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    18 - First Aid in Electrical Injuries

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    Isael sierra
    The document discusses safety procedures and first aid for electrical injuries. It covers topics like symptoms, factors that determine injury severity, types of circuit injuries, resistance of body tissues, physical effects of amperage, and guidelines for examining and providing first aid to a victim.

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    © All Rights Reserved
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    18 - First Aid in Electrical Injuries

    Uploaded by

    Isael sierra
    89 views39 pages
    The document discusses safety procedures and first aid for electrical injuries. It covers topics like symptoms, factors that determine injury severity, types of circuit injuries, resistance of body tissues, physical effects of amperage, and guidelines for examining and providing first aid to a victim.

    Original Title

    18_First Aid in Electrical Injuries

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    The document discusses safety procedures and first aid for electrical injuries. It covers topics like symptoms, factors that determine injury severity, types of circuit injuries, resistance of body tissues, physical effects of amperage, and guidelines for examining and providing first aid to a victim.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    89 views39 pages

    18 - First Aid in Electrical Injuries

    Uploaded by

    Isael sierra
    The document discusses safety procedures and first aid for electrical injuries. It covers topics like symptoms, factors that determine injury severity, types of circuit injuries, resistance of body tissues, physical effects of amperage, and guidelines for examining and providing first aid to a victim.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    You are on page 1of 39

    MARINE HIGH VOLTAGE SAFETY

    COURSE

    First aid in electrical injuries


    ABB, Marine Academy, Helsinki
    FOCUS ON SAFETY

    BANGKOK POST
    February 24th 2008

    Tightrope walker

    An employee of the Nawamin


    Cable TV Network company
    walks on electric power cables
    without any safety gear while
    working
    k near Nawamin
    N Road.
    R d
    He walks from 2-4 kilometres
    a day on the cables.
    Electrical injury
    An electrical injury can occur to the skin or
    internal organs when a person is directly
    exposed to an electrical current.
    The human body is a good conductor of
    electricity.
    y
    Direct contact with electrical current can
    be fatal. Though burns may be minor,
    there
    h may be
    b serious internall damage,
    d
    especially to the heart, muscles or brain.
    The outcome to the individual depends on

    † th
    the intensity
    int nsit off th
    the voltage
    lt
    † the time period of contact
    † the route of the current through the
    body
    † the victim’s state of health
    † the speed
    p and adequacy
    q y of the
    treatment
    Following injury may occur
    † cardiac arrest due to the electrical effect
    on the heart
    † muscle, nerve & tissue destruction from a
    current passing through the body
    † thermal burns from contact with the
    electrical source
    † blunt trauma from being thrown far from
    source
    S
    Symptoms may include
    i l d

    † skin burns
    † numbness, tingling, weakness
    † muscle contractions & pain
    † bone fractures
    † headache seizures
    headache,
    † hearing impairment, poor vision
    † heart arrhythmias & cardiac arrest
    † respiratory failure
    † unconsciousness
    F t
    Factors d
    determining
    t minin electrical
    l t i l inj
    injury

    † type of circuit
    † resistance
    † amperage
    † urat on of contact
    duration
    † voltage
    † pathway
    T
    Type of
    f circuit
    i it (DC/direct
    (DC/di or AC/alternating)
    AC/ l i )

    H h
    High-voltage
    l DC
    D exposure causes
    ¾ single muscle spasm – often throws victim from the
    source
    Æ shorter duration of exposure
    Æ great likelihood of traumatic blunt injury

    ¾ disturbances in cardiac rhythm depending on the


    cardiac cycle affected (eg. cardiac defibrillators)
    Hi h
    High-voltage
    lt AC exposure

    ¾ is
    i 3x
    3 more d
    dangerous th
    than DC
    ¾ causes continuous muscle contraction
    (tetany)
    ¾ f
    flexors are stronger
    g than extensors
    ¾ with contraction of flexors at wrist, elbow
    & shoulder the victim pulls the source
    closer to the body thus increasing the
    effect of electricity
    Resistance

    † is the tendency of a material to resist the flow


    of electric current
    † it is specific for each tissue depending on its
    moisture content, temperature & other physical
    properties

