Providing first aid in case of electric shock. First aid for electric shock

The widespread use of electricity not only makes life more comfortable, but often causes electrical injuries. Electric shock entails disorders that are dangerous to human health, and sometimes death. The risk of electrical injury is especially high during repair work mains, improper operation of electrical appliances, non-compliance with safety requirements, the presence of malfunctions.

Premises with increased risk of electric shock

According to the regulations of the PUE, all premises, regardless of purpose, are classified according to the degree of electrical hazard. The first class includes premises that do not have increased danger. The humidity level in them usually does not exceed 45%, they are equipped with a ventilation and heating system that maintains t ° - 18-20 ° C, dielectric floors. The occupancy of the space with metal objects does not exceed a factor of 0.2, there is no dustiness. This category includes residential and public buildings.
The second class includes premises characterized by heightened threat- kitchen, stairwells, laundries, cellars and warehouses.

They are divided into several groups:

• with high humidity(up to 100%);
• with high temperature conditions (above t ° - 30 ° C). elevated temperature regime indoors, leads to accelerated aging of insulation, increasing the likelihood of an emergency;
• with high dustiness. The dust that collects on electrical installations leads to the appearance of conductive paths that cause overheating and ignition of electrical appliances;
• with poor ventilation, creating conditions for dust accumulation and temperature rise;
• equipped with conductive floors and walls;
• having conditions under which contact with grounded structures is possible.

The third class includes premises that present a special danger - a swimming pool, a sauna, a bathroom, a garage, a workshop. They are characterized by the presence of 2 or more hazardous conditions. a separate category especially dangerous objects comprise territories equipped with open electrical installations.
The voltage value in the network is set according to the type of room. For the first class, -220 V is recommended, for the second class - up to 50 V, for the third - 12 V.

Protective Measures Against Electric Shock

Compliance with the protection measures established by regulatory documents can reduce the risk of electrical injury.

According to electrical safety rules:

• the insulation used must be of high quality, and the current-carrying elements are reliably protected, have double insulation, automatic safety interlock, RCD;
• used electrical equipment and components of electrical installations must be grounded, have a fence;
• job isolation;
• checking the condition of the insulation, as well as repairing electrical wiring and electrical equipment, should be carried out as planned;
• the use of warning signs and inscriptions, sound or light alarms;
• the use of devices that lower the voltage to acceptable values;
• application personal protection.

An additional factor that reduces the likelihood of electrical injury is a systematic safety briefing.
Compliance with the protective measures established by the regulatory documentation allows you to avoid the risk of electric shock.

Indirect defense against defeat electric shock

As a method of protection against electrical shock, it is recommended to use auxiliary protective equipment. These include rubber pads, dielectric gloves, mounting belts, fitter's claws, tools with insulating handles, overalls, shoes, ladders, ropes.
The use of such tools during the performance of various works related to electricity will reduce the number of emergencies and feel more confident.

Factors affecting a person's electric shock

The danger of electric current lies in the fact that it is hidden, that is, it is impossible to detect the presence of electric voltage with the help of the senses in advance. Certain factors can increase the risk of electric shock. These include moisture and sweating, low body resistance, the presence of heart disease, lack of special protection. The combination of these factors with the current passing through the human body leads to more serious consequences.

The first actions in case of electric shock to a person, what needs to be done?

Elimination of the source of damage and immediate first aid are the main actions that must be taken to save the victim.

1. De-energize the source of damage without touching it. To do this, using dry rubber gloves, a wooden stick or cloth, you must pull it out of the network. If it is impossible to perform this action, cut the wire or bite with pliers.
2. If it is not possible to de-energize the source of damage, it is necessary, without touching the skin of the victim with bare hands, pull it away, grabbing the edge of the clothes, a few meters.
3. Assess the physical and emotional state of the victim, and regardless of his condition, call a doctor, and be sure to provide first aid.

How to separate the victim from the current source?

There are several ways to free the victim from the action of an electric current. The simplest is to turn off the source of electric current using a knife switch, switch, plug connector, turning out plugs. In extreme cases, the electrical circuit can be interrupted by cutting the electrical wires in turn using wire cutters or pliers with insulated handles.
Touching the body of the victim, not covered by clothing, is possible only in dielectric gloves or wrapping the brush with a rag, scarf, stretched sleeve, standing on a non-conductive pad - a rubber mat, dry rag or board. Using a dry stick or other non-conductive electrical object, fold back the electrical wire if it touches the victim. If the victim squeezes it in his hand, wring out his fingers. You can do this while standing on a rubber mat or wearing dielectric galoshes that protect against possible step voltage, and dielectric gloves on your hands.

Providing first aid in case of electric shock:

Assistance to the victim should be provided immediately, provided there is no danger to the person providing assistance. A doctor is called by a person who does not provide first aid.
Electrical injury causes heating and contraction of muscle tissue, negatively affects the functioning of internal organs. Leaving marks at the entrance and exit, the electric arc deeply affects the skin tissue.

As a result of the injury, the victim may experience:

• dizziness;
• convulsions;
• heart attack;
• fainting.

The brain and heart suffer the most from electric shock. Violating the heart rhythm, electric shock can cause cardiac and respiratory arrest. Properly rendered first aid in the first minutes will save the life of the victim. What actions to take in this case is influenced by the condition of the victim and the complexity of the injuries inflicted on him.

The following factors influence the severity of electrical injury:

• How does electricity pass through the body?
• voltage parameters of the electrical appliance;
• physical condition of a person;
• quality and timeliness of first aid.

