Electric shock

Only in medicine is the deliberate connection of current-carrying electrical equipment to living individuals entertained on a regular basis. The situation is worsened in critically ill patients, because the normal resistance of the skin is frequently bypassed either by special treatment of the skin or by the placement of electrodes within the body. In addition, sick patients are likely to be more susceptible to the effects of electrical energy than healthy adults.

Biological effects of electric currents

At fairly low currents, there is a threshold of perception defined as the minimum current that an individual can detect. This is felt as a tingling sensation in an awake patient. As the current is increased, the 'let-go' current is reached. At the 'let-go' current local muscle spasm makes voluntary muscle relaxation at the point of contact impossible. This prevents the victim from releasing a live wire or piece of equipment. Further increases in the current produce respiratory muscle spasm and subsequently ventricular fibrillation. Beyond this level higher currents produce sustained myocardial contraction and tissue burns.

In an unconscious patient receiving mechanical ventilation, the first indication of electrocution may be ventricular fibrillation. This is more likely if the current pathway crosses the heart. The heart is most susceptible during the repolarization phase of the cardiac cycle. The most arrhythmogenic supply frequency is 50 to 60 Hz, ironically the usual frequency of the mains supply.

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