Electrical burns and electric shock: first aid, injuries and treatment

The NHS notes that burns can be caused by dry heat such as fire or a hot iron, and also by electricity or chemicals. An electrical burn is distinct because the injury is caused by current passing through the body, not just heat at the skin.

NHS inform explains that when someone is electrocuted, the electric current may stun them as it passes through their body. This can cause breathing and heartbeat to stop. The current can also cause burns where it enters and exits the body.

Because of this, the visible burn may be a poor guide to the seriousness of the injury. NHS inform stresses that the burn may be very small or not visible at all, but it can still cause damage deep into the tissues.

NHS inform says electric shock from high-voltage current is more likely in industry jobs and can also happen if you come into contact with a power line. Low-voltage shock can happen at home or at work.

Low-voltage causes listed by NHS inform include faulty or loose switches, frayed flexes, faulty appliances, and handling electrical appliances with wet hands or while standing on a wet floor. St John Ambulance says water is a very effective conductor of electricity.

Young children are at particular risk because they are more likely to put their fingers or other objects into wall sockets, according to NHS inform.

NHS inform sets out the steps. St John Ambulance gives the same sequence and says to call 999 or 112 for emergency help.

• Assess the area. Do not touch the injured person if they are still in contact with the electrical source.

• Turn off the source of electricity if possible: switch off at the mains or meter point, or remove the plug or pull the cable free.

• If that is not possible, stand on dry insulating material such as a wooden box or plastic mat and use a wooden pole or broom to push the source away. Do not use anything metallic.

• If you cannot use a wooden object, use a length of rope tied around the casualty's ankles or under the arms, taking care not to touch them as you attach it, and pull them away.

• Phone 999 for emergency help.

• Once you are sure the casualty is no longer in contact with the electricity, check their airway, breathing and circulation, and treat any injuries.

• Do not approach high-voltage wires until the power is turned off.

The NHS lists a burn caused by electricity among those for which you should call 999 or go to A&E, alongside burns that are very large or deep, on the face, genitals or bottom, or caused by acid or chemicals. It says not to drive to A&E: ask someone to drive you or call 999 for an ambulance, and bring any medicines you take.

Even if a person seems to be well after a shock, the internal injury may not be obvious, which is why assessment in an emergency department is recommended. The current can affect the heart rhythm, muscles, nerves and the tissues under small skin marks.

For burns that are not electrical, the NHS advises cooling under running water for 20 minutes as soon as possible, within 3 hours. For an electrical burn, make safety and the 999 call the first priority and then cool the burn if this can be done safely while waiting.

The sources used here describe burn care in general terms. The NHS says severe burns may need treatment in hospital, which may include medicines such as antibiotics or painkillers, having the burn cleaned and dressed, being given fluids through a vein, and surgery to repair the wound or reconstruct damaged skin.

In addition, because the heart can be affected, people who have had an electric shock are usually monitored. The specific tests and observation period for electrical injury are decided by the emergency team and are not set out in the patient pages reviewed here.

Small burns and scalds can often be treated at home and take around 2 weeks to heal, according to the NHS, but this applies to minor thermal burns, not to electrical injuries.

The NHS suggests taking painkillers such as paracetamol or ibuprofen for pain and using an emollient on healing skin if it becomes itchy and dry, with advice from a pharmacist. It says not to put creams, oils or butter on burns, not to use plasters or sticky dressings to cover a burn and not to burst blisters.

Once treated, follow the advice of the burns or surgical team about wound care and review. Skin that has been burned may scar and be more sensitive to sun, and the team can advise on support if needed.

NHS inform and St John Ambulance describe the common causes, which point to the main preventive steps: replace frayed flexes, repair or replace faulty or loose switches and appliances, and avoid handling electrical items with wet hands or while standing on a wet floor.

With young children, socket covers and supervision reduce the risk of fingers or objects going into sockets. Keep away from overhead power lines and do not climb near them.

Electrical injuries are emergencies managed by the NHS ambulance and emergency department route, with referral to burns services where needed. There is no planned private pathway for the acute event.

Follow-up for scarring, nerve problems or rehabilitation may be arranged through NHS burns or plastic surgery services, and some people use private services for scar treatment. Keep the GP informed.