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Electrocution: Prehospital Care of Electrical Burns

Cable Exposed Electrocution


Electrical burns signs and symptoms

Electrical injury symptoms will vary drastically from patient to patient depending on many factors. Location, duration, and strength of electrocution will all effect electrical burns signs and symptoms that are present for each patient.


Reasons for these electrical burns signs and symptoms are explained above in the pathophysiology section.


Here are some common signs and symptoms for EMS to look for after an electrical injury takes place. Some of these will be present with minor electrical burns, but many are signs that a high voltage injury has taken place.


• Shortness of Breath 


• Respiratory Distress

Cardiac Arrest

Tachycardia & Dysrhythmia

Limb Weakness or Stiffness

Paralysis of Limbs

Tingling Sensations in Extremities

Pulseless Extremities

Electrical burn on hand, fingers, & feet

Electrical burn entry and exit wounds

Thermal burn injuries

Muscle pain & Body pain

Injuries from being thrown

Dislocated Shoulder

Bone Fractures

Head Injury


Loss of consciousness

Headache, Dizziness

Mental Status Changes

Memory Loss & Confusion

Personality Changes

Deafness & Ruptured ear drums

Dilated Pupils

Brown, red or tea colored urine

Rhabdomyolysis & Acute renal failure


How to treat electrical burns

Electric burns can be minor, severe or life-threatening. Electrical injury treatment guidelines depend on the severity of the injury and will follow EMS protocols. Patients that experience lightning or other high voltage electrical injury should be considered victims of trauma, a cardiac event, and electric burns.


As discussed above, scene safety is especially important with electrocution patients because they may still be part of a live circuit. The EMT may have to delay providing patient care until the power is turned off by a professional. (You should call for additional personnel to turn off power if needed.)


Assure Safe Scene

– Once it’s safe, the EMTs and Paramedics can approach the patient.

– If the patient was thrown, or if head and neck trauma is present, suspected or unknown, apply cervical spine immobilization.


Airway, Breathing, Circulation

– Like other patients, ABCs are a priority with electrical injury patients.

– EMTs will need to provide airway management support and should insert an airway in unconscious electrocution patients.

– The first responder may need to perform CPR on electrocution patients who experience cardiac arrest or respiratory arrest.

– ALS providers should perform cardiac monitoring on all electrocution patients. Electrical burn management for cardiac arrhythmias will follow ACLS guidelines. These patients often have ventricular fibrillation or asystole which need to be treated. Watch for non-specific ECG changes which can indicate cardiac damage done to heart tissue during the electrocution.

– Supplemental oxygen should be placed as needed on patients with electric burns.

– ALS units should insert a large-bore intravenous (IV) line in anticipation of fluid resuscitation in the field. If possible place the IV in the uninjured extremity because it’s likely large amounts of fluids will need to be infused.


Treat Injuries

– Treat thermal burns and cover with dry, sterile dressings.

– Obtain a SAMPLE history and pain level assessment from patients who are conscious. Use family and loved ones to obtain a medical history for unconscious patients.

– Fully assess the patient looking for electrical burn entry and exit wounds. EMT should check tips of fingers and bottoms of feet. Make sure to also look for any thermal burns caused by jewelry heating up during electrocution. These electrical burns typically occur on the wrist, neck and chest. (From necklaces, chains and watches.)

– Splint and immobilize any dislocations and fractures that you find.

– Continue assessing patient for any signs of impending compartment syndrome. These can include circumferential burns, motor, sensory, neurological or vascular changes to extremities.

– Be prepared to transport all high voltage electrical injury patients to the ED, along with many low voltage injury patients.

Transport electrical injury patient by ambulance


Electrocution may not be the most common injury in the field, but it is likely that EMTs will eventually have electrical injury patients. These patients count on you to be knowledgable about the damage electricity does to the human body. Knowing potential complications, hidden injuries and side effects from both a low voltage and a high voltage electrical injury can save your patient’s life. Be the best EMT you can be and continue learning new information about patient care and emergency response in the field. 


⇒ This article contains medical terms, for more practice with medical terminology go here.

⇒ Thinking of becoming an EMT? Check out 15 Reason to become an EMT.


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