    High resistance = great potential for transformation


    gy to thermal energy
    of electrical energy gy

    Low resistance = good conductors of energy


    Resistance of body tissues
    (moisture lowers resistance)

    Low Intermediate High


    Nerves
    N D skin
    Dry ki Tendon
    T d
    Blood Fat
    Mucous membranes Bone
    Muscle
    Amperage

    = the measure of the electrical current that flows


    through an object

    Amperage is dependant on the source voltage and


    resistance of the conductor (varies according to
    tissues involved and their reaction to the
    energy; this is difficult to predict). There is a
    great difference between conduction of dry and
    wet areas (skin, ground etc.).
    Physical effects of different amperage levels at
    50-60 Hz

    Physical effects mA
    Threshold of perception 0.2 - 0.4
    g g sensation
    Tingling 1-4
    Let-go currant
    • children 4
    • women 7
    • men 9
    g to circuit
    Freezing 10 - 20
    Respiratory arrest 20 - 50
    Ventricular fibrillation (VF) 60 - 100
    D
    Duration
    i off contact

    The longer the duration of contact with high-


    voltage current – the greater is the electro-
    th
    thermal l heating
    h ti & d degree off ti
    tissue destruction.
    d t ti

    OBSERVE !
    Difference between direct & alternating circuit.
    Voltage

    HIGH or LOW voltage


    Æ 1000 V is a common dividing line

    HIGH:
    ƒ greater current flow
    fl
    ƒ greater potential for tissue destruction
    ƒ major amputations & tissue loss
    P th
    Pathway

    H
    Heart & thorax
    h Æ cardiac
    d d
    dysrhythmias
    h h & direct
    d
    myocardial damage

    Brain Æ respiratory arrest, seizures,


    paralysis

    Eyes Æ cataracts

    In high voltage injuries surface damage is a ”tip of


    the iceberg” – extensive deep destruction!
    Types of burns

    † Direct contact
    ƒ electrothermal heating

    † Indirect
    n r ct contact
    ƒ arc = most destructive, temperature 50000 C
    ƒ flame
    ƒ flash
    Damage to neural tissue

    † coagulation necrosis – drop in conductivity


    † damage from poor vascular (bloodvessel)
    supply
    l or myelin
    li sheath
    h h destruction
    d i or
    progressive edema
    Æ signs of damage may be immediate or appear
    in hours-days
    † brain is commonly injured
    - focal petechial hemorrhages in the brainstem
    - cerebral edema
    Damage to bloodvessels

    † vascular damage greatest in the media (outer


    layer), blood-vessel eventually ruptures
    † intimal
    i ti l (internal)
    ( l) damage
    d causes th
    thrombosis
    b i &
    vascular occlusion over a period of days
    † most severe injury is in the small vessel
    branches where bloodflow is slower
    † arterial thrombosis Æ NO PULSE
    DO NOT
    † ttouchh the
    th victim
    i tim with
    ith your b
    bare hands
    h nds
    until the current is safely off
    † go closer
    l than
    th 5-10
    5 10 meters
    t of
    f someone
    who is being electrocuted by high voltage
    † move theth victim
    i ti unless
    l there
    th is
    i iimmediate
    di t
    danger
    † touch h the
    h bburnt skin
    k area, b break k bl
    blisters,
    apply ointments or ice
    Examine the victim (when it is safe to do so)

    † Open the airways !!!

    † Does he breathe ? HOW ??


    - rate/minute
    - breathing sounds
    - use of assesory muscles
    - ability
    y to speak
    p / words? sentences?

    † Does he respond? LOC (level of consciousness)?


    - spontaneously
    - to speech
    - to pain
    - no response
    If he does not respond => CPR
    (cardio-pulmonary resuscitation)

    Call for help!


