 DEFINITION-An electric shock is a painful stimulation of sensory

and motor nerves caused by a sudden flow, cessation of flow or

variation of the intensity of the current passing through the body
resulting in mild discomfort and fear for loss of consciousness and
death in a few cases.

 THE FUNDAMENTALS OF PROTECTION AGAINST ELECTRIC

SHOCK IS DTAILED IN THE DOCUMENT IEC 61140.

 STANDARD DISTINGUISH 2 KINDS OF DANGEROUS

CONTACT-DIRECT AND INDIRECT CONTACT.
 DIRECT CONTACT- Refers to a person coming into contact with
a conductor which is live in normal circumstances.

 INDIRECT CONTACT- Refers to a person coming into contact

with any part of electric circuit which is not normally live,but has
become live due to an accidental insulation failure or some other
fault.

 LIVE-Electrically connected to a source of potential difference ,or

electrically charged so it has a potential significantly different from
that of the earth in vicinity.
 A measure that combines protection against direct and indirect contact(for
example-safety class III appliances that operates on a safety extra low
voltage of 50V AC or 120V DC-because of their low power such appliances
are not widespread in use).
 The combination of a measures of protection against direct and indirect
contact-:
 THE MEASURE AGAINST DIRECT CONTACT ARE:
 Insulation of live parts
 Barriers or Enclosures
 Obstacles
 Placing out of reach
 THE MEASURES AGAINST INDIRECT CONTACT ARE:
 Automatic disconnection of supply
 Non-conducting location
 Electrical seperation
 Earth free location equipotential bonding
ELECTRICAL SEPERATION BARRIERS OR ENCLOSURES
 It requires all exposed and conductive part to be connected
to a protective conductor which in turn is connected to the
main earthing terminal.
 By doing so the body of the electrical equipment is brought
to the same potential as earth , and this prevents flow of
leakage of current(if any) through body of an operator in case
he/she touched the equipment accidentally.

 ADDITIONALLY PROTECTION-:RCD
 In certain circumstances all of the preceding protective
measures are not sufficiently effective due to , for example:
 Lack of proper maintenance
 Carelessness normal wear and tear of insulation
 Immersion in water
 Accidental contact
 THE HARMFUL EFFECT ON THE INTERNAL ORGANS AND
THEIR PROPER FUNCTION MAINLY DEPENDS ON THE
FOLLOWING FACTORS:
 Amount of current (voltage, ampere, low frequency, high frequency)
 Duration of contact time
 Path of current
 Type of current(AC or DC)
 The right help in first few minutes, until the arrival of the emergency services,
can be crucial for the severity of injuries or even for survival.
 First responders in an electrical accident must first ensure for their own safety,
It is essential that all power sources are isolated before first aid is provided to
injured persons.
 If anyone grabs the victim or pulls the person off the current with their hands ,
they might become the part of the circuit and become injured as well.
 It is necessary to turn the power off at the mains ,if possible or remove any
live part , that is still in contact with the casualty and also to isolate yourself
from the ground.
 It is also possible to use an object of low conductivity to push away the power
source . Overhead power cables are an example of high voltage power source.
 High voltage has the ability to jump or arc distances of up to a few meteres
and step voltage can also be dangerous.
 It is necessary to remain at a safe distance until the power has been switched
off by an official company.
 Once safety is ensured, it is necessary to continue with the normal procedures
applicable to first aid.
 Only suitably trained persons may perform effective first aid.
• Electric Shock can be of two types depending upon
1.Amount of current flow/According to point of entry

