Electric shock and lightning strike in children
Introduction
Introduction to children's electric shock and lightning strikes The chances of children's contact with electricity in daily life increase with the development of society. The reason for electric shock is mostly the touch of electrical appliances, power jacks or hand-cranked wires. Even in rainy days, lightning strikes under the trees. In severe cases, it can cause serious damage to the local and the whole body, and even cause the child to be disabled and die. basic knowledge Sickness ratio: 0.0001% Susceptible people: children Mode of infection: non-infectious Complications: coma, gas gangrene, electric burn, acute renal failure
Cause
Children's electric shock and lightning cause
(1) Causes of the disease
1. Reason
(1) Ignorance: Children play with electric lights plugs, sockets, wires or other electrical appliances for ignorance or curiosity. When the wires are broken, they do not know how to avoid them or even touch them by hand.
(2) The socket is installed too low: the indoor electrical socket is installed too low, it is easy to be touched by children, or it is digging with fingers, keys, coins, metal pins, etc.
(3) Mistakes: Climb the roof or tree to catch birds, and accidentally touch high-altitude wires during play.
(4) Unprotected equipment: There is no protective equipment to pull the loved ones or partners.
(5) Avoid rain under the big trees: the clothes are wet when lightning, and rain or play under the big trees.
2. Factors affecting the degree of damage
(1) AC power is more dangerous than DC: low frequency of AC is more dangerous than high frequency.
(2) High voltage: The higher the voltage or the higher the current, the more serious the damage.
(3) Power-on time: The longer the power-on time, the more serious the damage.
(4) Contact site: The body contact site is far from the heart. The closer the brain distance is, the more likely it is to die. The smaller the resistance of the contact site, the easier it is to show systemic reaction.
(5) Current access point and outflow point: the direction of current entry point and outflow point, position and single line electric shock or double line electric shock, the damage is different.
(6) Step voltage electric shock: people around the high-voltage line around the place (about 10m), although not directly in contact with the wire, due to the different potential differences formed by the two feet, muscle spasm and even coma can occur, the so-called step voltage electric shock .
(two) pathogenesis
The severity of current damage to the human body depends on the following factors: 1 current type (AC, DC); 2 current intensity; 3 voltage level; 4 current resistance; 5 human contact current time; 6 current flowing through the body Path; 7 frequency of current (low frequency, high frequency).
According to Ohm's law: current = voltage / resistance, the body's various tissues have different resistance to current, and their size is bone, tendon, fat, skin, muscle, nerve, blood vessel, and various tissues are in different states, and their resistance also changes. If the skin is sweaty, when it is wet, the resistance is smaller than when the skin is dry.
The mechanism by which current is harmful to humans is not fully understood.
1. When the tissue burn current passes through the tissue, due to the presence of electrical resistance, the electrical energy is converted into thermal energy to generate tissue burns, and the site where the electrical injury is seriously damaged is often a large electrical resistance.
2. Causes strong excitability of the nervous system and muscles. AC can cause strong excitement in the nervous system and muscles. In addition to skeletal muscle, bronchial smooth muscle can also cause respiratory arrest due to strong contraction of excitement, and can also cause cardiovascular function disorders, coronary artery The heart stops.
3. The tissue is decomposed by electrolysis to cause decomposition of the tissue by electrolysis, and the ion balance inside and outside the cell membrane is destroyed.
The above is the basic pathogenic mechanism of current to the human body.
Prevention
Children's electric shock and lightning strike prevention
Publicize and educate children to understand the use of electricity knowledge, understand the serious consequences of electric shock, clear responsibility, often check the operation of electrical appliances, to prevent leakage, power supply should be away from children can touch, avoid contact, indoor wiring, transformer materials and If people have dangerous live facilities, the fence should be properly installed to strengthen the legal awareness, everyone cares, everyone is responsible to reduce the occurrence of electric shocks.
Complication
Children's electric shock and lightning strike complications Complications, coma, gas gangrene, electric burn, acute renal failure
Severe ventricular fibrillation and central nervous system inhibition, can occur coma, respiratory heartbeat stop; can be complicated by serious infections, such as gas gangrene can occur fatal bleeding; can cause fractures, dislocation, electric burns affect deep muscle tissue, Due to extensive muscle destruction, a large amount of myoglobin is produced, which needs to be removed by the kidney. Therefore, in the case of shock, water, electrolyte, acid-base balance has not been completely corrected, the kidney is prone to damage and cause acute renal failure.
Symptom
Children's electric shock and lightning strike symptoms Common symptoms Powerless complexion pale severe burn palpitations Nausea blood pressure drop tachycardia dizziness coma shortness of breath
The clinical manifestations are mainly systemic reactions of local tissue electrical burns and electroshock.
Systemic response
Children are more likely to have electric shocks on their hands.
(1) Light weight: After the electric shock, the face is pale, weak, numbness of the electric finger, mild muscle spasm, but easy to release the power from the power, short-term dizziness, palpitations, nausea, shortness of breath, skin pain in the electric shock, generally conscious.
(2) Heavy: Immediate coma after electric shock, rapid breathing or pause, rapid respiratory paralysis, blood pressure drop, arrhythmia, tachycardia or ventricular fibrillation, unfavorable recovery, resulting in respiratory heartbeat stop, most timely treatment The child can be saved.
2. Local tissue damage
After the electric shock, the local skin shows severe burns. The current flows out of the body to form a current inlet and more than one current outlet. This is a special manifestation of electric shock. Generally, the skin burns in the entrance range is not large, but the burn is serious and the outlet burn range is large. The degree of burn is mild, and the skin burns are mostly elliptical black charcoal, which is scorched. The dry crack of the epidermis can reach the underlying tissues of the skin, including bones, brain, internal organs, spinal cord and other major organs. The pain is mild. In the first 1-2 weeks after injury, most of the changes are progressive necrotic changes. Therefore, it is difficult to make accurate diagnosis based on epidermal burns in the early stage of burn. It can be complicated with serious necrosis due to tissue necrosis, especially anaerobic infection. Large, such as the occurrence of gas gangrene, it is necessary to cut off the infected limbs, such as large blood vessels can be injured due to sudden ulceration and fatal bleeding.
Children with burns caused by electric arc or spark can cause large-area skin burns due to burning of clothes. The extent and extent of deep tissue damage are slightly less than electric shock. Some research results show that children with arc burns have a certain increase in current value. There is also a certain amount of current actually passing through the body.
Children with burns after electric shock can cause fracture and dislocation due to strong muscle contraction.
Limb electrical burns, deep fascia of the affected limb due to high edema of muscle tissue, local pressure increase, often accompanied by fascial compartment syndrome, further affecting the limb blood supply, exacerbating tissue damage, treatment can not lead to limb necrosis.
Examine
Children's electric shock and lightning strike inspection
Blood, urine, routine examination, blood electrolytes, pH, liver and kidney function tests should be performed. According to the clinical selection of X-ray, B-ultrasound, electrocardiogram, brain CT and other examinations.
Diagnosis
Diagnosis and identification of electric shock and lightning strike in children
According to the history and clinical manifestations, laboratory and auxiliary examinations can help to understand the condition and complications. After diagnosis, the severity of the disease, the severity of the tissue damage, and the presence or absence of complications must be identified and confirmed by necessary laboratory and auxiliary examinations.