Even a minor electrical injury is dangerous, since its effects on the lungs, central nervous system, and heart may not appear immediately, but only after some time.

victim is conscious

The measures taken depend on the condition of the victim. If he is conscious, first aid consists of the following steps.

1. Lay the victim on a blanket, clothes, other soft bedding. It should not be allowed to move, even in the absence of damage, until the doctor arrives and conducts a professional examination.
2. Treat the skin around the burn with iodine or potassium permanganate and apply a bandage. In case of a fracture, bruise and other injuries - provide first aid.
3. You can give the victim an anesthetic - analgin or aspirin and up to 30 drops. valerian diluted in water to relieve nervous tension.
4. Call or take the victim to the doctor.

unconscious victim

If the victim of an electrical injury is in a faint and at the same time his pulse is palpated in the area of ​​the carotid artery, there is breathing, then the provision of first aid involves:

• release from clothing that constrains the body;
• laying on a soft, even bedding;
• bringing the victim to consciousness with the help of ammonia or spraying with water;
• in warming, wrapping the victim.

the victim is on top

If the victim at the time of electric shock is at a height, it is necessary to release from the action of electric current. In this case, it should be taken into account that as a result of turning off the electrical equipment, the victim may simply fall from a height, so steps should be taken to prevent injury to him, for example, pull a tarpaulin. Only after the victim is lowered to the ground can you begin to examine and provide first aid.

the victim has no signs of life

The absence of signs of life in case of electric shock may indicate clinical death (imaginary), therefore, even in the absence of a heartbeat and pulse, dilated pupils or intermittent breathing, the victim must be given first aid. Resuscitation of the victim is carried out using artificial respiration techniques, as well as the practice of indirect heart massage. Before that, you should unbutton his clothes and clean his mouth. If the muscles of the mouth are spasmodic and mouth-to-mouth breathing is difficult, artificial mouth-to-nose ventilation should be performed.

Outcome of electric shock

Outcome of electric shock
Several factors affect the severity of an electrical injury:

• current value. In the presence of dry hands, a voltage of 30 V is considered safe, in the case of wet hands - 20 V, if the whole body is wet - 10 V. The danger of injury increases with increasing current;
• duration of action. The severity of electrical injury increases depending on how long the victim was under the influence of electric current;
• the current path has a significant impact on the outcome of the lesion, since most of it passes through the streams of tissue fluids, blood vessels, nerve trunks, touching the brain, heart and other organs. In addition, some parts of the body are hypersensitive to electric current, provoking increased pain reactions;
• its frequency. Direct and alternating current have different effects on human body. The least noticeable is the current with a force of 0.5 - 0.15 mA, the current value at which it is no longer possible to get rid of the circuit itself - 10-15 mA. A current of 50-80 mA provokes a chaotic contraction of the heart (fibrillation), in which it does not perform its main function, which leads to a cessation of blood circulation. A current of 90-100 mA, acting for more than 3 seconds, causes respiratory spasm and cardiac dysfunction;
• individual characteristics of the human body. Persons suffering from pathologies of the central nervous system, heart and lungs are more at risk of damage.

Types and types of human electric shock

The impact of electric current causes various violations of life activity - electrical injury and electric shock. The most common types of electrical injuries include:

• electric burns that occur when strong electric currents flow through the skin. The area subjected to such a burn usually does not heal for a long time;
• mechanical injuries in the form of ruptures of tendons, muscles, blood vessels, fractures of bones. Such injuries are formed during convulsive contraction of the muscles caused by the action of an electric current passing through the body of the victim;
• metallization of the skin occurs as a result of particles of short-circuit melted metal entering the epidermis;
• electrophthalmia develops as a result of damage to UV rays from the electric arc of the eyes.

An electric shock to the nervous system is called an electric shock.

According to the severity of the impact, electric shock is classified:

• Grade 1 is characterized by convulsive muscle spasms, while the victim is conscious;
• Grade 2 is manifested by convulsive muscle contraction and loss of consciousness;
• Grade 3 is characterized by respiratory and cardiac dysfunction;
• Grade 4 is manifested by the onset of clinical death, lasting 6 minutes. in adults and 8-10 min. in children.

Consequences of electric shock

The action of the electric current causes a severe electric shock, accompanied by coma, cardiac and respiratory dysfunction. The victim may experience seizures, aggression, disorientation. Current damage to the kidneys can cause acute renal dysfunction.
The development of neurological pathologies is one of the consequences of an electrical injury. The victim may develop peripheral neuropathy, visual acuity and disability may decrease. Survivors after a severe electrical injury may suffer from amnesia, depression, mental disorders.

How to do artificial respiration and heart massage

If the victim of electrical injury is not breathing and has no heartbeat, he must be given first aid by performing artificial ventilation of the lungs and massage of the heart muscle.

