Electric shock to children

The high voltage electric shock causes severe thermal damage, including charring (surface burns, wounds at the entrance and exit points of the current, burned arcs). When a low-voltage current is applied, the development of cardiac arrhythmias, primary and secondary respiratory arrest, consciousness disturbances, paresthesia and paralysis are at the forefront. Death in electro-injury occurs due to mechanical asphyxia, cardiac dysfunction, shock, often without external signs of burns. The peculiarities of clinical death in electric trauma in children include its lengthening up to 8-10 min, which allows increasing the efficiency of cardiopulmonary resuscitation.

When the electrocurrent passes through the brain, instant death may occur due to blockade of the centers of regulation of vital organs and systems, cardiac arrhythmias, ventricular fibrillation, acute hepatic insufficiency, laryngospasm, bronchospasm, paralysis of the diaphragm, respiratory muscle paralysis and acute renal failure. The defeat of the electrocurrent of skeletal muscles and vessels is accompanied by severe pain syndrome, kidney failure, collapse. Electrical injury can cause various neurological disorders: cerebral (coma, convulsions) and / or focal disorders (paresis of limbs, epilepsy), as well as damage to the spinal cord and neuropsychiatric disorders.

The defeat of alternating current leads to more severe consequences than the action of direct current.

There are four degrees of gravity of electric trauma:

• In case of electric injury of the 1st degree, the child is conscious, excited, or deafened. Typical tonic contraction of the muscles of the affected limb, pain in the burn area, tachypnea and tachycardia, skin pallor.
• At the II degree a severe pain syndrome develops up to a shock, consciousness can be absent. Various heart rhythm disorders, convulsions and development of respiratory failure are possible. Burns are more extensive and deeper.
• For the third degree, the development of coma, heart rhythm disturbances, shock, acute respiratory failure, laryngospasm is characteristic.
• At the fourth degree, clinical death occurs, due to ventricular fibrillation.

Emergency medical assistance in case of electric shock in children

It is necessary to stop contact with the source of electric current, the wires are removed with wooden, plastic and rubber objects. Then the child is laid horizontally, releasing the chest from clothing.

• In the case of clinical death, cardiopulmonary resuscitation is performed, including electrical defibrillation and mechanical ventilation. When defibrillation is carried out in children, a discharge of 4 J per 1 kg of body weight is used.
• In case of mild lesion, the child is shown sedative treatment and anesthesia with analgesics.
• With persisting symptoms of bronchospasm, ipratropium bromide is used (children 2-6 years in a dose of 20 mcg, 6-12 years - 40 mcg, over 12 years - 80 mcg), ipratropium bromide + fenoterol (berodual) in a nebulizer (children under 6 years of age - 10 drops, 6-12 years - 20 drops, over 12 years - 20-40 drops) or salbutamol (100-200 μg) in the form of inhalations.
• In case of pain syndrome, 50% solution of metamizole sodium (analgin) 10 mg / kg, 1-2% solution of trimiperidine (promedol) or omnopon 0.1 ml per year of life.
• With convulsive syndrome, diazepam (seduxen) 0.3-0.5 mg / kg or midazolam 0.1-0.15 mg / kg intramuscularly, prednisolone 2-5 mg / kg intravenously, intramuscularly.
• With the development of shock, catheterization of the vein, infusion therapy with crystalloids, colloids from the calculation of 15-20 ml / (kghh), auxiliary breathing, monitoring of vital signs, relief of accompanying cardiac arrhythmias.

[1], [2], [3]