This article began as a lesson in what to do to avoid an electrical shock. In focusing on electrical-related injuries and fatalities, several questions arose. Why do certain incidents result in a fatality rather than an injury? Could proper first aid have made a difference? What areas of first aid are critical to electrical exposure incidents?
This article looks at first aid related to the incidents reviewed and offers response tips. Accident prevention will not be addressed.
The first incident illustrates why the Occupational Safety and Health Administration (OSHA) requires individuals trained in first aid on job sites. It also serves as a reminder why the first-aid procedures must be followed in proper sequence.
Never render first aid unless the scene is safe. Make sure all sources of electricity that may have caused the shock have been deenergized. Many a would-be rescuer has become a victim when approaching an injured individual who was still energized.
Knowing the ABCs
An apprentice was replacing ballasts and fluorescent lighting tubes. He was told to turn off half of the lights and work on the deenergized circuit. He was also instructed to use a fiberglass ladder. The body was later found lying next to an aluminum ladder.
The medical examiner cited the cause of death as cardio-respiratory arrest due to electrocution. In this case, a properly trained individual would have addressed the ABCs first: airway, breathing and circulation. With no breathing and circulation in place, cardiopulmonary resuscitation (CPR) would have been started.
Shock, falls and broken bones
While installing lighting fixtures, an electrician climbed a stepladder to do preparatory work. He received an electric shock and could not release his grip. He kicked the ladder out and fell to the floor. His impact with the concrete floor drove a pair of pliers into his back, causing severe injuries.
Falls are common in the industry. Whether initiated by a shock or other causes, broken bones, puncture wounds or other trauma can result. The DOTS check, (a physical exam to look for deformities, open wounds, tenderness and swelling), will reveal these types of injuries.
Stabilize the neck and spine from movement if you suspect a neck or back injury. Treat open wounds and stabilize extremity fractures. Even if you do not suspect a fall, be sure to check for these injuries. An electrical shock can cause violent muscle reactions, and result in the same types of injuries.
Treating electrical burns
An electrician was removing a light switch while the circuit was energized. He contacted the energized parts of the 277-volt lighting circuit and received an electric shock. He was transported to a burn center, where he died from his injuries 22 days after the accident.
There are three types of electrical burns: thermal burn, arc flash burns and true electrical injury. Although it is not clear by OSHA’s description, this individual probably encountered a true electrical injury. With this injury, the major damage occurs inside. The electricity travels along the nerves and blood vessels.
However, performing the ABCs followed by a DOTS check, a first responder can take appropriate action. An entrance and an exit wound can confirm suspicion over whether an unconscious colleague has been electrocuted. Look for burn marks around the wounds. There may be more than one exit wound. Treat the victim for shock and seek medical attention as soon as possible.
Burns may occur even if a victim was not in direct contact with the electricity. In another burn instance, an electrician renovating an electrical system dropped a pair of pliers into the panelboard. The employee was burned by the ensuing electric arc.
Delayed shock results
An electrician was working on a junction box, connecting wiring for an outdoor overhead lighting fixture. He contacted a conductor and the metal conduit simultaneously and received an electric shock. He died of his injuries 10 days after the accident.
This incident was presented to encourage follow-up treatment for any electrical exposure. An electrical shock can cause internal damage that is not always obvious. For example, disruptions in heart rhythm may not be immediately visible to the first aid responder. If left unchecked, fatal consequences can result. Always have a victim of electrical shock evaluated by a physician.
Be sure employee training in first aid and CPR is current. This will keep employees up-to-date on the latest techniques. Current training includes automated external defibrillators (AED). An AED is used in cardiac arrest cases to help correct the unorganized electrical activity of the heart. EC
O’CONNOR is with Intec, a safety consulting, training and publishing firm that offers on-site assistance and produces manuals, training videos and software for contractors. Based in Waverly, Pa., he can be reached at 607.624.7159 or firstname.lastname@example.org.