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JAMA Patient Page
September 26, 2017

Electrical Injury

JAMA. 2017;318(12):1198. doi:10.1001/jama.2017.11156

Electrical injury occurs when an electrical current contacts or passes through the body.

Electric current may cause local damage to the skin or muscle and may involve other organs, such as the heart. Electrical injury may result from contact with faulty electrical appliances or machinery or contact with open household wiring or electrical power lines. A skin burn may be seen at contact sites, but most serious injuries are not visible.

Effects of Electrical Injury

The severity of injury depends on the following:

Voltage: High voltage usually causes more severe injuries. A voltage level higher than 1000 V is considered high voltage. Most household wiring and appliances are less than 120 V in the United States or less than 250 V outside of the United States.

Type of current: Electrical current is either direct or alternating. Alternating current, which is the type used in the United States and European wall sockets, is more dangerous as it can cause muscle contraction that can prevent people from releasing their grip on the source.

Duration of contact with the source: Longer exposure to the current leads to worse injury.

Electrical injury can affect the skin (burn at contact sites); muscles (uncontrolled contractions or tissue damage); heart (arrhythmias or cardiac arrest); brain (confusion, seizures, or loss of consciousness); eyes (abnormal vision); and nerves (abnormal sensation, difficultly speaking or swallowing, weakness, or paralysis [can be delayed in onset]).

Treatment

Turn off the power source immediately. If the individual is in cardiac arrest, initiate cardiopulmonary resuscitation after ensuring that the person is not still in contact with the source and have the person taken to the nearest medical facility. At the hospital, doctors will evaluate for skin burn, tissue damage, abnormal heart rhythms, and any other traumatic injuries. Burns will be treated and intravenous fluids will be given if the burn caused any internal damage.

Prevention

  • Follow electrical safety rules.

  • Never put electrical appliances or cords in or near water.

  • Do not touch electrical wires or equipment while barefoot or in wet environments.

  • Extension cords should always be powered off when not in use and kept in good repair, especially if children have access to the area.

  • Have an electrician ensure that you have a functioning ground fault circuit interrupter (GFCI) in areas where electricity may be near water (bathroom, kitchen, pool area). A GFCI is a device that shuts off an electrical circuit when it detects that current is flowing along an unintended path, such as through water or a person.

  • Poles and ladders should not be used near power lines. Any ladder with a chance of electrical contact should be wooden, not metal.

  • Workers who are operating on or near any electrical apparatus should not work alone.

  • Do not touch a person who is still in contact with an electric current. If possible, shut off the current immediately.

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For More Information

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
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Article Information

Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: Arnoldo BD, Purdue GF. Hand Clin. 2009;25(4):469-479.

Jain S, Bandi V. Crit Care Clin. 1999;15(2):319-331.

Mills W, Switzer WE, Moncrief JA. JAMA. 1966;195(10):852-854.

Spies C, Trohman RG. Ann Intern Med. 2006;145(7):531-537.

Topic: Injury Prevention

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