1. For resuscitation, care should be taken that the victim lies on a hard surface.
2. Throw back the victim's head, and fix this position with the help of a rag rolled into a roller, placed under the shoulders. The above action cannot be performed if the victim has signs of a neck fracture.
3. Check if the victim's airway is blocked. If there is sand or other foreign objects in his mouth, clean it with a finger wrapped in a handkerchief.
4. To perform mouth-to-mouth breathing, it is necessary to hold the victim's jaw with one hand so that it is open, and close the nose tightly with the other. Taking a deep breath, gently and at the same time strongly blow air into the mouth of the victim, pressing his lips tightly against him. The duration of air blowing is up to 1.5 seconds, then open the victim's nose for 4 seconds. Repeat the action at intervals of 10-12 times per minute. The fact that air enters the lungs is evidenced by the lifting of the chest during inhalation.
5. To perform an indirect heart massage, you should kneel to the left or right of the victim, then correctly determine the impact point. It is located in the center of the chest at a distance of 2 longitudinal fingers from the edge of the sternum.
6. Place the palm of the victim on the chest so that its base lies on the point of impact, and thumb was directed to the stomach or head, put the second palm crosswise on top.
7. Press on the chest with your weight, without bending your elbows so that it drops by about 4 cm. Perform 30 strong pushes, then continue to do artificial respiration. After performing 2 exhalations, return to the massage of the heart muscle again, making 30 pushes. Repeat these steps until the ambulance arrives. Performing resuscitation, you should check the presence of breathing, light reaction of the pupils, and pulse every minute.

This video demonstrates in detail how to properly help the victim as a result of an electrical injury by performing a massage of the heart muscle.

electrical injury- damage to organs and systems of the body under the influence of electric current.

• The first mention of death from electric current was registered in 1879 in France, Lyon, a carpenter died from a generator alternating current.
• In developed countries, the frequency of cases of electric shock is on average about 2-3 cases per hundred thousand of the population.
• Most often, young people of working age suffer from electric shock.
• The death rate of men from electrical injuries is 4 times higher than that of women.

The effect of electricity on the human body

Electric current has a thermal, electrochemical and biological effect on a person.

• thermal effect: electrical energy, meeting resistance with the tissues of the body, goes into thermal energy and cause electrical burns. Mostly burns occur at the point of entry and exit of current, that is, in places of greatest resistance. As a result, the so-called labels or current signs. Thermal energy, converted from electrical energy, destroys and changes tissues on its way.
• Electrochemical action:“gluing”, thickening of blood cells (platelets and leukocytes), movement of ions, change in the charges of proteins, formation of steam and gas, giving tissues a cellular appearance, etc.
• Biological action: disruption of the nervous system, impaired conduction of the heart, contraction of the skeletal muscles of the heart, etc.

What determines the severity and nature of electrical injury?

Electric shock factors:

1. Type, strength and voltage

• Alternating current is more dangerous than direct current. At the same time, low-frequency currents (about 50-60 Hz) are more dangerous than high-frequency ones. The frequency of the current used in everyday life is 60 Hz. With an increase in frequency, the current travels along the surface of the skin, causing burns, but is not fatal.
• The most significant is the strength and voltage of the electric current.

The reaction of the body to the passage of alternating current
Current strength	How does the victim feel?
0.9-1.2mA	The current is barely perceptible
1.2-1.6 mA	Feeling of goosebumps or tingling
1.6-2.8mA	Feeling of heaviness in the wrist
2.8-4.5 mA	Stiffness in the forearm
4.5-5.0 mA	Convulsive contraction of the forearm
5.0-7.0 mA	Spasmodic contraction of the shoulder muscles
15.0-20 mA	Can't take my hand off the wire
20-40mA	Very painful muscle cramps
50-100mA	Heart failure
More than 200 mA	Very deep burns

• High voltage current (more than 1000 volts) causes more severe damage. High voltage electric shock can occur even while being a step away from the current source (“voltaic arc”). As a rule, deaths occur precisely as a result of high-voltage lesions. Low voltage shocks are mostly domestic and fortunately the percentage of deaths from low voltage shocks is lower than with high voltage injuries.

1. The path of current through the body

• The path that current takes through the body is called the current loop. The most dangerous is a full loop (2 arms - 2 legs), in this case, the current passes through the heart, causing malfunctions in its work up to its complete stop. The following loops are also considered dangerous: hand-head, hand-hand.

1. Current duration

• The longer the contact with the current source, the expression of the lesion and the higher the probability of death. Under the action of a high voltage current, due to a sharp contraction of the muscles, the victim can be immediately thrown away from the current source. At lower voltages, muscle spasm can cause a prolonged grip on the conductor with the hands. With an increase in the time of exposure to current, the resistance of the skin decreases, therefore, contact of the victim with the current source should be stopped as soon as possible.

1. Environmental factors

The risk of electric shock increases in damp and damp rooms (bathrooms, baths, dugouts, etc.).

1. The outcome of an electrical injury also largely depends on age and body condition at the moment of defeat

• Increase the severity of the lesion: childhood and old age, fatigue, exhaustion, chronic diseases, alcohol intoxication .

