ELECTRICAL INJURIES
Dr. Abhishek Karn
Dept. of Forensic Medicine
& Toxicology
The injuries caused by contact with
electrical conductors.
Depends upon
1. Kind of current
2. Amount of current
3. Path of current
4. Duration of the current flow
Direct current (DC)
Alternating current (AC)
AC 4 -5 times more dangerous as
compared to an equal voltage of DC.
The amount of current flow through or over
the body = V/R
where:
V=voltage &
R=resistance of the body in ohms
Skin Resistivity -
Ohms/cm2
Mucous membranes
100
Vascular areas
300 - 10000
volar arm, inner thigh
1,200 1,500
Wet skin (Sweat)
2,500
Other skin
10,000
40,000
Sole of foot
1,00,000
2,00,000
Heavily calloused palm 10,00,000
20,00,000
Skin Resistivity
Least
Nerves
Blood
Mucous membranes
Muscle
Intermediate
Most
Dry skin
Tendon
Fat
Bone
Electrocution rare at < 100 volts
Most deaths occur at > 200 volts
High voltages (>1000 volts) may cause
victim to be thrown clear, while lower
voltages (~240 volts) cause m/s
contraction, due to which the victim
holds onto the source of current.
Death is more likely to occur if the brainstem or heart are in the direct path of the
current.
The current passes through the skin
producing heat, which causes boiling and
electrolysis of tissue fluids.
A well-moistened skin may not show
electrical burn, while a thick dry skin may
show well-marked electrical burn.
Specific and diagnostic of contact with
electricity and is found at the point of
entry of the current.
Endogenous thermal burn due to heat
generated in the body from electricity.
The marks are round or oval, shallow
craters, one to three cm. in diameter, and
have a ridge of skin about one to three
mm. high, around part or whole of their
circumference.
They are commonly found on exposed part
of the body, especially on the palmer
aspect of the hands.
The skin of the mark is pale, but there may
be mild hyperaemia of the adjacent intact
skin, due to rapid dilatation of pre capillary
vessels.
In spark burn, there is an air gap between
metal and skin. Here a central nodule of
fused keratin, brown or yellow in colour is
surrounded by the typical areola of pale
skin.
Brief contact with a live wire, may not
produce burns. In this case, the person may
collapse from ventricular fibrillation and fall
away from wire.
Very high voltage currents produce massive
destruction of tissue with loss of extremities
and rupture of organs.
When a bone is involved, periosteum may be
elevated or superficial layers of the bone
may be destroyed or fracture may occur.
Accidental - most common
Suicidal - rare
Homicidal rare
All patients who are asymptomatic and
who have a normal ECG after a 120v or
240v injury can be safely discharged.
Judicial electrocution :- 2000 volts for 1minute causes
tetanic spasm & loss of
consciousness, then same current is
passed again for 1more minute.
-brain can be heated up to 600C.
- in some states of USA.
1.
2.
3.
4.
Ventricular fibrillation (low voltage)
Respiratory failure (inhibition of
respiratory centre) (high voltage)
Cerebral anoxia
Delayed complication of burn
Electrical discharge from cloud to
earth.
Potential of 1000 million volts (DC).
Much energy is liberated along the track of
the current, most of which is converted into
light.
Attracted by the highest points.
Normally passes along the outside of a
conductor & as such, persons in buildings are
relatively safe.
Affects person outdoors.
Because of the skin being
poor conductor, most of the
electric charge shoots across
the body surface to the
groundFlashover.
The burns produced may be:
1. Linear
burns- 3-30cm in length & 0.3-2.5cm
wide, in moist creases & skin folds.
2. Arborescent
burns- superficial, thin, irregular
& tortuous marking resembling branches of a
tree or fern-like pattern.
3. Surface
burns- occur beneath metallic
objects worn/carried by the person.
Arborescent Burn or
Filigree Burn or
Lichtenbergs flowers:
Burn like that of
branches of a tree
Superficial ferning
Disappear in 24 hours
Pathognomonic for
lightning strike
CAUSE OF DEATH:
Involvement of the CNS with paralysis of
heart/ respiratory system or electrothermal
injuries.
MLA:
<50% people struck by lightening are killed.
Always accidental.
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