Electric Shock And Lightning Strike

Electric shock and lightning strike • Electric shock o Direct effect of the current o Conversion of electric to heat energy • Factors determine the nature and severity: magnitude of energy delivered, resistance to current, type of current, current pathway, and duration of contact o Bone and skin have a high resistance o Blood vessels, muscle, nerve have a low resistance o The skin resistance can be ↓ by moist → and convert a low voltage to a life threatening shock o Alternating current is more dangerous than a direct current o Transthoracic (hand-hand) are more dangerous than vertical ones o VF more common with alternating, while asystole more with direct o Respiratory arrest due to CNS effect (medulla), tetanic contraction of resp muscles, and prolonged paralysis o Consider C-spine precaution, and other injuries

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o Potential burn to the face → early intubation o Cardiac arrest → ACLS o High risk of rhabdomyolysis → myoglubinuria → renal damage → bicarb bolus and infusion with diuretics, fluid resuscitation o Other CNS→ Sz, arterial and venous thrombosis o Myocardial effect → R on T phenomena and coronary artery spasm Lightening Strike o Very high voltage 100 M -2 billion V o Less internal damage than electric shock o Avoid secondary hypoxic cardiac arrest