A) Macro shock.
B) Micro shock.
2. Severity of shock
A) Mild shock.
B) Severe shock.
• If the current flow is from the body surface through the
skin into the body a relatively large amount of current
is needed to produce a harmful shock.
• Macro shock is a harmful shock.
• Example:-Main current (AC).
• Macro shock occurs when current passes between two
contact point on the skin.
• If the current by passes tthough body and enters the
heart by way of the myocardial electrodes(Pace
maker),and a transvenous catheter a minute current
can produce a fatal shock without the patient
experiencing any thing.
• For e.g if
the therapist may be handling a
patient with a electtrical electrodes (pace
maker) on the heart.
• Then the patient feel Micro shock or ventricular
fibrillation.
• When the intensity of current gives rise to shock is
upto 20mA.
• The patient may only gets a painful sensory
stimulation
and upest breathing with lots pf fear and
distress.
• And there is no loss of consciousness.
• In this case the victim May become frightened and
possibly historical.
* If the current flow more than 20mA.
• It results in difficulty to the person can not move
from the conductor away.
• So which lead to muscular paralysis, falls in blood
pressure and cause loss of consciousness so if we can
see the person who falling on the ground he is
affecting with severe shock.
• And also severe shock causes the cessation of
respiration, ventricular fibrillation irregular
heartbeat.
•
 And cardiac arrest may caused in few cases
result in death.
 Normally death usually occurs i.e above
100A.
• An electrical hazard can be defined
as a serious workplace hazard that
exposes workers to electrical
injury.
• Direct/Primary Hazards:
a) Electrocution or death to the electrical shock.
b) Electric shock.
c) burns.
Indirect/Secondary hazards:
1)falls
2)fire
• Electrocution results when a
human is exposed
to a lethal amount of electrical
energy.
• Shock results when the body
becomes part
of the electrical circuit.
• It is also defined as reflex
response to the
passage of electric current
through the body.
• A burns is the most common electrical
related injury.
• Typically occurs on hands.
• Very serious injury that needs
immediate attention.
• Most electrical fires results from
problems with
faulty electrical outlets,old wiring,
problem with cords,
plugs and switches.
• Explosion happens when electrical
faults develop
into fires when combustible materials
are present.
• Unwanted voltage will not be
safely eliminated.
• Leakage of current to the ground.
• Removal of the ground pin.
• Exposed electrical tools can include:
*Breakers Boxes without a cover,electrocal
terminals in motors,
applicances and electronic equipment,
exposed electrical parts.
• Defective insulation to protect you, electrical
wires are insulated by a plastic or rubber
covering.
• Insulation prevents conductors from coming in contact
with each other and with people.
• Make sure the insulation of tools and cords you are
using is not damaged.
• Overloading a circuit increases the potential
for fires to occur.
• Overload hazards exist if:
*Too many devices are plugged into a circuit.
*No overcurrent protection device is used
overloaded circuits.
• Wet Conditions are hazardous because you can
become an easy path for
electrical current.
• There are many circumstances that creates wet
conditions:
*Standing in water.
*Wet clothing.
*Hight humidity etc.
Health Effects :

A shock can cause cardiac arrest :

If a current of 50 mA passes through the heart, it can cause cardiac arrest.
The heart is also a muscle, which beats to pump blood through the body. The rhythm of
our heartbeat is controlled by electric impulses—it is these impulses that are monitored
by an electrocardiogram. If a current from outside the body passes through the heart, it
can mask these impulses and disturb the heart’s rhythm. This irregular heartbeat is
called arrhythmia and can even manifest as a total disorganization of the rhythm,
known as ventricular fibrillation.
When ventricular fibrillation occurs, the heart stops pumping and the blood stops
circulating. The victim rapidly loses consciousness and dies
A shock can cause burns to tissues and organs :

When a current above 100 mA passes through the body, it leaves marks at the
points of contact with the skin. Currents above 10,000 mA (10 A) cause serious
burns that may require amputation of the affected limb.
Some burns are easy to recognize because they look like the burns you can get
from contact with heat. Others may seem harmless but aren’t: tiny charred
craters indicate the presence of much more serious internal burns.
Electrical burns often affect internal organs.
A shock can effect the nervous system :

When nerves are effected by an electric shock , the consequences includes pain,
tingling, numbness ,weekness, difficulty moving a limbs these effects may clear up
with time or be permanent . Electric injury can also effects the central nervous
system
Effects of electric current passing through the
human body :

Currents in milliampere : Effects :