Degrees of electric shock

Electrical Hazard or the consequences of an electric shock

System	Effects
Nervous system	Possible: loss of consciousness of varying duration and degree, loss of memory of past events (retrograde amnesia), convulsions. In mild cases, possible: weakness, flickering in the eyes, weakness, dizziness, headache. Sometimes nerve damage occurs, which leads to impaired motor activity in the limbs, impaired sensitivity and tissue nutrition. Possible violation of thermoregulation, the disappearance of physiological and the appearance of pathological reflexes. The passage of electric current through the brain leads to loss of consciousness and the appearance of convulsions. In some cases, the passage of current through the brain can lead to respiratory arrest, which often causes death from electric shock. Under the action of a high voltage current on the body, a deep disruption of the central nervous system can develop with inhibition of the centers responsible for respiration and cardiovascular activity, leading to "imaginary death", the so-called "electrical lethargy". This is manifested by imperceptible respiratory and cardiac activity. If resuscitation in such cases is started on time, in most cases they are successful.
The cardiovascular system	Cardiac disorders in most cases are functional in nature. Violations manifest themselves in the form of various failures of the heart rhythm (sinus arrhythmia, an increase in the number of heart contractions - tachycardia, a decrease in the number of heart contractions - bradycardia, heart blockade, extraordinary heart contractions - extrasystole;). The passage of current through the heart can cause a violation of its ability to contract as a whole, causing the phenomenon of fibrillation, in which the cardiac muscle fibers contract separately and the heart loses its ability to pump blood, which equates to cardiac arrest. In some cases, electric current can damage the wall of blood vessels, leading to bleeding.
Respiratory system	The passage of electric current through the respiratory center located in the central nervous system can cause inhibition or complete cessation of respiratory activity. In case of high voltage shock, bruises and ruptures of the lungs are possible.
sense organs	Tinnitus, hearing loss, tactile disturbance. Tympanic membrane ruptures, middle ear injuries with subsequent deafness (in case of exposure to high voltage current) are possible. When exposed to bright light, damage to the visual apparatus can occur in the form of keratitis, choroiditis, cataracts.
striated and smooth muscles	The passage of current through the muscle fibers leads to their spasm, which can be manifested by convulsions. Significant contraction of skeletal muscles by electric current can lead to fractures of the spine and long bones. Spasm of the muscular layer of blood vessels can lead to an increase in blood pressure or the development of myocardial infarction due to spasm of the coronary vessels of the heart.
Causes lethal outcome: The main causes of death in electrotrame: cardiac arrest and respiratory arrest as a result of damage to the respiratory center.
Long-term complications: The action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing loss, etc. Electrical burns can heal with the development of deformities and contractures of the musculoskeletal system. Repeated exposure to electric current can lead to early arteriosclerosis, obliterating endarteritis, and persistent vegetative changes.

Electric shock sign or electrotag

electrotag- areas of tissue necrosis at the points of entry and exit of electric current. Occurs as a result of the transition electrical energy into thermal.
The form	Colour	Characteristic features	A photo
Rounded or oval, but may be linear. Often there is a ridge-like elevation along the edges of the damaged skin, while the middle of the mark seems to be slightly sunken. Sometimes it is possible to peel off the top layer of the skin in the form of blisters, but without liquid inside, unlike thermal burns.	Usually lighter than the surrounding tissue - pale yellow or grayish white.	Complete painlessness of the marks, due to damage to the nerve endings. Deposition of conductor metal particles on the skin (copper - blue-green, iron-brown, etc.). When exposed to a low voltage current, metal particles are located on the surface of the skin, and when a high voltage current is applied deep into the skin. The hair in the area of ​​the marks is twisted in a spiral, retaining its structure.
Electrical burns are not always limited to marks on the skin. Quite often, damage to deeper tissues occurs: muscles, tendons, bones. Sometimes lesions are located under apparently healthy skin.

Help with electric shock

The consequences of electric shock largely depend on the provision of timely assistance.

Should I call an ambulance?

There are cases of sudden death within a few hours after electric shock. Based on this, any victim of an electric shock must necessarily be taken to a specialized hospital, where, if necessary, emergency assistance can be provided.

Electric shock relief steps

1. Stop the effect of current on the victim, respecting established rules. Open the electrical circuit with a circuit breaker or switch, or remove the plug from the socket. Remove the current source from the victim using insulating objects (wooden stick, chair, clothing, rope, rubber gloves, dry towel, etc.). You should approach the victim in rubber or leather shoes on a dry surface or with a rubber mat or dry boards under your feet.

In the case of a current source above 1000 volts, special safety measures must be taken to save the victim. To do this, it is necessary to work in rubber shoes, rubber gloves, use insulating pliers for the appropriate voltage.
If necessary, drag the victim out of the “step voltage” zone of action (at a distance of up to 10 m), holding him by the belt or dry clothes, while not touching open parts of the body.

1. Determine the presence of consciousness

• Take it by the shoulders, shake it (do not do it if you suspect a spinal injury), ask loudly: What's wrong with you? Do you need help?

1. Assess the state of cardiac and respiratory activity. And, if necessary, perform resuscitation measures, according to the ABC algorithm (closed heart massage, artificial lung ventilation (mouth-to-mouth breathing)).

ABC algorithm	What to do?	How to do?
BUT	Free up the airways	It is necessary to make a number of techniques to move the root of the tongue away from rear wall and thus remove the obstruction to the air flow. The palm of one hand is placed on the forehead, with 2 fingers of the other hand they raise the chin, pushing the lower jaw forward and upward, while tilting the head back. (if you suspect a spinal injury, do not throw your head back)
AT	Check for breath	Bend over to the victim's chest and determine if there are respiratory movements of the chest. If it is visually difficult to determine whether there is breathing or not. To the mouth, to the nose, you can bring a mirror, which will fog up in the presence of breathing, or you can bring a thin thread, which will deviate in the presence of breathing.
With	Determine if the pulse	The pulse is determined on the carotid artery, fingers bent at the phalanges.
On the present stage medicine, it is recommended to start resuscitation from point C - indirect heart massage, then A- release of the airways and B- artificial respiration.
If respiration and pulse are not detected, it is necessary to start resuscitation measures: Indirect cardiac massage, 100 compressions per minute on the chest (with an amplitude for adults of 5-6 cm and with full expansion of the chest after each compression). For manipulations, the patient must lie on a flat hard surface. The point of placement of the hands during the massage should be located on the chest between the nipples, the shoulders should be directly above the palms, and the elbows should be fully extended. Mouth to mouth breathing 2 breaths every 30 chest compressions. If it is impossible to perform mouth-to-mouth breathing, only chest compressions can be performed. CPR should continue until the ambulance arrives. Optimal time start resuscitation 2-3 minutes after cardiac arrest. The practical limit of resuscitation is 30 minutes, with the exception of victims who are in cold temperatures. The effectiveness of resuscitation is assessed by the color of the skin of the victim (rosination of the face, the disappearance of cyanosis).
Medical treatment. If the measures are unsuccessful for 2-3 minutes, 1 ml of 0.1% adrenaline is administered (intravenously, intramuscularly or intracardiac), calcium chloride solution 10% - 10 ml, strophanthin solution 0.05% - 1 ml diluted in 20 ml 40% solution glucose.
In the presence of breathing, the victim must be given a stable lateral position and wait for the arrival of an ambulance.

