. Jensen PJ, Thomsen PE, Bagger JP, Nørgaard A, Baandrup U. Electrical injury causing ventricular arrhythmias. Br Heart J. Mar 1987;57(3):279-83. [Medline].

  16. Saffle JR, Crandall A, Warden GD. Cataracts: a long-term complication of electrical injury. J Trauma. Jan 1985;25(1):17-21. [Medline].

  17. Haberal MA. An eleven-year survey of electrical burn injuries. J Burn Care Rehabil. Jan-Feb 1995;16(1):43-8. [Medline].

  18. Rosen CL, Adler JN, Rabban JT, Sethi RK, Arkoff L, Blair JA, et al. Early predictors of myoglobinuria and acute renal failure following electrical injury. J Emerg Med. Sep-Oct 1999;17(5):783-9. [Medline].

  19. Bailey B, Gaudreault P, Thivierge RL. Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study. Emerg Med J. May 2007;24(5):348-52. [Medline].

  20. Dollery W. Towards evidence based emergency medicine: best BETs from the Manchester Royal infirmary. Management of household electrical injury. J Accid Emerg Med. Jul 1998;15(4):228. [Medline].

  21. Chen EH, Sareen A. Do children require ECG evaluation and inpatient telemetry after household electrical exposures?. Ann Emerg Med. Jan 2007;49(1):64-7. [Medline].

  22. Achauer BM, Martinez SE. Burn wound pathophysiology and care. Crit Care Clin. Mar 1985;1(1):47-58. [Medline].

  23. Bailey B, Gaudreault P, Thivierge RL. Cardiac monitoring of high-risk patients after an electrical injury: a prospective multicentre study. Emerg Med J. May 2007;24(5):348-52. [Medline].

  24. Bailey B, Gaudreault P, Thivierge RL. Neurologic and neuropsychological symptoms during the first year after an electric shock: results of a prospective multicenter study. Am J Emerg Med. May 2008;26(4):413-8. [Medline].

  25. Baxter CR, Waeckerle JF. Emergency treatment of burn injury. Ann Emerg Med. Dec 1988;17(12):1305-15. [Medline].

  26. Canady JW, Thompson SA, Bardach J. Oral commissure burns in children. Plast Reconstr Surg. Apr 1996;97(4):738-44; discussion 745; 746-55. [Medline].

  27. Colic M, Ristic L, Jovanovic M. Emergency treatment and early fluid resuscitation following electrical injuries. Acta Chir Plast. 1996;38(4):137-41. [Medline].

  28. Cooper MA. Electrical and lightning injuries. Emerg Med Clin North Am. Aug 1984;2(3):489-501. [Medline].

  29. El-Badawy A, Mabrouk AR. Epidemiology of childhood burns in the burn unit of Ain Shams University in Cairo, Egypt. Burns. Dec 1998;24(8):728-32. [Medline].

  30. Fish RM. Electric injury, part I: treatment priorities, subtle diagnostic factors, and burns. J Emerg Med. Nov-Dec 1999;17(6):977-83. [Medline].

  31. Fish RM. Electric injury, part III: cardiac monitoring indications, the pregnant patient, and lightning. J Emerg Med. Feb 2000;18(2):181-7. [Medline].

  32. Gomez R, Cancio LC. Management of burn wounds in the emergency department. Emerg Med Clin North Am. Feb 2007;25(1):135-46. [Medline].

  33. Hammond JS, Ward CG. High-voltage electrical injuries: management and outcome of 60 cases. South Med J. Nov 1988;81(11):1351-2. [Medline].

  34. Leibovici D, Shemer J, Shapira SC. Electrical injuries: current concepts. Injury. Nov 1995;26(9):623-7. [Medline].

  35. Milano M. Oral electrical and thermal burns in children: review and report of case. ASDC J Dent Child. Mar-Apr 1999;66(2):116-9, 85. [Medline].

  36. Singerman J, Gomez M, Fish JS. Long-term sequelae of low-voltage electrical injury. J Burn Care Res. Sep-Oct 2008;29(5):773-7. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

electrical injury, electrical shock, electrical burns, lightning injury, electrocution, low-voltage injury, high-voltage injury, nerve depolarization, muscle depolarization, alternating current injury, AC injury, thermal burns, electrical flashes, direct current electrical injuries, DC electrical injuries, flash burns, arc burns, contact burns, internal electrical injury, external electrical energy, burn treatment, electrical injury treatment, myoglobinuria, myoglobinemia, lightning strike

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Tracy A Cushing, MD, MPH, Instructor in Medicine, Department of Emergency Medicine, Harvard Medical School; Attending Physician, Department of Emergency Medicine, Mount Auburn Hospital
Tracy A Cushing, MD, MPH is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Ronald K Wright, MD, JD, Associate Professor (Retired), Department of Pathology, University of Miami School of Medicine; Private Practice, Forensic Pathology
Ronald K Wright, MD, JD is a member of the following medical societies: American Academy of Forensic Sciences, American College of Legal Medicine, American Medical Association, American Society for Clinical Pathology, College of American Pathologists, and National Association of Medical Examiners
Disclosure: Nothing to disclose.

Medical Editor

Jerry Balentine, DO, Professor of Emergency Medicine, New York College of Osteopathic Medicine; Executive Vice President, Chief Medical Officer, Attending Physician in Department of Emergency Medicine, St. Barnabas Hospital
Jerry Balentine, DO is a member of the following medical societies: American College of Emergency Physicians, American College of Osteopathic Emergency Physicians, American College of Physician Executives, American Osteopathic Association, and New York Academy of Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Eric L Legome, MD, Chair, Department of Emergency Medicine, St Vincent's Hospital Manhattan; Associate Professor, Department of Emergency Medicine, New York Medical College
Eric L Legome, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, Council of Emergency Medicine Residency Directors, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.