Electrical Burn In Children

GENERAL INFORMATION:

What are electrical burns?

• Electrical burns are injuries that may happen when your child touches an electric current (electricity). If a current enters your child's body, it will cause damage wherever it passes. Your child may also get electrical burns even if the current does not go through his body. If your child is near enough, electricity may jump from an electrical source to his body. This makes an arc or flash with enough heat to burn your child's clothing or body. The current causes the most damage to skin and tissue where electricity enters and exits your child's body. Your child's muscles, blood vessels, nerves, bones, and fat may also get damaged.
  
  
• If your child gets an electrical burn, his body tissue gets damaged and begins to die. The heat from the burn may damage your child's bones. Damage from swelling and lack of blood from damaged blood vessels may hurt your child's organs. When your child's muscles are damaged, they may release toxins (dangerous chemicals) into his body. Toxins may further damage your child's nearby organs and tissue. With treatment, your child may have less pain or infections caused by germs called bacteria. Your child may have less tissue damage and he may feel better about his appearance. Your child may be able to return to school or his normal daily activities sooner than without treatment.

What causes electrical burns?

• When your child touches an electric current, the electricity may kill or damage nearby body cells and tissue. Touching low-voltage electrical currents often found in household machines and electric cords may cause small, deep burns. Voltage is a way to measure electricity. As the voltage increases, the burns may be worse and your child may have more damage to his organs. High-voltage currents are often found outside in electric wires and cables.
  
  
• Your child may get more damage the longer he touches the current. If your child touches a high-voltage current, he may be unable to move away from the current. The damage will continue to become worse until someone is able to break his contact with the current. Electric currents that pulse on and off may cause more damage to your child's body than steady currents. Lightning may also cause burns to your child. Lightning may strike your child directly, or reach him through plumbing, wires, or even the ground. Ask your child's caregiver for more information about lightning injuries.

How may my child get electrical burns? Your child may come in contact with electric currents both inside and outside of your home. Common ways your child may get an electrical burn include:

• Inside:
  
  
  • Your child sticks his finger or something metal into an electric outlet (plug).
    
    
  • Your child touches electrical cords or wires.
    
    
  • Your child puts electrical wires or cords into his mouth.
    
    
  • Your child touches household electric machines near water.
    
    
  • Your child touches a water heater or a radiator (room heater).
  
  
• Outside:
  
  
  • Your child touches a power line.
    
    
  • Your child climbs a utility pole and touches a source of electricity.
    
    
  • Your child touches a power line with something else he is touching, like a kite.
    
    
  • Your child touches a power box or transformer.
    
    
  • Your child is in an open area while a storm is approaching.

What are the signs and symptoms of electrical burns? If your child has an electric current go through his body, he will have marks on his skin. These marks may be shaped like bull's-eyes and will occur where the current entered and exited his body. The area where he was burned may feel dry and cold to touch. Your child may not be able to feel anything that is touching him where he was burned. Other types of electrical burns may cause his skin to have blisters or become blackened or reddened. Symptoms may occur right away or appear after a few months or longer. Your child may pass out or stay awake after he has an electrical burn. Your child may also have any of the following:

• Fast or abnormal heartbeat.
  
  
• Weakness, stiffness, or muscle pain.
  
  
• Red or reddish black urine.
  
  
• Problems moving or keeping his balance.
  
  
• Headache, dizziness, or problems with his memory.
  
  
• Trouble thinking or staying awake.
  
  
• Seizures (uncontrolled shaking).
  
  
• Trouble breathing.
  
  
• Swelling, bleeding, or damage in your child's mouth.

What other problems can electrical burns cause? Electrical burns may also cause your child to have any of the following:

• Thick scars, which can cause problems with your child's joints and bones.
  
  
• Compartment syndrome (too much pressure on his body organs).
  
  
• Cataracts (clouding over your child's eyes) or other eye problems.
  
  
• Paralysis (unable to move part or all of his body).
  
  
• Hemorrhage (bleeding that does not stop).
  
  
• Heart attack or other heart problems.
  
  
• Brain damage.
  