4. Dry gauze or contour dressings should be applied to the burned surfaces. The imposition of ointment bandages is contraindicated.

5. If the victim is conscious, you can give painkillers (analgin, ibuprofen, etc.) and / or depressant(tincture of valerian, persen, ankylosing spondylitis, etc.).

6. The victim should be transported only in the prone position and warmly covered.

Treatment in the hospital

• All victims with symptoms of shock are hospitalized in the intensive care unit.
• Victims without signs of electrical or burn shock with limited electrical burns are hospitalized in the surgical ward. According to indications, a toilet of burn wounds, dressings, drug treatment(heart and antiarrhythmic drugs, vitamins, etc.). If necessary, complex surgical interventions are carried out to restore the integrity and functional ability of damaged tissues and organs.
• Victims without local lesions, even in a satisfactory condition, need to be hospitalized in a therapeutic department for further observation and examination. Since there are cases of belated complications, both from the cardiovascular system (cardiac arrest, cardiac arrhythmias, etc.), and from other systems (nervous, respiratory, etc.).
• People who have suffered an electrical injury often need long-term rehabilitation. Since the action of electric current can cause long-term complications. Such complications include: damage to the central and peripheral nervous system (inflammation of the nerves - neuritis, trophic ulcers, encephalopathy), cardiovascular system (disturbances in heart rhythm and conduction of nerve impulses, pathological changes in the heart muscle), the appearance of cataracts, hearing impairment, as well as impaired functions of other organs and systems.

Electric shock protection

The best protection against electric shock is "head on shoulders". It is necessary to clearly know all the requirements and safety rules when working with electric current, use the necessary personal protective equipment and be extremely careful when performing any work on electrical installations.

Means of protection:

• Insulating pads and stands;
• Dielectric carpets, gloves, galoshes, caps;
• Portable grounding;
• Tools with insulating handles;
• The use of screens, partitions, cameras for protection against electric current;
• Use of special protective clothing (type Ep1-4);
• Reduce the time spent in the danger zone;
• Posters and safety signs.

Safety requirements

• Approach live parts only at a distance equal to the length of the insulating part of electrical protective equipment.
• Be sure to use an individual shielding set of clothing when working in open switchgears voltage of 330 kV and above.
• In electrical installations with voltages above 1000V, it is necessary to use dielectric gloves when working in electrical devices above 1000V.
• In conditions of an approaching thunderstorm, all work in switchgears should be stopped.

The main source of energy in modern world is an electric current. The main voltage in the electrical network of residential premises is 220 V. This is a sufficiently high voltage at which, when the circuit is closed with the human body, a sufficiently strong current can pass through it. Significant electrification has led to a fairly frequent defeat of the human body by electricity.

On average, there is one death in 100,000 cases of electric shock, which is associated with very high voltage and current strength, as well as incorrect or untimely provision emergency care to the victim.

Features of electrical injury

Electric current is the movement of electrons through a conductor (metals are the best conductor for electric current). The human body is 80% water with compounds dissolved in it, therefore it is a fairly good conductor. There are several factors and features that affect the severity of electrical injury (up to death), these include:

• At a higher voltage, a more significant current flows through the human body, which leads to a pronounced damage to cells and tissues along its route.
• Lower skin resistance in the area where the electrical wire touches (wet skin or clothing) results in more severe electrical injury.
• Very dangerous is the path of propagation of electric current through the heart (touching both hands to the wires) or the brain (touching the wire to the head and other parts of the body).
• The general condition of the human body at the time of injury.
• The duration of exposure to electric current - the longer, the more pronounced will be the damage to the cells and tissues of the body.

Significant impact on the severity of electrical injury has a general condition of the body. So in the presence of alcohol intoxication at the time of the defeat, the risk of death after an electric shock significantly increases.

The mechanism of development of electrical injury

There are several damaging effects of electric current on the human body:

• A significant violation of the frequency and rhythm of heart contractions up to the development of its fibrillation (chaotic contraction of myocardial muscle fibers without effective blood flow) and cardiac arrest (asystole).
• Violation of the functional activity of the structures of the central nervous system - damage to the vasomotor and respiratory center with collapse of blood vessels and respiratory arrest, in which a fatal outcome is possible. Impact on the structures of the central and peripheral systems is always accompanied by involuntary contractions of the striated skeletal muscles.
• A skin burn in the area of ​​contact with an electric current source can have a different area and depth of tissue damage, depending on the voltage and current strength. Also in case of injury electric arc(arc formation occurs between a very high voltage source and the human body due to air ionization) a severe burn can develop.

These lesions are of varying intensity. When exposed to low voltage, they are insignificant and pass without a trace.

