An electrical burn is a unique and dangerous form of injury caused by an electric current passing through the body. Unlike a conventional thermal burn from a flame or hot surface, the damage is not limited to the skin’s contact point. The electrical energy travels through tissues, generating heat and disrupting the body’s natural electrical signals along its path. This internal route of the current means the visible skin injury often fails to represent the true extent of the damage beneath the surface.
How Electricity Damages Tissue
The physical mechanism of an electrical burn is governed by the principle of Joule heating. This law states that the heat generated is directly proportional to the tissue’s resistance and the square of the current passing through it. Tissues in the body possess varying degrees of electrical resistance, which dictates the severity of the burn.
The skin acts as the body’s main resistor; if dry, it can resist current flow and generate intense heat at the point of contact. Once the current breaches the skin, it encounters internal tissues like nerves, blood vessels, and muscle, which are much more conductive due to their high water and electrolyte content. Conversely, highly resistant tissues like bone and fat absorb more energy and heat up significantly, causing deep-seated thermal destruction. The current often follows the path of least resistance between the entry and exit points, leading to internal injury that may not be immediately apparent.
The External Appearance: Entry and Exit Points
The visible signs of a contact electrical injury manifest as distinct entry and exit wounds where the current enters and leaves the body. The entry wound is frequently small, depressed, and may appear dry, leathery, or charred. This constricted appearance results from the intense heat generated when the current first encounters the high resistance of the skin.
These entry sites can appear deceptively minor, sometimes looking like a small, dark spot that belies severe internal trauma. The exit wound is often larger and more dramatic than the entry wound. It may present with an explosive or star-shaped pattern due to the pressure buildup as the current rapidly exits the body.
It is important to distinguish true electrical burns from “flash” burns, which are caused by the heat and light of an electrical arc. Flash burns are essentially thermal injuries to the skin and are often more widespread and superficial. They do not involve current passing through the body’s core and therefore do not carry the same risk of deep internal damage as a contact burn.
Why Electrical Burns Are Deceptive: Internal Damage
The most dangerous characteristic of an electrical burn is the profound internal damage that can occur with minimal external signs. The severity of the injury is judged by the path the electricity took through the body, not the size of the skin wound. The current flowing internally can cause immediate and delayed effects on multiple organ systems.
One of the most immediate life threats is to the cardiovascular system, especially if the current path crosses the chest. The electrical energy can interfere with the heart’s natural rhythm, causing immediate cardiac arrest or dangerous arrhythmias. Even if the victim appears stable initially, cardiac monitoring is necessary due to the risk of delayed rhythm disturbances.
The intense heat generated internally can cause severe muscle damage, a condition known as rhabdomyolysis. This rapid breakdown of muscle tissue releases myoglobin into the bloodstream, a substance toxic to the kidneys. If not aggressively treated with intravenous fluids, this can quickly lead to acute kidney injury or failure.
The nervous system is also highly susceptible to electrical damage because nerves are excellent conductors. Neurological complications can range from immediate loss of consciousness or seizures to long-term issues like peripheral nerve injury or spinal cord damage. These neurological problems may not manifest for days, weeks, or even years after the initial incident.
Immediate Response and First Aid
The first step in responding to an electrical burn incident is to ensure the area is safe for the rescuer. Before touching the victim, the power source must be immediately turned off or disconnected. If the source cannot be safely disabled, use a non-conductive object, such as a dry wooden stick or plastic item, to separate the person from the source of electricity.
Emergency medical services must be called immediately, regardless of how minor the external burn appears. While waiting for help, check the victim’s airway, breathing, and circulation, and begin cardiopulmonary resuscitation (CPR) if they have no pulse or are not breathing. Any burned areas should be covered with a sterile gauze bandage or a clean cloth, but do not apply ointments or ice. All victims require a comprehensive medical assessment to check for hidden internal damage.