1. 1 ma -only a faint tingle
2. 5 ma -slightly shocks(not painful)
3. 10 to 30 ma -painful shock (loss of
muscular control)
4. 50 to 150 ma -streamly painful job(tissue
damage or
heart fibrillation, leading
to death)
 Poorly designed or badly serviced electro-
medical apparatus.
 Mishandling of equipments.
 Poor insulation of equipment and connecting
leads/wires.
 Poor communication between physiotherapist
and patient,for example-no prior instructions or
improper instructions to the patient regarding
treatment modalities and its effects.
 Poor safety measures related to the equipment
selection , inspection and maintenance,clinical
use of modality, environmental safety of
Electrotherapy department.
A Person may obtain a shock without touching the
active wire of the power supply by the following
ways
1. Sudden alteration of the current flow- If, while on
the start of treatment the low or medium frequency
current is switched on with control turns up or if
insufficient time is allow for apparatus to warm up.
So that the current come on suddenly after the
controls have been turned up ,it results in sudden
flow of current giving shock.
2. Faulty Electrical Components- The presence of
faulty components such as a faulty transformer or
leaky capacitor may be dangerous giving electric
shock.
3. Non-insulated Flooring- It is mandatory to have the
floor of Electrotherapy unit to be insulated throug
“VINYL” or some other ininsulate floorings, it
enhances the occurrence of the earth shock.
4. Leakage Currents- With high quality insulation
material and good circuit designs there will be no
problem with leakage currents but with poor
designs the leakage current from the wires carrying
the current will be dangerous.
The symptoms of Electric Shock depend on how
severe it is.
 Potential symptoms of an electric shock include:-
1. Loss of consciousness
2. Muscle spasms
3. Numbness or tingling
4. Breathing problems
5. Headache
6. Problems with vision
7. Burns
8. Seizures
9. Irregular heartbeat
10. Pain in hand or foot or a deformity of a part of the body
may indicate a possible broken bone resulting from the
Electric Shock
11. In Children,the typical electrical mouth burn from
biting an electric cord appears as a burn on the lip. The
area has a red or dark,charred appearance
-Electric shocks can also cause “COMPARTMENT
SYNDROME”. This happens when muscle damage causes
your limb to swell. In turn this can compress arteries,
leading to serious health problems. Compartment Syndrome
might note be noticeable immediately after the shocks,so
keep an eye on your arms and legs following a shock.
 Current should be switched off immediately
patient has not to be disconnected from the
source of supply if their is no switch in the
circuit, the victim must be removed from the
contact with the conductor but the rescue
must take care not to get a shock by
touching the effected person.
 The contact with the effected person should
only be made by a think layer of insulated
material.
 Following a minor shock, the patient is
reassure and giving rest.
 Water may be given to drink but not drinks
should be avoided as they cause vasodilation
and sweating leading to further fall in blood
pressure.
 Tight clothing should be removed and plenty
of air should be given.
 If the shock is more given and response of
the person has stopped than the airways are
immidiately cleared and artificial respiration
must be given.
 If the patient is unconcious, than no water or
anything else should be given through the mouth
as it may lead to aspiration and medical officers
should be called.
 If the respiration has ceased, clear the airways
and start artificial respiration by mouth to nose
method and proceed for oxygen administration
by a bag and mask
 In the event of cardiac arrest start external
cardiac arrest start external cardiac massage. It
is essential to call for medical health
immediately but no delay should be made in
starting the CARDIOPULMONARY RESUSCITATION
[CPR] must be given and patient should be
shifted to the hospital as early as possible.
When you can safely touch the person, do CPR
if the person is not breathing or does not
have a pulse.
• For a child, start CPR for children.
• For an adult, start adult CPR.
 Ifthe person is bleeding, apply pressure and
elevate the wound if its an arm or leg.
 They may be a fracture if the shock caused
the person to fall.
 For burn, see BURN TREATMENT.
 Even if the injuries seems minor, its crucial
to see a doctor after an electric shock to
check for internal injury.
 Depending upon the injury, potential electric
shock treatment include:-
 Burn treatment, including the application of
antibiotic ointment and sterile dressings.
 Pain medication.
 Intravenous fluid.
 A tetanus shot, depending on the source of
the shock and how it occured.
 Forsevere shocks, a doctor may recommend
staying in the hospital for a day or two so
they can monitor you for any heart issues or
severe injuries.
 Symptoms that may indicate that
unconciousness is about to occur include:-
 Sudden inability to respond.
 Slurred speech.
 A rapid heart rate.
 Confusion.
 Dizziness or lightheadedness.
• All the apparatus should be checked before use.
• All the wire connection should be checked before application.

• Control should be checked to ensure that they are at zero

before switching on the apparatus.
• All the connecting wires should be inspected carefully for any
cuts or cracks.
 The current intensity should be increase gradually
.
 Patient should never be allowed to touch the
electrical equipment.

 Allthe apparatus should be properly serviced

regularly by the technicians.
 Avoid water at all times when working with
electricity.
 Never use equipment with frayed cords, damaged
insulation or broken plugs.
 Do not turn electrical switches on or off or touch an
electric appliance while your hands are wet, while
standing in water , or when sitting in a bathtub.

 Cover all electric sockets with plastic safety caps..

 Covering of apparatus should be of insulating
material.
 The following should be absorbed for the
prevention of an electric shock particularly while
treating patient.
 Arrange the department in such a way that there is
less possibility of anyone making an earth
connection while is contact with the apparatus.
 Water & gas pipes should be out of reason of the
apparatus and of patient receiving treatment.
 The floor should be insulated and kept dry.
 Ensure that the patient does not touch the
apparatus which on treatment.
• Switches must break the live wire of fuse must be on the live wires
will so that if an earth circuit is made and a large current passes ,
the fuse glow and stop the current flow.