  
• Damage to his organs, such as his kidneys or lungs.

How are electrical burns in children diagnosed? Your child's caregiver will examine your child's body and mark down how much of his body is burned. He will look for the places where the current entered and exited your child's body. Your child's caregiver will ask you what your child was doing when he got burned. Your child's caregiver will also check your child's eyes and his memory. Your child's caregiver may ask your child to walk across the room. He may also ask your child to do certain movements to test his joints. Joints are areas in your child's body where two bones meet. Your child's caregiver will ask you about your child's health history.

What tests might my child need? Your child may need one or more of the following tests:

• Blood and urine tests: Your child may need blood or urine tests. These tests help your caregiver check for damage to your child's muscles, heart, and other organs. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV. An IV is a tiny tube placed in your child's vein for giving medicine or liquids. Your child may need to have these tests more than once.
  
  
• Heart monitor: This is also called an ECG, electrocardiogram, or telemetry. Three or five sticky pads are placed on your child's chest. Each pad has a wire leading to a TV-type screen or to a small portable box (telemetry unit). This screen or box shows a picture of your child's heartbeat. Caregivers watch this picture to make sure your child's heart is doing OK.
  
  
• Imaging tests: These tests help your child's caregiver see images (pictures) that show how your child's body is doing. Your child may need any of the following:
  
  
  • CT scan: This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your child's body. It may be used to look at your child's bones, muscles, brain, body organs, and blood vessels. Your child may be given dye by mouth or in an IV before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.
    
    
  • MRI: This test is called magnetic resonance imaging. During the MRI, 3-D (three-dimensional) pictures are taken of your child's body. An MRI may be used to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his MRI. Never enter the MRI room with an oxygen tank, wrist watch, or any other metal objects. This can cause serious injury.
    
    
  • Scintigraphy: Scintigraphy is a test that takes pictures of your child's body. Scintigraphy may help your child's caregiver find dead tissue in your child's body. Scintigraphy may also help him figure out how much dead tissue needs to be removed during surgery.
    
    
  • Ultrasound: An ultrasound is a simple test that looks inside your child's body. Sound waves are used to show pictures of his organs and tissue on a TV-like screen. Your child may also have a Doppler ultrasound or duplex scan done. With these tests, your child's caregiver will see how well blood flows in your child's blood vessels.
  
  
• Neurologic signs: These are also called neuro signs, neuro checks, or neuro status. A caregiver may check your child's eyes, memory, and how easily your child wakes up. The strength of your child's arms, hands, legs, and feet may also be checked. These signs may tell caregivers how your child's brain is working.

How are electrical burns treated? Your child may need to be brought to a special treatment center for people with burns. Your child may need any of the following:

• Fluid therapy: Your child may need more fluid in his body. Your child's caregiver may give him intravenous (IV) fluids through a tube placed in your child's vein. This tube is capped or connected to tubing and the liquid. Your child's caregiver may also give your child extra nutrition through his IV tubing.
  
  
• Pressure garments: Your child may need to wear special pressure garments (clothing) over his burns. Pressure garments may help keep thick scars from forming. Your child may need to wear a garment for most of the day. Pressure garments are custom made to fit your child. Ask your child's caregiver for more information about pressure garments.
  
  
• Wound care: Your child's burns will be kept moist and clean. Medicine will be put on your child's burn under the bandage. Your child's caregiver may then cover your child's burn with a bandage called gauze. Your child's dressings will be changed at least twice a day. During dressing changes, your child's burn may be cleaned with soap and water.
  
  
• Surgery: Your child may need one or more surgery.
  
  
  • Debridement: During debridement, damaged tissue is removed from your child's body. Your child's caregiver will remove enough tissue until he can see healthy tissue. Caregivers may do this to avoid infection, decrease inflammation (pain and swelling), and improve healing. Your child may need to have this surgery more than once.
    
    
  • Escharotomy: In an escharotomy, your child's caregiver will remove dead tissue from your child's body. This surgery may decrease your child's chances of getting an infection or more damage to his skin.
    
