Thursday 19 April 2012

Electric Shock Information


1) Danger
If you suspect someone has received an electric shock you must ensure all power sources are isolated before you can treat the casualty.

High voltage
Overhead power cables are an example of a power source generating high voltage electricity. High voltage electricity has the ability to ‘jump’ or ‘arc’ up to distances of 18 metres or over. If faced with a casualty resulting from high voltage electricity:
  • Do not approach. Stay at least 25 metres away from the casualty until the power has been switched off by an official agency i.e. Electricity Board.
Low voltage
If faced with a casualty who is in the process of receiving an electric shock you should:
Attempt to turn the power off at the mains.
Remove any cables/power tools etc., still in contact with the casualty.

Action to take
Insulate yourself from the ground with books / newspapers / rubber matting.

Use an object of low conductivity i.e. a wooden broom or rolled up newspaper, to push away the power source

2) Response
To give your casualty the optimum chances of survival you must quickly assess their levels of response. A rapid assessment will allow effective treatment to be administered and will also allow for accurate information to be passed on to the ambulance service.

Check whether the casualty is conscious
1. Ask “hello, can you hear me” and call their name if you know it.
2. Ask in both the casualty’s ears to open their eyes.
3. Pinch an ear lobe or gently tap the shoulders.
4. Shout for HELP!
5. DO NOT move the casualty unless the environment or situation is dangerous.

3) Shout
Call for help
If alone call for help. If someone responds to your call ask them to stay with you whilst you assess the Airway and Breathing. One of you should wait with the casualty whilst the other calls the emergency medical services (EMS).
NB If no-one responds do not leave the casualty but go on to assess the airway and breathing.

Calling the emergency medical services
Lift the receiver and wait for a dialling tone.
DIAL 999 IN UK (112 IN EUROPE)
The operator will ask you which service you require. Once you have stated ‘ambulance’ you will be connected to ambulance control. The operator will ask you a set of questions. Do not hang up at any stage of the conversation. The operator will terminate the call when appropriate.

Isolate or cordon off the exposed, damaged or faulty electrical source
As soon as possible after the casualty has been taken to hospital report the incident to the local supervisor. Give all information you can as an IRF needs to be completed for all accidents and incidents. Leave details about yourself so that you can be contacted should the need arise. Report defective equipment that caused the shock (if applicable) so that repairs can be made.
RIDDOR (Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995).

4) Airway
For an unresponsive casulaty open the airway
1. Look in the mouth to ensure there are no obvious obstructions.
2. Open the airway by lifting the chin and tilting the head back. This will free the tongue from the back of the throat.
3. If neck/spinal injury is suspected, put one hand on the stomach to feel if it rises and falls. This indicates normal breathing.

Assess for breathing
1. LOOK for the rise and fall of the chest.
2. LISTEN for sounds of breathing.
3. FEEL for air on your cheek.
4. Carry this out for up to 10 seconds.

Breathing normally
If breathing is present go straight to the Recovery Position section.

Not breathing
If the casualty is not breathing normally, commence full Cardio-Pulmonary
Resuscitation (CPR).
If you are alone, leave the casualty at this stage and call for help. Return to the casualty and commence CPR (Cardio-Pulmonary Resuscitation).

5) Breathing & Circulation
To commence CPR:
For an unresponsive casualty
1. Ensure the casualty is on a firm, flat surface.
2. Place your hands one on top of the other in the centre of the casualty’s chest
3. Compress the chest (up to a maximum depth of approximately 4-5cm) 30 times at a rate of 100 compressions per minute. The compressions and releases should take an equal amount of time.
4. After 30 compressions, open the airway again using head tilt/chin lift.
5. Seal the nostrils with your thumb and forefinger (Fig 2).
6. Blow steadily into the mouth until you see the chest rise, take about a second to make the chest rise. It is advisable to have Resuscitation Equipment at this stage such as a face shield.
7. Remove your mouth to the side and let chest fall. Inhale some fresh air, when breathing for the casualty.
8. Repeat so you have given 2 effective rescue breaths in total.
9. If chest does not rise after the second breath, go back to 30 compressions then
try again with 2 breaths.
10. Return your hands to the correct position on the chest and give a further 30 chest
compressions.
Continue with CPR until
The casualty shows signs of recovery.
Emergency services arrive.
You become exhausted and unable to continue.
The situation changes and you are now in immediate danger.

6) Recovery Position
Unconscious and breathing noramlly
Turn the casualty into the recovery position.
The recovery position is used when a casualty is unconscious and breathing.
The recovery position allows the head to be placed tilted back and down. This stops the tongue from blocking the airway and will allow any vomit and fluid to drain from the mouth.
If the casulaty is breathing normally
1. Check for any other obvious injuries.
2. Remove sharp objects from pockets.
3. Turn the casualty into the recovery position.
4. Place the nearest arm at a right angle to the body.
5. Draw the furthest arm across the chest and place the back of the hand across the cheek.
6. Keep this here whilst you raise the furthest leg by grasping the top of the knee.
7. Gently pull on the knee so that the casualty pivots over onto their side facing you.
8. The casualty should be fully over and stable.
9. Re-check the airway, breathing and circulation.
10. Draw up the leg at a 90 degree angle.
11. Check for continued breathing.
12. Send someone to ring 999.
EMS or if you are alone, leave the casualty and call 999 / EMS yourself.

7) Burns
Burns
Exposure to electricity can cause burns to the skin and, in severe cases, internal organs. In such cases the electricity may, for example, enter via a hand and leave via the feet causing ‘entry’ and ‘exit’ burns.
Conscious casualties
Cool burns for a minimum of 10 minutes under cold water.
Unconscious casualties
Cool the burn with wet dressings after placing them in the recovery position.
DO NOT
Burst any blisters.
Apply adhesive dressings.
Remove damaged skin.
Apply ointments/creams.
Cover with ‘fluffy’ dressings.
Affix dressing too tightly.
Apply butter/fats/margarine.
Remove damaged clothing.
Apply ice.

8) Other Injuries
Muscle spasm/seizures
These may be present for some time after the exposure to electricity and indicate a seriously ill casualty.

Action in the event of a major seizure
1. The casualty will almost definitely collapse during a major seizure. Try to control the fall.
2. Ensure the safety of the casualty by removing any objects that may cause injury if they are struck.
3. Place padding under the head of the casualty. Improvise if necessary by using clothing.
4. DO NOT place anything in the casualty’s mouth.
5. Loosen any clothing that may restrict the airway.
6. When the seizure has subsided:
7. Check the casualty’s Airway, Breathing and Circulation (ABC).
8. If unconscious and breathing normally or semi-conscious, place the casualty in the recovery position (see opposite). Perform CPR if not breathing.
9. Can also put a blanket over casualty to preserve modesty, also time the seizure.
10. Reassure the casualty whilst continuing to monitor the ABC and any other injuries.
Casualties with no apparent injury
If no injury is present and the casualty appears well, it is still advisable to take the casualty to a hospital or medical facility for a check up, as certain organs/systems within the body may be affected several hours after a shock.
The information contained is for guidance only and should not be used as a substitute for recognised training.



Electric Shock Information

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