Symptoms

Manifestations after exposure to electric current depend on its strength and voltage. With a severe lesion, at the time of exposure to electricity, an involuntary contraction of the muscles of the body occurs, which leads to the development of characteristic convulsions. Then a violation of consciousness (confusion, its absence), breathing (up to a complete stop) may develop. A pronounced decrease in the level of systemic arterial pressure is also determined, the pulse on the main arteries (in particular, it is determined on the radial artery by pressing it against the bone in the wrist area) may not be determined. In the area where the skin touches the source of electric current, a burn usually develops in the form of a characteristic red spot (hyperemia), followed by the formation of blisters (bulls) filled with liquid. At high voltage, the burn can be significant with charring of the skin.

There are cases of electric shock with a voltage of the order of several tens of thousands of volts, in which the severity of the burn was so great that almost the entire surface of the skin was charred. In such cases, even the timely and correct provision of emergency medical care does not guarantee a favorable prognosis.

Urgent care

The algorithm for providing emergency first aid includes a number of activities:

The very first action should be de-energization electrical circuit, then after assessing the general condition
victim and rendering (if necessary) resuscitation measures, it is imperative to call an ambulance.

In some cases, there is a period of “imaginary well-being” with an improvement in the condition of the victim, however, over a short period of time, late life-threatening complications in the form of pulmonary and cerebral edema may develop, so the person should be under medical supervision.

Thanks to correct execution measures in relation to the provision of emergency care can minimize the likelihood of a fatal outcome.

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1.1. First aid for electric shock. Damage prevention. Emergency medical care for victims

In case of natural disasters, industrial accidents, malfunctions of electrical appliances, exposure to lightning and other accidents, people may be struck by electric current - electrical injuries.

They call pain, convulsive muscle contractions, activity disorder nerve centers, respiratory and circulatory organs. There may also be instant death. At the point of contact with the source of damage, so-called current signs appear, sometimes burns of varying degrees, up to charring and combustion separate parts body. The severity of electrical injury depends on the magnitude and degree of current exposure, the ways it passes through the body.

Electric shocks are possible due to unauthorized overcoming of electrified wire fences used for the protection and defense of various objects, including military ones.

Electric shock occurs not only from touching a source of electricity, but also when approaching high voltage installations at a distance sufficient to form a spark or a voltaic arc.

First aid for electrical injury. A person who has been energized must first of all be freed from the effects of electric current as soon as possible (Fig. 1). If it is impossible to turn off the current with a switch, a knife switch, or unscrew electrical plugs, you need to cut the wires with an ax with a wooden handle or a tool whose handle is wrapped in insulating material. Cord-twisted wires to avoid short circuit and the burn should be crossed one at a time, at some distance from each other.

Rice. 1. Releasing the victim from the action of electric current

You can remove the wires or conductive part of an object under voltage with a dry board, stick, pole, dry roll of an overcoat and other objects.

When an electric current passes through the body of the victim into the ground, you need to move a dry board or other insulating material under his feet. It is very important to take precautions so that you yourself do not get under stress. In this case, it is advisable to use rubber gloves and rubber shoes.

Severe injuries are often found in victims of lightning - detachment of limbs, crushing of bones, paralysis of limbs, etc. The appearance of a sinuous, branched pattern of a reddish color on the skin is characteristic.

After releasing the victim from the action of the current, in case of respiratory arrest and palpitations, it is necessary to immediately begin a closed heart massage and expiratory breathing “from mouth to mouth” or “from mouth to nose”. The success of resuscitation is determined by the timeliness of the start of these activities - they should be carried out, as a rule, no later than 1-2 minutes after the electric shock.

While maintaining breathing and heartbeat, but the unconscious state of the victim, he needs to unfasten his clothes, provide an inflow fresh air, give a sniff ammonia or spray the face with water and, in a lateral stabilized position, evacuate the victim to medical institution.

The victim, who is conscious, must be laid down, not allowed to remain on his feet, as complications associated with severe circulatory and metabolic disorders are possible. A sterile bandage is applied to the burned areas of the body. The victim should be protected from cold.

For an objective assessment of the severity of the condition and the appointment of further treatment, it is necessary to call a doctor to the scene of the incident as soon as possible.

Prevention of electrical injuries consists in the exact fulfillment of safety requirements during the installation, operation and repair of electrical installations and electrical appliances.

1.2. First aid for drowning. A warning. Emergency medical care for victims

Drowning is usually observed as a result of neglecting the rules of bathing. The causes of drowning may be the inability to swim, malaise, overwork, previous overheating, alcohol intoxication, fear of a person in the water. Sometimes even good swimmers drown due to overestimation of their capabilities. Drowning occurs when crossing water barriers, natural disasters associated with floods and a large rise in water.

When rescuing a drowning person, first of all, you should take care of your own safety. A drowning person is characterized by convulsive, not always sufficiently conscious movements, which can pose a serious danger to the rescuer.

You should swim up to a drowning person from behind and, grabbing him by the hair or armpits, turn him face up so that he is above the water. The victim must be pulled out of the water as soon as possible, freed from clothing that makes it difficult to breathe (unfasten the collar, waist belt, etc.).

After that, the rescuer lays the victim with his stomach on the thigh of his leg bent at the knee, face down, so that the head of the victim is below the body, cleans the oral cavity from silt, sand, mucus. Then, by vigorous pressure on the body, the lungs and stomach are freed from water. No more than 20–30 seconds should be spent on cleansing the respiratory tract and freeing them from water. (Fig. 2).

Rice. 2. Removal of water from the respiratory tract

If the victim is not breathing, it is necessary, without wasting a minute, to begin resuscitation.

