Electrocution,

Lightning &
Radiation
 Introduction in short
• Like heat and cold, electrocution,
lightning and radiation are considered
as physical agents which can lead to
various nonfatal injuries and death
• Death due to electrocution and
lightning is not very uncommon in
Bangladesh
 Contd.
• As regards to electrocution, it is
most common among the electricity
workers
 Electrocution
• Passage of Electricity through the
tissues can cause skin lesions, organ
damage or death which is called
electrocution
• Electrocution is caused either by
artificial electric current or by
spontaneously generated electrical
energy in nature by lightning
 Fatalities
• Accidental: Usually accidental, both
in domestic & industrial environment
• Suicidal: Suicides from electricity
have recently increased especially in
Germany
• Homicidal: It is rare but is recorded
and in United states, electrical
suicidal death sentence execution is
exercised
 Types of Electrical
current
• Direct current (D.C) & Alternate
current (A.C).
• Direct current flows continuously in
one direction & is less dangerous
(200-250 milliamps intensity of
direct current is lethal). A high
amperage of D.C (above 4-A) may
revert the cardiac arrhythmia to
sinus rhythm. So it is used in cardiac
defibrillation at resuscitation
 Contd.
• Alternate current shows rapid
alteration in direction of flow and is
more dangerous than direct current
(70-80 milliamps intensity if A.C is
lethal), which is because of the “hold
on” effect imparts the muscles
undergo a tetanoid spasm prevents
the victim releasing the live
conductor- likely to cause
ventricular fibrillation or cardiac
arrest
 Three major life
threading events
• Current commonly passes across the
heart, when brought to contact with
live conductor of one hand & most
dangerous is the right hand
• Current passes obliquely along the
axis of heart causes cardiac
arrhythmia usually ventricular
fibrillation ending in a systole
 Contd.
• Less often current passes through
the chest and abdomen where
occurs respiratory failure from
paralysis of respiratory muscles &
the diaphragm
 Contd.
• Rarely current passes through the
head & neck. Commonly occurs in
electrical worker when contact with
overload power lines through a
conductor having direct effect on
the brain stem paralyzing the cardiac
or respiratory center
 Local & Constitutional
effects of electric current
• Local effects:
• Burns and blisters causing puckering of
skin round the edges of the burns without
any red line surrounding it or reddening of
the base at the site of entry (hands &
fingers) and exit (opposite hand or feet).
The skin lesion- thermal burn from heating
the epidermis and dermis seen at the point
of contact. These entrance wounds often
known as Joule burns(Electrical burns or
Electrical marks)
 Contd.
• Lacerated or punctured wound with
Contusions of the margins
• Bruised patches or spots or streaks
with arbores cent appearance
• Burning of clothes & Singeing of hair
• In fatal cases, except the marks on
the clothes there may not be any
findings
 Micro pathological skin
changes
• Basically it is an electrical burn
• These local lesions are found in the
hands or fingers at entry or exit of
electricity being mostly severe on
the feet or opposite hands
• The changes are: * Compression of
the horny layer * Homogenous plaque
& * Ironing out of the underlying
papillary process
 Contd.
• Fissures and hollows appear between
Corneum and germinativum
• Basal cells changes are surest sign-
coalescence basal cells in to a star
shaped or rod like structure- in each
group of the rete-malphigii
 Contd.
• Charring and vacuolation- In the
deeper cells with occasional
deposition of fine metallic particles
of the conductor substance, may be
in few cells
 Flash or spark Burns
• Intense heat resulting from flash of
electricity, produces burns which
resembles thermal burns over a large
area, called as Crocodile Skin lesion
 Contd.
• Sometimes multiple lesions found in
the region of excess flexion of a limb
where the current has passed across
the joints instead of passing around
it
 Constitutional Effects
• Immediate death from shock
• Hemiplegia or paraplegia
• Loss of sight, hearing, speech etc.
• Momentary shock with complete
recovery if current is small
The A.C. with moist
clothes, bad health, state of anxiety
etc. may aggravate the effect
 Contd.
• In high voltage electricity- Inhibition
of respiratory center
• In low voltage electricity-
Ventricular fibrillation
• Complications like- Infection,
septicemia etc.
Medico legal importance
• Usually accidental but
• Suicidal & Homicidal cases also
recorded
• In USA death penalty is carried
out by electric chair- One electrode
is placed on shaved scalp & other on
the rt. Lower leg, passes current for
one minute and repeat it for another
minute for the second time
 Lightning
• Differs only in degree from ordinary
electrical current
• A flash of Lightning is due to passage
from a thunder cloud to the earth of
a direct current of enormous
potential
• Along the track of the current much
energy is liberated most of which is
converted into heat
 Contd.
• There occurs burn due to heat
• Also occurs electrical burn &
• Mechanical lesion in many ways
 Effects of Lightning
• Immediately death from Syncope or
paralysis of nervous system
• Delayed death from the complication
of burn like septicemia, gangrene,
premier etc.
 Post mortem features-
External
• On the body: Ecchymosis & burns of
all degree (caused by fused metallic
substances).
• “Arbores cent markings” also known
as “filigree burns” or lightning
prints etc. on the skin are caused by
deposition of copper on the dermis, it
is said that these are not burns
 Postmortem features-
Internal
• Congestion in the membranes often
laceration
• Intra cranial or intra cerebral
effusion of blood
• Patchy hemorrhage on the pleura and
lung surface
• At times severe disruption may cause
widespread petechiae
 Findings on Clothes
• Burnt clothes at the site of entry
and exit of lightning
• Fused metallic articles in the vicinity
 Diagnosis
• Evidence of lightning & thunder in
the locality
• Incidence of casualties of animals in
the locality
• Presence of fused metallic substance
in the vicinity
• Damage of trees
• Absence of any wound in the body or
burn & severe injury to the body
parts
Medico legal importance
of lightning
• It is always accidental or having
characteristic features which always
go in favor of accident
 Radiation
• In the modern world people are
exposed to ionizing radiation from
various sources using external beam
• In medical field, radiotherapy is
exposed to the cancer patient as
treatment using radioactive cobalt &
super voltage therapy
• Therapeutic dose is by & large
harmless but skin reaction at the site
of super voltage application are
common
 Pathology
• At first presents with depletion and
erythema of the skin
• Later may produce blisters
• Finally discoloration of the area
takes place
• There occurs burn
• Eczematous reaction
 Other than medical
• Industrial- In watch factory, drug &
chemical analysis radioactive
substances are used
• During war- Nuclear weapons used
by the super powers
 Medico legal Aspects
• The doctors in charge of cancer
treatment has to be very careful
during application of super voltage
therapy as the patient can sue him or
her if the patient can prove
negligence on the part of the doctor
 THANKS
• For attending the class……