ELECTRICAL SAFETY
Shocking Effects
May is Electrical Safety Month. Here's everything you didn't know about electric shock injuries.
BY ANGELO VERZONI
Most electricians know the tingling sensation of a small amount of electrical current passing through the body. When a crew member is “just a little bit off,” others will often joke they’ve been shocked one too many times, said Derek Vigstol, senior electrical specialist at NFPA, on an NFPA Podcast episode that aired in February.
But there’s more truth to the joke than most people realize.
“A subset of [electrical injury patients] are a little off,” said Dr. Neil Pliskin, a neuropsychologist at the Chicago Electrical Trauma Rehabilitation Institute (CETRI). “And what’s off is their thinking speed is slower—it’s harder for them to recall information on their own. Some individuals complain of significant anxiety and depression while never having had symptoms like that before.”
RELATED: Listen to a new podcast on electric shock injuries on the job and in the home
Vigstol interviewed Pliskin and Drs. Raphael Lee and David Weiss for the episode, which aired during National Burn Awareness Week. The three renowned specialists discussed the devastating physical impact electrical shock can have on the human body, from burns and musculoskeletal pain to cardiac arrest, as well as some of the lesser-known effects it can have on the brain. NFPA Journal is revisiting this podcast, as well as a video series released late last year, to mark National Electrical Safety Month, which is observed each year in May.
Nerves ‘gone haywire’
Pliskin said about 75 percent of patients who’ve come to CETRI present with “complaints of failing memories, complaints of concentration difficulties, and significant changes in mood and emotions—to the point that a psychiatrist or psychologist diagnoses conditions like anxiety, depression, and post-traumatic stress.”
It can be especially troubling to see individuals who don’t seem to have major physical injuries exhibit these symptoms, Pliskin added. “Some people who have seemingly minor physical consequences as a result of their injuries have maximal changes in mood, emotion, and thinking abilities,” he said. “I’m talking about firefighters, about emergency medical responders, about people who have been trained to be resistant to stress who now, after they’ve had an electrical shock, don’t want to leave the house, they’re crying all the time, they’re upset, they’re irritable.”
The physical toll electrical injuries take on the body, including pain and lack of sleep, can exacerbate these behavioral health symptoms, the doctors said.
“They can have pain throughout their whole bodies, and that just adds to what Dr. Pliskin was stating,” said Weiss, a physical medicine and rehabilitation specialist. “If you have pain, everything is worse.”
Electrical injuries are still not fully understood in medicine, and Lee said CETRI continues to research the phenomenon. “We have made some progress in trying to understand these problems and to develop therapeutic approaches, but we don’t have all the answers,” said Lee, a surgeon and trauma medicine physician. “I think we’re asking the right questions, such as ‘What happens in an electrical shock patient that triggers all these processes?’”
Lee said doctors believe many of the effects are due to nerves not healing correctly. “The nervous system and the muscles are injured,” he said. “And just like when you get a cut on your skin and it heals, it’s not the same as it was before.”
In terms of treatment, the doctors said it can be difficult to find a one-size-fits-all approach—people have different pain thresholds and biological abilities to heal. In general, Weiss said treatment is aimed at regaining control of a nervous system that’s “gone haywire.”
“Normally, when you touch a body part it’s interpreted as touch, but in these patients, touch can cause muscle spasms,” Weiss said. “How do you reverse that process? If you let your body control you, that’s a bad thing, so you have to start controlling your body. When that idea is grasped by patients, they go all in and there’s a lot of hope and ability to reverse this process.”
On May 18, as part of NFPA’s 125th Anniversary Conference Series, a daylong schedule of virtual educational presentations on electrical safety will feature a presentation from Pliskin on neuropsychological issues following electrical injuries. Register for the event here.
Shining a light on survivors
CETRI isn’t the only place survivors of electrical shock can go for holistic, long-term care that meets not only their physical needs, but also their psychological needs.
“At the burn center at [the University of California, Irvine] we take a very deliberate approach to treating the whole person, meaning not just the acute medical and surgical needs, but also paying attention to the psychosocial or the emotional, mental, spiritual, and entire social dynamic that the patient and their families are in,” said Dr. Victor Joe, a burn surgeon at UCI’s Health Regional Burn Center. “We extend this into the outpatient clinic. ... In the clinic visit we will have therapists, social workers, burn psychologists, and child life specialists.”
Joe spoke with NFPA late last year for a video series aimed at raising awareness of electrical injuries. The videos, produced by NFPA and the Phoenix Society for Burn Survivors, were released as part of the longstanding NFPA Faces of Fire campaign, which originally promoted the importance of fire sprinklers through the stories of burn survivors.
“Exposure to electricity poses a real injury risk to workers and the public,” said Lorraine Carli, NFPA’s vice president of Outreach and Advocacy. “Many people are not aware of electrical dangers, and yet each year people are injured or killed as a result of these hazards. The Faces of Fire Electrical campaign helps educate people about the true dangers of electricity and ways to prevent related tragedies from happening.”
In addition to the video featuring Joe, six other videos feature survivors of electrical injuries sharing their stories. One such survivor, Samoana Matagi, a former power line worker, lost both his hands in 2010 after nearly 15,000 volts of electricity surged through his body during an accident.
“We as power line workers need to see that a person standing up for safety is actually more macho than a person who’s not standing up for safety,” Matagi says in the video. “I go and talk to other burn survivors and tell them that inside of them there’s a power to overcome their accident. They can tap into that by doing certain things. It’s called resilience. I know that everybody has resilience, and we can build up resilience and work through our accidents.”
Watch all of the videos from the campaign at nfpa.org/facesoffire.
ANGELO VERZONI is a staff writer for NFPA Journal. Follow him on Twitter @angelo_verzoni.