It is possible to restore the life of the victim if the person has been under water for no more than 5 minutes, and assistance was immediately provided to him. However, there are cases when, due to a spasm of the larynx, the lungs do not fill with water, while the heart continues to work for some time. In these cases, salvation is possible even after a person stays under water for half an hour.

It should be remembered that artificial respiration and closed heart massage are only priority measures.

To determine the severity of the condition and further treatment, it is necessary to call a doctor without delay and, if possible, quickly transport the victim to a medical institution, where resuscitation measures should be continued in full.

1.3. First aid for a fall from a height. A warning. Emergency medical care for victims

When falling from a height, the easiest injury to the victim may be a bruise.

Swelling quickly appears at the site of the bruise, and bruising (bruising) is also possible. When large blood vessels rupture under the skin, accumulations of blood (hematomas) can form.

In case of injury, first of all, it is necessary to create rest for the damaged organ. It is necessary to apply a pressure bandage to the bruised area, to give this area of ​​the body an elevated position, which helps to stop further hemorrhage into the soft tissues. To reduce pain and inflammation, cold is applied to the site of injury - an ice pack, cold compresses.

When falling from a height, open bleeding wounds often appear in various parts of the body. They can cause most deaths due to acute blood loss, so the first measures should be aimed at stopping bleeding by any means. possible way(pressure of the vessel, pressure bandage, and in case of severe arterial or venous bleeding - the application of a tourniquet, etc.). An equally important task of first aid is to protect the wound from contamination and infection. Proper wound treatment prevents the development of complications in the wound and reduces the healing time by almost 3 times.

Wound treatment should be carried out with clean, preferably disinfected hands. When applying an aseptic dressing, you should not touch those layers of gauze with your hands that will be in direct contact with the wound.

The wound can be protected by a simple application of an aseptic bandage (bandage, individual bag, scarf). The skin around the wound is lubricated with 5% iodine tincture, loose foreign bodies are removed from the wound.

When providing first aid to a patient with a penetrating wound of the chest, it is necessary to stop the communication of the pleural cavity with the external environment as soon as possible using a sealing bandage.

The wound should not be washed with water - this contributes to infection. Cauterizing antiseptic substances should not be allowed to enter the wound surface. The wound should not be covered with powders, ointment should not be applied to it, cotton wool should not be applied directly to the wound surface - all this contributes to the development of infection in the wound.

Another result of a fall can be a fracture. A fracture is a break in the integrity of a bone.

Fractures are divided into closed (without damage to the skin) and open, in which there is damage to the skin in the fracture zone. A fracture is characterized by: a sharp pain that increases with any movement and load on the limb, a change in the position and shape of the limb, a violation of its function (inability to use the limb), the appearance of swelling and bruising in the fracture zone, shortening of the limb, pathological (abnormal) bone mobility.

The main task of first aid for bone fractures is to immediately immobilize bone fragments by immobilizing the limb (limb immobilization). This is done by applying a tire. The tire can be standard (service) or made from improvised material (boards, pieces of plywood, sticks, weapons, etc.).

Basic first aid measures for bone fractures

• creating immobility of the bones in the fracture area;
• implementation of measures aimed at combating or preventing shock;
• organization of immediate delivery of the victim to a medical institution.

The rapid immobilization of the bones in the area of ​​the fracture - immobilization reduces pain and is the main point in the prevention of shock. Immobilization of the limb is achieved by the imposition of transport splints or splints made of improvised solid material.

Splinting should be carried out directly at the scene of the incident and only after that the patient should be transported.

In case of an open fracture, an aseptic bandage must be applied before immobilization of the limb. When bleeding from a wound, methods of temporarily stopping bleeding should be applied (compressive bandage, tourniquet, etc.), an anesthetic from a syringe tube of an individual first-aid kit should be introduced.

1.4. First aid for backfilling with soil. A warning. Emergency medical care for victims

Victims who find themselves under the rubble of buildings, defensive structures, etc., may have various injuries, as well as be in a state of acute hypoxia from suffocation caused by blockage of the respiratory tract by dust, earth, lack of air, compression of the chest and neck.

After carefully removing the victim from under the collapse, his mouth and nose are cleaned and, if necessary, resuscitation is carried out. After restoration of spontaneous breathing in the victim, if necessary, anti-shock measures are taken, bandages are applied, fractures are immobilized, and then evacuation to a medical institution.

Particular attention is paid to identifying the fact of prolonged compression of the victim. A peculiar complex of disorders, called the compression syndrome, arises and develops as a result of prolonged (over 3 hours) compression of soft tissues - more often the lower extremities. This syndrome develops after the resumption of blood circulation upon release from prolonged tissue compression. The severity of the condition of the victims depends on the extent of damage to the soft tissues and the duration of being under the rubble. Paleness, sometimes cyanotic spots, is observed on the limbs that have undergone prolonged compression. The general condition of the victims in the beginning usually does not cause concern. However, after a few hours, a bluish-purple color of the limb appears, blisters filled with bloody contents appear on the skin. Subsequently, tissue necrosis is noted. The absorption of poisonous decay products of damaged tissues leads to a sharp deterioration in the general condition of the victims, especially the kidney function is significantly reduced. Complete cessation of urine output is possible.

In the case of establishing signs of prolonged compression, the victims are considered as seriously affected, regardless of their condition. Rendering them medical care begins with the rapid elimination of compression, tight bandaging (from the foot) and transport immobilization of the injured limb. It is necessary to enter an analgesic from a syringe tube. In case of severe injuries of the limb, a tourniquet is applied.

