Electrical Burns

Electrical accidents can cause several different types of burns, including flame burns caused by ignited clothing, electrical current injury, or electrothermal burns from arcing current. Sometimes all three types will be found on the same child. Nearly two-thirds of electrical burn injuries among children aged 12 and under are associated with household electrical cords and extension cords. Wall outlets are associated with an additional 14 percent of these injuries. Among children aged 14 and under, hair curlers and curling irons, room heaters, ovens and ranges, irons, gasoline, and fireworks are the most common causes of product-related thermal burn injuries.

An electric current injury is characterized by focal burns at the point where the current entered and left through the skin. Once an electric current enters the body, its path within the body is determined by tissues with the least resistance. Bone offers the most resistance to electrical current, followed in descending order by fat, tendon, skin, muscle, blood, and nerve. The path the current takes determines whether the child will survive, since current passing through the heart or the brainstem will result in almost instantaneous death from a disturbed heart rhythm. As current passes through muscle, it can set off severe spasms that can fracture or dislocate bones. Although bone does not conduct current well, it stores the heat from the electricity and can damage surrounding muscles.

Electrothermal burns are heat injuries to the skin that occur when high-tension electrical current touches the skin, causing intense, deep damage. Damage is severe because the arc carries temperature of about 2,500°C (hot enough to melt bone). Skin at both entry and exit of the current is usually gray, yellow, and depressed; there may be some charring. All of these wounds must be debrided, which is the removal of ruined or dead tissue.

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