MedicalParamedics and Emergency Medical Response

Prevention and Treatment of Electrical Burns

How much do we know about electrical burns? These burns occur rather often and we need to be prepared for the prevention and our response and treatment of electrical burns.

We approached the experts from Burnshield to gain some important insights:

How prevalent are electrical burns in South Africa?

Burn injuries remain a significant cause of death and disability in the global south, with children amongst the most vulnerable. In South Africa, burns are critical health and economic burdens in densely populated and energy-impoverished communities. A study published in the Journal of Energy in Southern Africa used secondary data on burn injuries from 19 health facilities to differentiate between risk for scalds and flame burns across three household energy sources (firewood, paraffin and electricity).

The sample was 2 933 cases of child burn victims, with key analytical procedures being descriptive statistics and logistic regression analysis. Results showed that 52% of burn injury admissions reported electricity as the household energy source used at the time of injury. Most burn injuries were scalds (85.3%), with infants and toddlers at the greatest risk.

The differentiation between wood and paraffin was associated with a threefold increase in scalds relative to flame burns, while that between paraffin and electricity indicated a sevenfold increase in scalds and nineteen times such an increase between wood and electricity. This was an indication of continued challenges for the country in addressing paediatric burns despite, and in the context of, the continued electrification of poor households.

The study recommends improved regulation of electrical appliances used by low-income households, and targeted household safety education initiatives.

Do you believe many of these are closely related to the high incidence of illegal electrical connections in South Africa?

In Soweto, housing ranges from freestanding homes with all amenities, to neighbourhoods of informal dwellings (known as shacks) lacking utilities such as plumbing, water supply and electricity.

Electrification of some informal dwellings is improvised using nearby formal electrified structures such as street lights and electricity meters. Wires of various lengths are connected from the permanent structures to reach the informal dwellings.

Information regarding the mechanism of injury was available for 76 patients. One patient had contact with a wall socket, 11 sustained an electrical injury while contacting an appliance, 54 patients sustained injuries from contact with exposed outdoor wires.

Electrical injuries comprised 7% of total burns admissions. Where mechanism of injury was known, 71% of injuries were sustained from contact with unauthorized electrified wires or open electrical boxes.

For inhabitants of informal housing, electricity allows access to lighting and a safer energy source for cooking and heating water for bathing than open flame sources. At present, no affordable alternative supply of electricity is available to this population.

In part, this is because informal settlements are not always accessible to existing infrastructure and the lack of formal town planning in these areas. In addition, urban growth is exceeding local municipal capabilities

What are the most important do’s and don’ts in the treatment of electrical burns?

A person who has been injured by contact with electricity should be seen by a doctor. Sometimes an electrical injury can cause damage to internal tissues, usually in an arm or a leg. The damage may be worse than one would expect from the burn on the skin.

  • Don’t touch the injured person if he or she is still in contact with the electrical current.
  • Call your local emergency number if the source of the burn is a high-voltage wire or lightning.
  • Don’t get near high-voltage wires until the power is turned off. Overhead power lines usually aren’t insulated.
  • Stay at least 20 feet (about 6 meters) away — farther if wires are jumping and sparking.
  • Don’t move a person with an electrical injury unless the person is in immediate danger.

Call your local emergency number if the injured person experiences:

• Severe burns
• Confusion
• Difficulty breathing
• Heart rhythm problems (arrhythmias)
• Cardiac arrest
• Muscle pain and contractions
• Seizures
• Loss of consciousness

Take these actions immediately while waiting for medical help:

  • Turn off the source of electricity if possible. If not, move the source away from both you and the injured person using a dry, nonconducting object made of cardboard, plastic or wood.
  • Begin CPR if the person shows no signs of circulation, such as breathing, coughing or movement.
  • Try to prevent the injured person from becoming chilled.
  • Apply a bandage. Cover any burned areas with a sterile gauze bandage, if available, or a clean cloth.
  • Don’t use a blanket or towel, because loose fibres can stick to the burns.

[Advice via Mayo Clinic]

• Are there special considerations where the victim is a child/ toddler?

The department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital caters for children up to 10 years of age affected by all surgical conditions, including traumatic injuries. There is a dedicated Paediatric Burns Unit with 18 ward beds as well as a seven-bed ICU managed by Paediatric Intensivists. All cases of suspected electrical injuries presenting to CHBAH are admitted to the PBU

Also view:

Safety Advice to Prevent Electrical Burns and Burn Injuries

Safety with Electricity and Preventing Electrocution and Fire 

Burnshield and the Treatment of Burns

Safety, Prevention and Treatment of Burns

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