    † check for signs of life (movement, reaction,
    breathing) if none…
    breathing), none
    † start chest compressions 30 x
    † check breathing, if none… blow 2 x
    † continue 30 : 2 about 100x/min
    † if ppossible – elevate feet, this increases the
    amount of blood in the central circulation
    Finnish Red Cross guidelines

    See pictures
    CHECK THE VICTIM
    FOR A RESPONSE

    Not responding.
    CALL FOR HELP

    BASIC LIFE SUPPORT GUIDELINES 2006 / 5


    CHECK FOR NORMAL BREATHING

    Look for chest movement.


    Listen at the victim's mouth for
    breath sounds.
    Feel for air on your cheek.

    BASIC LIFE SUPPORT GUIDELINES 2006 / 6


    OPEN AIRWAY

    BASIC LIFE SUPPORT GUIDELINES 2006 / 7


    CHEST COMPRESSION

    Press down on the sternum 30 times.


    Place the heel of one hand in the centre of
    th victim's
    the i ti ' chest.
    h t

    BASIC LIFE SUPPORT GUIDELINES 2006 / 8


    RESCUE BREATHS

    Open airway.

    Give 2 rescues breaths.

    BASIC LIFE SUPPORT GUIDELINES 2006 / 9


    AUTOMATED EXTERNAL
    DEFIBRILLATION

    BASIC LIFE SUPPORT GUIDELINES 2006 / 10


    PAEDIATRIC BASIC LIFE SUPPORT

    Check the child for


    a response.
    Unresponsive.
    Not breathing
    normally.

    CALL FOR HELP

    5 rescue breaths

    30 chest compressions 2 rescue breaths

    Continue chest compressions


    p and rescue breaths
    with the 30:2 ratio.

    BASIC LIFE SUPPORT GUIDELINES 2006 / 11


    PAEDIATRIC BASIC LIFE SUPPORT
    (infant)

    No
    response

    Call
    C ll for
    f
    help

    5 rescue breaths

    30 compressions 2 rescue breaths

    Continue chest compressions and rescue breaths


    with the 30:2 ratio.

    BASIC LIFE SUPPORT GUIDELINES 2006 / 12


    FOREIGN-BODY AIRWAY OBSTRUCTION

    Command
    to cough

    Heimlich manouvre

    BASIC LIFE SUPPORT GUIDELINES 2006 / 13


    THE RECOVERY POSITION

    Observe
    b tonque

    BASIC LIFE SUPPORT GUIDELINES 2006 / 14


    THE RECOVERY POSITION

    Allways turn towards yourself

    BASIC LIFE SUPPORT GUIDELINES 2006 / 15


    BASIC LIFE SUPPORT (ADULT) ALGORITHM
    Responsive?

    no

    Call for help.

    Open airway.
    Breathing normally?

    Turn the casuality to


    recovery position.
    yes
    Monitor the breathing until
    professional help arrives.
    no

    Start chest compressions.


    Perform 30 compressions.
    p

    Start mouth-to-mouth ventilation.


    Give 2 rescue breaths.

    Continue chest compressions and mouth-


    to-mouth ventilation with the 30:2 ratio.

    Continue until professional help arrives, normal


    breathing resumes or you become exhausted.

    BASIC LIFE SUPPORT GUIDELINES 2006 / 16


    BASIC LIFE SUPPORT
    Check
    victim for
    response.
    Unresponsive

    Call for help

    Check for
    normal
    b
    breathing
    thi

    No

    30 chest compressions
    2 rescue breaths

    Continue chest compressions and rescue breaths


    with
    i h the
    h 30
    30:2
    2 ratio.
    i

    BASIC LIFE SUPPORT GUIDELINES 2006 / 17


    Examine the victim (continued)

    † Are there visible injuries?


    - burn marks
    - bruises,, cuts,, bleeding
    g
    - fractures
    † Do a manual examination
    - thorax /
    th /ribcage
    ib
    - abdomen
    - pelvis
    - head
    - neck, back
    - upper & lower limbs
    First aid in other injuries

    † Blunt trauma
    - immobilize fractures
    - stop bleeding
    o not mo
    - do move th
    the victim
    ct m unnecessarily
    unn c ssar y

    † Thermal burns
    - if possible cool the burn area
    Practice

    † Examining the victim

    † Resuscitation (CPR)

    † Helping an unconscious victim


    -turn to recovery position / on side

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