What Are the Three Types of Electrical Burns?

The severity of electrical burns depends on the voltage of the electricity, how much came into contact with the body, and how long the contact lasted. 

Symptoms of a superficial skin burn (previously called a first-degree burn) include: 

• Skin pain, redness, and dryness
• When the burned area is pressed, it turns white
• Heals in three to six days and does not leave a scar

Symptoms of a superficial partial-thickness burn (previously called a second-degree burn) include:

• Skin is painful to a light touch or air temperature changes
• Skin redness 
• Skin leaks fluid
• Blisters may occur
• When the burned area is pressed, it turns white
• Takes one to three weeks to heal, and the area of skin that was burned might be darker or lighter than it used to be when it heals
• May or may not scar

Symptoms of a deep partial-thickness burn (previously called a third-degree burn) include:

• Hurts when pressed hard
• Does not turn white when pressed 
• Blisters
• Takes more than three weeks to heal
• The area will probably scar

Symptoms of a full-thickness burn (previously called a fourth-degree burn) include:

• Does not usually hurt because the nerves in the skin that send pain signals to the brain are damaged
• The skin may be white, gray, or black
• Skin dryness
• Treated with possible hospitalization, surgery, and medications

• Electrical burns are caused by a person touching electrical wiring or equipment that is used or maintained improperly. Clothing may catch fire and a thermal burn may result from the fire.
• High-voltage electrical injuries are most commonly caused by a conductive object touching an overhead high-voltage power line. 
• Low-voltage electrical injuries often occur from children biting into electrical cords producing lip, face, and tongue injuries, or an adult who becomes grounded while touching an appliance or other object that is energized. 
• Direct current electrical injuries may occur, for example, when the third energized rail of an electric train system is contacted while a person is grounded, which sets up a circuit of electric current through the victim, causing severe electrothermal burns. 

Electrical burns are diagnosed with a patient history and physical examination. 

If the burn is more serious, tests to determine the extent of the injury may include: 

• Lab tests
  • Blood tests
    • Complete blood count (CBC) 
    • Electrolytes
    • Creatinine 
    • Serum myoglobin 
    • Creatine kinase (CK) levels 
    • Arterial blood gas
  • Urinalysis
• Imaging tests
  • Chest X-ray if a patient has cardiac or respiratory arrest, shortness of breath, chest pain, low blood oxygen, CPR at the scene, or fall/blunt trauma
  • Head computed tomography (CT) scan if a patient has altered mental status, significant trauma, seizure, loss of consciousness, or focal neurologic deficits
  • Cervical/spine imaging if a patient has loss of consciousness, significant trauma, focal neurologic deficits, or evidence of spinal cord injury
  • CT/ultrasonography to evaluate for internal injuries
• Electrocardiogram (ECG)/cardiac monitoring

Warnings

If a person has an electrical burn, be careful to not come into contact with the electrical source yourself or you may also be injured. 

• If possible, shut off the electrical current if the victim is still in contact with the energized circuit and have someone else call 911  
• If you are unable to shut off the current or access it quickly, you might attempt to move the victim from the circuit with something that does not conduct electricity such as dry wood
• DO NOT approach the person until you are certain the power source has been turned off
• Remain with the person until emergency medical services (EMS) has arrived if it is possible to do so safely

How to Treat Electrical Burns

First aid for minor electrical burns includes: 

• Clean the burn
  • Remove any clothing that is covering the area; if clothing sticks to a burn, see a doctor 
  • Cleanse the burned area gently with plain soap and cool water 
  • It is not necessary to disinfect the skin with alcohol, iodine, or other cleansers 
• Cool the burn
  • Use a cool compress or cloth on the skin or immerse the area in cool tap water
  • Keep the cool compress or water on the skin for about 10 minutes or until the pain decreases
  • Do not use ice on burned skin
• Prevent infection 
  • If the burn is deeper than the top layer of skin, to help prevent infection, apply topical aloe vera, petroleum jelly, or an antibiotic such as bacitracin
  • Do not apply home remedies such as butter, egg whites, mustard, mayonnaise, lavender oil, or toothpaste to skin burns because these may cause infection
  • If the burn blisters, cover it with a clean, non-stick bandage and change the bandage once or twice daily as needed
  • Do not pop blisters, which can increase the risk of infection
• Don’t scratch the burn
  • Scratching can increase the risk of infection
  • Use moisturizing lotion to hydrate skin or petroleum jelly to retain moisture and prevent dryness that can cause itching
  • Over-the-counter (OTC) antihistamines such as diphenhydramine (Benadryl) may help relieve itch
• Treat pain 
  • Over-the-counter (OTC) pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be used to help relieve pain and inflammation
  • If you are unable to manage pain with OTC pain relievers, contact your doctor
  • Topical numbing medications (anesthetics) should not be used regularly on burns, because they may irritate the skin
• Tetanus prevention 
  • If you have not had a tetanus shot in the past five years and the burn is superficial partial-thickness (formerly, a second-degree burn) or deeper get a tetanus booster

More serious electrical burns are usually treated in the hospital. While waiting for EMS to arrive: 

• Check for breathing
  • If the person is not breathing, start CPR if you are trained
• Raise burned arms and legs above the level of the person’s heart
• Cover the person with cool, wet cloths (if the area is safe)
  • Do not use butter, ointments, or any other home remedy
  • Do not break blisters or remove burned skin

In the hospital, treatments for electrical burns may include:

• Prescription pain medications
• Special bandages
• Topical antibiotics and other types of creams or ointments
• Surgery to repair the burned area
• Treatment for damage to internal organs