Chapter 31 Electrical injuries
In a two-year period from 2002, 1493 people in Australia were hospitalised as a result of an electrical injury, including 77 from lightning strikes. Of the 1493, 209 were aged 0–14 years, with 18 of those sustaining injury from high voltage lines.
Low voltage electrical injury may be further subdivided into patients with or without cardiac and/or respiratory arrest.
PATHOPHYSIOLOGY
Electricity may cause injury via three broad mechanisms:
1. causing direct tissue damage, altering cell membrane resting potential and eliciting muscle tetany
2. conversion of electrical energy into thermal energy, causing tissue destruction and coagulative necrosis
The site of either direct tissue or thermal energy damage depends on the pathway of current flow.
PHYSICS
In order to avoid lightning there are some simple measures which should be followed:
• Avoid contact with any metal such as golf clubs, umbrellas, tent poles, gates, roofs or hair clips.
• Do not stand with your feet apart, as this increases your stride potential and can result in major burns.
• If caught alone, the correct procedure is to curl up on the ground, preferably in a ditch, well away from higher objects.
Wide-band magnetic direction finders are increasingly used to warn of incoming lightning storms.