FIRST AID PROCEDURES AFTER GETTING SHOCK

Be familiar with first aid treatment for electric shock and burns. Always keep a first aid kit on hand at the facility. Figure illustrates the basic treatment for electric shock victims. Copy the information, and post it in a prominent location. Better yet, obtain more detailed information from your local heart association or Red Cross chapter. Personalized instruction on first aid usually is available locally. Table lists basic first aid procedures for burns.

Figure: Basic first aid treatment for electric shock.

For electric shock, the best first aid is prevention. In the event that an individual has sustained or is sustaining an electric shock at the work place, several guidelines are suggested, as detailed next.

Table: Basic First Aid Procedures

a) SHOCK IN PROGRESS

For the case when a co-worker is receiving an electric shock and cannot let go of the electrical source, the safest action is to trip the circuit breaker that energizes the circuit involved, or to pull the power-line plug on the equipment involved if the latter can be accomplished safely. Under no circumstances should the rescuer touch the individual who is being shocked, because the rescuer’s body may then also be in the dangerous current path. If the circuit breaker or equipment plug cannot be located, then an attempt can be made to separate the victim from the electrical source through the use of a non-conducting object such as a wooden stool or a wooden broom handle. Use only an insulating object and nothing that contains metal or other electrically conductive material. The rescuer must be very careful not to touch the victim or the electrical source and thus become a second victim.

If such equipment is available, hot sticks used in conjunction with lineman’s gloves may be applied to push or pull the victim away from the electrical source. Pulling the hot stick normally provides the greatest control over the victim’s motion and is the safest action for the rescuer. After the electrical source has been turned off, or the victim can be reached safely, immediate first aid procedures should be implemented.

b) SHOCK NO LONGER IN PROGRESS

If the victim is conscious and moving about, have the victim sit down or lie down. Sometimes there is a delayed reaction to an electrical shock that causes the victim to collapse. Call 911 or the appropriate plant-site paramedic team immediately. If there is a delay in the arrival of medical personnel, check for electrical burns. In the case of severe shock, there will normally be burns at a minimum of two sites: the entry point for the current and the exit point(s). Cover the burns with dry (and sterile, preferably) dressings.

Check for possible bone fractures if the victim was violently thrown away from the electrical source and possibly impacted objects in the vicinity. Apply splints as required if suitable materials are available and you have appropriate training. Cover the victim with a coat or blanket if the environmental temperature is below room temperature, or the victim complains of feeling cold.

If the victim is unconscious, call 911 or the appropriate plant-site paramedic team immediately. In the interim, check to see if the victim is breathing and if a pulse can be felt at either the inside of a wrist above the thumb joint (radial pulse) or in the neck above and to either side of the Adam’s apple (carotid pulse). It is usually easier to feel the pulse in the neck as opposed to the wrist pulse, which may be weak.

The index and middle finger should be used to sense the pulse, and not the thumb. Many individuals have an apparent thumb pulse that can be mistaken for the victim’s pulse. If a pulse can be detected but the victim is not breathing, begin mouth-to-mouth respiration if you know how to do so. If no pulse can be detected (presumably the victim will not be breathing), carefully move the victim to a firm surface and begin cardiopulmonary resuscitation if you have been trained in the use of CPR. Respiratory arrest and cardiac arrest are crisis situations. Because of loss of the oxygen supply to the brain, permanent brain damage can occur after several minutes even if the victim is successfully resuscitated.

Ironically, the treatment for cardiac arrest induced by an electric shock is a massive counter shock, which causes the entire heart muscle to contract. The random and uncoordinated ventricular fibrillation contractions (if present) are thus stilled. Under ideal conditions, normal heart rhythm is restored once the shock current ceases. The counter shock is generated by a cardiac defibrillator, various portable models of which are available for use by emergency medical technicians and other trained personnel.

Although portable defibrillators may be available at industrial sites where there is a high risk of electrical shock to plant personnel, they should be used only by trained personnel. Application of a defibrillator to an unconscious subject whose heart is beating can induce cardiac standstill or ventricular fibrillation, just the conditions that the defibrillator was designed to correct.