-M.

VASANTH
Guided by
Dr.BALA
 Electrical injury occurs due to flow of electric current
through body caused by contact with electrical conductors .
 Extent of injuries depend upon the following factors
 Kind of current (ac 4to 5times dangerous than dc)
 Amount of current (<100v safe >200v
unsafe ”india220to240v” us ,japan 110v)
 duration of current
 Path of current(death more likely to occur if brain stem or
heart is in the direction of current)
 Fatal electrocution(harm due to passage of current as a
whole)
 Electric shock (local electric effect)
 Burns(local thermal effect)
 Blood has low resistance and tends
To conduct electricity
 Current passes through the skin producing heat ,which causes
boiling and electrolysis of tissue fluids
 Skin explodes and rolls back from the surface
 Well moistened skin may not show well marked electric burn
 Specific and diagnostic of contact with electricity
 Found at point of entry of current
 Endogenous thermal burn due to heat generated in the body
from electricity
Features
 round or shallow
 Shallow craters (1to3cm in dia)
 Ridge of skin (1 to 3mm high)
 Floor of crater plane and flattened
 Coagulation of dermis
 Seperation of epidermis with dermis with cells arranged acute
or right angle to dermis
 The intense heat which may result from flash over
produce burns which resemble exogenous
thermal burns.
 In spark burn there is an air gap between metal and
skin
 Feature
 Central nodule of fused ratin brown or yellow in
colour
Surrounded by areola of pale skin
 1000v will jump several mm
 100kilo jump around 35cm
 It produce massive destruction of tissue with loss of
extremities and rupture of organs
 multiple burnt or punched out lesions are produced due to
the arc over the body surface over large present as crocodile
flash burns
 High amperage often produce blast like effect resembling
bullet or stab wounds
 Low voltage electrocution
 Brief contact (less duration)with wire .here person collapse
fron ventricular fibrillation
 When electrocuted with wire the metallic ions gets deposited
in skin and subcutaneous tissues
 Copper or brass leaves bright green imprint
 Splits are dry ,hard,firm,charred ,insensitivewith ragged edges
 Seen as splits at points where the skin has been been raised
into ridges
 External
 Examination of scene more impotant than the body
 Cardiac arrythmia -pale ,respiratory paralysis –cyanosed
 Eyes congested pupils dilated
 External marks of entry and exit wounds electric burning
laceration or contusion
 Lesion may extend to muscles ,bone leaves no of greyish
white circular spots which are firm on touch and free from
inflamation
 Arcing of current may produce pit like defect in hair surface.
 Lungs congested and edematous
 Brain and meninges congested
 Petechial haemorrhage may be found along he line of passage
of current
 small balls of molten metal derived from the contacting
electrode carried deep into tissues called current pearls
 Heat produced alond the line of passage of current melts
calcium phospate present in bone seen radiologically as as
typical round dense focci called bone pearls
 Passage of death and causes
 Arm to arm affects upper cervical cord
 Limbs to head involves upper cervical cord and brain stem
 Arm to leg involves heart
 instant death due to v fib and cardiac arrest
 Also need not be instant where person sble to walk some
distance nd talk before collapse nd death occurs due to
muscular paralysis and asphyxia usually ocuurs if contact time
is high and current is low
 High voltage current causes respiratory arrest or
electrodermal injuries
 Non fatal cases hemiplegia or paraplegia ,loss of sight
,hearing and memory loss may occur.
 The person in contact with electricity should not pulled with
bare hand but with dry cloth newspaperor rubber gloves
 Artificial respiration and cardiac massage(cpr) principle forms
of treatment
 Occurs due to defective electrical equipments and shortcircuit
 Rarely death occurs due to convulsant therapy to mentally ill
patients
 In industry death may result from contact with overhead
cables , handling of charged lamps,toolsetc.
 Death penalty is carried out in the electric chair in some states
of usa
 Person strapped in awooden chain cap like electrode placed
on shaved scalp and other electrode on right leg
 A current of 2000volts and 7amperes is passed for one minute
through the body
 Lightning occurs due to electrical discharge from
cloud to earth
 Factors influencing injuries
 Direct effect from electrical discharge passing to
earth
 Surface flash burns from the discharge
 Mechanical effect : force of displaced air by heat
expansion
 Compression effect due to air movementin return
wave
 Expanded ,displaced air causes disruptive blast like
lesions
 Patches of haemorrhages seen inpleuraand
pericardium
 Ruptures of eardrum and haemorhage inmiddle ear
may be seen
 Cause of death
 Central nervous system with paralysis of heart or
respiratory center or electrothermal injuries
 Surface burns
 Linear burns((1stdegree burn with
length 3 to 30cm and width .3 to 2.5cm)
 Arborescent or filigree burns
 These are superficial ,thin,irregular tortuous
marking on the skin.these markings have a
general pattern resembling the branching of
tree.
 Mechanism: haemoglobin from lysed rbs
along patch of current < boiling of intracelular
fluid
 It mainly indicates psth taken by the discharge
and disappears in one or two days
 Most death occur in open
 Eg open field sheltering under a tree,sheltering in a vehicle is
safe since vehicle tyre provide insulation
 Diagnosis based on history of thunderstrom in the area
 Evidence of ligthning in the vicinity of the body and fusion or
magnetisation of metallic substances
Thank you!!!