By Tedler D. Depaynos, MD
Many times we accidentally touch exposed live wires and electrical current may enter thru our touching hand but we do not suffer any injury except perhaps a little burn on our hand that got in contact or perhaps a sudden shock that gives us fear to touch live wires again.
From our basic textbooks, exposure to at least 1000 volts which may be termed high voltage would surely enter our body and find an exit which would cause serious injuries. Since the current would pass inside the body following the bones, blood vessels, nerves and muscles, the injury would not be obvious externally. The skin maybe intact but the deep muscles may be damaged and swell and since they are covered by a fascia which would limit its expansion we will have the so called compartment syndrome. Emergency incision of the fascia is usually done called fasciotomy to relieve the pressure which maybe compressing still viable nerves or blood vessels resulting in immediate gangrene.
The high voltage current may also pass thru the heart which may cause irregular heartbeats or arrhythmia and if severe may lead to heart failure. Hence, cardiac monitoring for at least 72 hours is a must. The current may destroy also the red blood cells leading to anemia and the destroyed cells will be excreted thru the kidney. This is manifested by highly colored urine which is sometimes called “pigmented urine” in medical parlance. If excretion of this “pigmented urine” is severe, acute renal failure may ensue and dialysis may be required.
Basically these are the complications of a high voltage electrical injury that are usually watched out so that prevention of their occurrence or immediate treatment is done to save the patient. Of course other complications may occur like severe pain, severe infection which may lead to sepsis, fluid and electrolyte imbalance, etc. are in the mind of attending physicians so that taking care of these patients is not ordinary. It is a serious matter!
This was done to an employee of a local electrical cooperative who recently suffered such injury accidentally. The high voltage current apparently entered his right arm and excited thru his right leg. He was monitored closely and the attending surgeons attempted a very conservative approach by doing an emergency fasciotomy and later repeated debridement of the necrotic tissues hoping that the involved extremities would be saved. When the extent of injury however became more obvious and there was no chance of saving the injured extremities, amputations and skin grafting were eventually done.
The patient was doing well especially when he was assured that artificial arms and legs could eventually be fitted so he could return to his usual activities. Patients undergoing amputations are usually depressed so that this is one major aspect considered in the treatment of these patients especially so if they think they can no longer return to work.
As they always emphasize, Prevention is Always Best than Cure. There are times when the required SAFETY PROCEDURES are not closely followed because some individuals take things for granted. It is always a must that Safety Rules should always be strictly implemented and monitored.
I could recall an incident where an electrician was electrocuted because of “poor coordination” according to some of his co-workers. It is good that the victim’s relatives were well compensated. There was also an incident where during a typhoon that caused a temporary brownout, an engineering graduate climbed up an electrical post trying to fix something. An electrical spark hit the cornea of his unprotected right eye that eventually caused his partial blindness. Initially his companions thought that the current they saw was exiting thru his eye. I would not like to imagine the consequences if the current really passed thru his brain exiting thru his eye.**