    
  • Fasciotomy: Fasciotomy is surgery to cut into your child's fascia. Fascia is strong tissue that divides your child's body into sections. This surgery is done to release pressure that is caused by swollen muscles. With fasciotomy, your child may be less likely to have more damage to his nerves, organs, or tissue.
    
    
  • Skin grafts and flaps: Your child's caregiver may place grafts to cover or replace dead skin or tissue. Grafts may come from healthy tissue in your child's body. It may also be natural or man-made material. A graft can help close your child's wounds, prevent an infection, or decrease scarring. Skin flap surgery is done to fix large wounds that cannot be closed by skin grafting. A skin flap is skin and tissue that is stretched to cover the wound area. Skin flaps may improve the appearance of your skin.
    
    
  • Arthroplasty: Your child may need arthroplasty if he has damaged joints. He may also need skin flaps to cover any joints that are exposed (seen).
    
    
  • Nerve release (decompression): A nerve in your child's body may be compressed (squeezed) after he is burned. Your child may need this surgery to release the pressure on the nerve. Decreasing pressure may help prevent further injury to your child's body.
    
    
  • Amputation: Amputation is removing one of your child's body limbs, such as a finger, arm, shoulder, or leg. Your child may need this surgery if there is too much dead tissue in his limbs. Your child may later be measured for an artificial (fake) limb to use instead of his amputated limb.
    
    
  • Reconstructive surgery: Reconstructive surgery may repair damaged bones, muscles, and tissue of your child's body. It may help your child's body function better. Plastic (cosmetic) surgery may be used to help your child's skin look less burned. Plastic and reconstructive surgery may improve your child's appearance.
  
  
• Blood transfusion: A blood transfusion may be needed if your child loses too much blood. This is donated whole blood, or parts of blood your child may get through an IV. You may be worried that your child will get AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus. If you refuse a blood transfusion for your child, his condition may get worse, and he may die.

What medicines might my child need?

• Antibiotics: This medicine may help your child fight infections. This medicine may be put on your child's skin before his burn is bandaged. Your child may also get antibiotics as a pill, shot, or in his IV. Antibiotics may have silver in it to help fight infection and help your child's burn heal faster. Silver medicine may be placed on your child's skin as an ointment or his bandages may contain silver.
  
  
• Pain medicine: Caregivers may give medicine to decrease your child's pain. Tell a caregiver if your child's pain does not go away or comes back after taking this medicine. Pain medicine can have side effects. Tell a caregiver if your child has trouble breathing, is very sleepy, or has an upset stomach. Tell a caregiver if your child is allergic to any medicine.
  
  
• Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.
  
  
• Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.
  
  
• Steroid medicine: Steroid medicine may be given to decrease pain and swelling. It may help your child's muscles become stronger. Your caregiver may put steroids on your child's skin as an ointment. He may also give steroids to your child as a pill, shot, or in his IV. This medicine can help a lot but may also have side effects. Be sure you understand why your child needs steroids. Do not stop giving this medicine without your child's caregivers OK. Stopping steroid medicine without your child's caregiver's OK may cause problems.
  
  
• Tetanus shot: This is medicine to keep your child from getting tetanus (lock jaw). It is given as a shot. Your child should have a tetanus shot if he has not had one in the past 5 to 10 years. Your child's arm can get red, swollen, and sore after getting this shot. Ask your child's caregiver for more information about protection against tetanus.

What other therapies may help my child get better? Your child may need to have rehabilitation (rehab). Rehab uses different therapists to help your child function better.

• Physical therapy: A physical therapist may help your child with special exercises. These exercises may help your child's muscles and bones become stronger. Your child may move his limbs in different directions by himself or with the help of his caregiver. By exercising your child's joints, a physical therapist may help find where thick scars are forming. He may also help your child's joints function better. Your child may need to wear splints or casts to help prevent his muscles from shrinking. This may help prevent his joints and bones from becoming deformed.
  
  
• Massage therapy: A massage therapist may help your child feel less pain. Massage therapy may also help prevent thick scars from forming.
  
  
• Speech therapy: A speech therapist may work with your child to help him talk.