2. First aid kit at the workplace and how to use it

Inventory of the first aid kit (Order of the Ministry of Defense of the Russian Federation No. 30 of 2002)

Item name	unit of measurement	Quantity	Shelf life	Note
Personal protective equipment
Dressing package medical individual sterile
General medicines
Ammonia 10% solution, 1 ml. in an ampoule with a braid (ammonia)
Validol 0.006 tablet, 10 pcs. per pack (menthol solution in methyl isovalerate)	package
Iodine 5% solution, 1 ml. in a braided package (iodine tincture)
sodium bicarbonate
Nitroglycerin 0.0005 tablet, 40 pcs. per pack (nitroglycerin)	package
Dressings and suture materials, adhesive plasters
Bandage gauze medical sterile size 5mX10cm.
Elastic tubular bandage medical type"Regelast" No. 1 (for the brush)
Bandage elastic tubular medical type "Regelast" No. 2 (for the foot)
Bandage elastic tubular medical type "Regelast" No. 3 (for the foot)
Cotton wool medical hygroscopic sterile 100 gr. in a pack
Medical scarf (dressing)
Bandage small medical sterile
Medical supplies
Medical pin
Medical items, devices and surgical instruments
Hemostatic rubber tourniquet
Rubber syringe with soft tip No. 6 (capacity 180 ml)
Apparatus, devices for general anesthesia and intensive care
Breathing tube TD-1.02	Set

Due to the specifics of the impact of electric current, before providing first aid to victims, you should protect yourself. To eliminate the risk of electric shock, you can wrap your hands with a dry cloth before touching the victim. If possible, you should de-energize the object or try to kill or move away from the victim electric wires dry branch or other non-metallic object.

Emergency first aid for electric shock includes a specific sequence of procedures. Let us briefly outline the algorithm of actions to be taken:

1. Moving a person who has experienced an electric shock to a safe place. Before rendering first aid, it is necessary to stop the effect of electric current on the body.
2. If the pulse is not felt and breathing is not observed, then first of all, it will be necessary to produce, as well as the heart muscle.
3. To provide medical assistance, dry gauze bandages are applied to the areas of the body damaged by an electric discharge. Possible fractures must be fixed by applying a splint from improvised means.
4. If the victim from the electric current did not lose consciousness, then after providing first aid for an electrical injury, you should give him weak tea, water or compote to drink. Any will do beverage, excluding alcohol or coffee.

The photo and video materials presented on our website clearly illustrate first aid measures in case of electrical injury.

The danger of electrical injury lies in the fact that it negatively affects internal organs and can lead to cardiac arrest. Competently performed first aid in case of electric shock significantly increases the chances of the victim to be saved.

Pre-medical first aid to a victim in a lightning strike is carried out in almost the same way as rendering assistance in case of household electrical injury. If the clothes on the victim caught fire, then you should not try to bring down the flame by covering the person with earth. This leads to difficulty in the process of blood circulation and respiration. After providing first aid, you need to call a doctor.

Types of electrical injuries

The method of first aid in case of electric shock should be chosen taking into account the injuries received. It must be borne in mind that the effect of electric current on the body can be prolonged or instantaneous. According to the degree of localization, the consequences of electric shock should be divided into two categories:

Degrees of electric shock

1. Light electrical injury. The victim experiences convulsive twitching and involuntary muscle contraction, as well as discomfort. During the electric shock, consciousness is preserved. There may be weakness and headache. Medical assistance is not always required.
2. Average electric shock. It is characterized by convulsions and impaired consciousness. The person may become agitated or fall into a stupor. There is a possibility of memory lapses - partial amnesia is provoked by the state of shock in which nervous system.
3. Severe electrical injury suggests a violation of vital functions. The first symptom is a violation of the rhythm of breathing, arrhythmia develops. After regaining consciousness, a person may not remember the fact of the injury, as well as some other past events.
4. Instant death, not involving the provision of medical care.

In which case medical assistance is required

The provision of professional medical care for electrical injury becomes necessary if the following symptoms are observed:

• Severe dizziness, nausea
• Pain in the region of the heart
• High blood pressure

After an electric shock, the muscular circulation of the heart can be disturbed. In this case, hospitalization will be required - the patient must spend some time under the supervision of doctors. The patient is prescribed cardiac, analgesic and sedative drugs. If necessary, specialists perform resuscitation measures.

The main ways in which first aid is provided in case of electric shock before the arrival of specialists is an indirect heart massage and artificial respiration. Press on the chest with sharp and rhythmic shocks, with an approximate frequency of once per second. Every 15 pressures, 2 breaths of air should be taken into the person's mouth. If timely measures are not taken to normalize the work of the heart muscle, then the cells of the brain and spinal cord may die.

In the process of providing medical care in case of electrical injury, the victim is transported only in the supine position. Ventilation should not be stopped until respiratory function is fully restored.

Symptoms of electric shock

During first aid for electrical injury, the observed clinical picture should be taken into account. The patient often shows changes in the work of the central nervous system, respiratory and cardiovascular systems. The most common symptoms include:

• Arrhythmia, muffled heart sounds
• Bradycardia - decreased heart rate
• Asphyxia due to damage to the muscles of the larynx
• visual impairment
• Partial memory loss, retrograde amnesia
• Fatigue, fatigue

In severe electric shocks (electrical injuries), cardiac fibrillation is manifested, which can provoke a cessation of blood circulation. After providing the victim with emergency first aid in case of electric shock, it is necessary to immediately hospitalize the person.