How can I help prevent electrical burns in my home? It is important to put socket covers on all unused electric outlet plugs in your home. Ask your caregiver for more information about the right kind of socket cover for you. Other safety measures include:

• Cords and wires:
  
  
  • Never allow your child to touch, bite, or suck on wires.
    
    
  • Cover or fix wires that are exposed (seen).
    
    
  • Replace damaged electric cords.
    
    
  • Use safety cords like circuit breakers or ground fault interrupters.
    
    
  • Avoid using extension cords.
  
  
• Electric machines: Electric machines use a cord that plugs into the wall or batteries. Some examples of household electric machines include radios, computers, blenders, toasters, vacuums, and televisions. Some toys may also have cords or batteries.
  
  
  • Keep electric machines out of reach of your child.
    
    
  • Turn off and unplug electric machines when not in use.
    
    
  • Do not use electric machines near water.
    
    
  • Fix or throw away broken electric machines.
  
  
• Toys:
  
  
  • Supervise your child when using electric toys.
    
    
  • Do not allow your child to play with an electric toy that does not have an Underwriter's Laboratory (UL) safety label.
    
    
  • Do not allow your child to play with damaged electric toys.

What are electricity safety measures I can teach my child? Ask your child's caregiver for the best way to teach electricity safety measures to your child. Your child's caregiver may tell you to do any of the following safety measures:

• Inside:
  
  
  • Tell your child to never touch or put anything inside of an electric outlet.
    
    
  • Tell your child to never touch, bite, or suck on wires.
    
    
  • Tell your child to never touch an electric machine without your OK.
    
    
  • Tell your child to never touch a water heater or a radiator (room heater).
  
  
• Outside:
  
  
  • Tell your child to never climb a power pole.
    
    
  • Tell your child to never touch a power line or wire with part of his body.
    
    
  • Tell your child to never touch a power line or wire with a stick, pole, or other object.
    
    
  • Tell your child to never touch a power box or transformer.
    
    
  • Tell your child to never fly a kite near power lines.

What lightning safety measures can I teach my child? Your child can get a high-voltage electric burn from lightning. Lightning safety measures may help your child decrease his risk of being struck by lightning. Teach your child to do the following during a storm:

• Go inside when it starts to rain, he hears thunder, or sees lightning.
  
  
• Do not touch any metal objects, such as fences or bicycles.
  
  
• Sit on his heels with both feet together and place his hands over his ears (if outside).
  
  
• Do not bathe, shower, or touch faucets.
  
  
• Avoid standing next to objects taller than him.
  
  
• Do not touch anything during a storm that uses electricity, including a computer, telephone, or radio.

Where can I find support and more information? Electrical burn injuries may be life-changing for your child and your family. Accepting that your child had an electric burn injury may be hard. Your child may be worried or feel sad about his burn and his appearance. These are normal feelings. Talk to your child's caregivers, family, or friends about these feelings. You may also talk with your child's school staff and counselors. Contact the following for more information:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org
  

• American College of Surgeons
  633 N. Saint Clair St.
  Chicago, IL 606113211
  Phone: 1-312-2025000
  Phone: 1-800-6214111
  Web Address: http://www.facs.org
  

When should I call my child's caregiver? Call your child's caregiver if:

• Your child feels dizzy or weak.
  
  
• Your child has problems moving or keeping his balance.
  
  
• Your child has stiffness or pain in his muscles.
  
  
• Your child has swelling, bleeding, or damage in his mouth.
  
  
• You have any questions or concerns about your child's condition, treatment, or care.

When should I seek care for my child? Seek immediate care for your child, or call 911 if:

• Your child came in contact with electric currents or was struck by lightning.
  
  
• Your child has burns on his body.
  
  
• Your child has trouble breathing.
  
  
• Your child has trouble thinking or staying awake.
  
  
• Your child fainted (passed out).
  
  
• Your child has a seizure (uncontrolled shaking).
  
  
• Your child suddenly has trouble seeing or hearing.
  
  
• Your child has red or reddish black urine.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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