6

B.C. LUMBER WORKER

Deaths by electrocution mount —

through public indifference

By N. GILLMOR LONG, M.D.

The boom of a crane suddenly gets entangled with overhead high-voltage power lines. There is a flash of light and before the operator can shout a warning a labor- er who had been leaning against the crane tread is electro- cuted. The operator emerges safely after the boom has swung free or after the power is cut off.

A housewife is electrocuted while using’ a defective low-volt- age hair dryer,

In England, a guitar player is electrocuted while strumming his electrical instrument at a con-

cert. T.V. Set The list grows, with public apathy penetrated in an occas- jonal tragic case such as the death of a boy in an accident centred about a TV set. In this age of electric razors, typewrit- ers, appliances, and home work- shop tools, it must be emphasized repeatedly that severe or fatal burns and shocks can stem from relatively high-amperage and low voltage as well as from high tage sources. - Unfortunately, the pungent, distinct, ne ve r-to-be-forgotten odor of burning human flesh was not extinguished with the destruction of Dachau and Bu- chenwald. It is a daily universal occurrence due to the careless handling of electricity. By the same token, electrocutions are not always official payment of debts to society, but many times the innocent paying the price in the hands of a careless execu- tioner—a fellow worker. Traprove Safeguards Organizations such as the Bureau of Safety, Edison Elec- tric Institute, National Associa- tion of Mutual Casualty Com- panies, and, National + Safety Council are ‘constantly ‘on the alert to improve safeguards against mechanical . defects ‘in

manufacture and application and are conducting a never-ceasing public education program to in- sure the safe use of electricity.

Electrical burns usually are

“|by the release of toxin from a

‘| aititoxint ‘or tetanus” ‘toxoid. “To

the more serious type of burns treated in medical and industrial practice. The odor from such a burn is most offensive—cooked human flesh. A severe burn is a wound with. sudden blood and blood plasma loss and resulting hypovolemic shock (increasing blood viscosity), causing what is termed “burn shock.” Shock Is Different

This is somewhat different from electrical shock in that the effect on the heart is more grad- ual, A smaller volume of blood returns to the heart, lessening heart output and lowering the blood pressure.

A moderately to severely burned patient should always be forced to lie down, with his head level with or lower than his body. He will quickly go into a condi- tion of shock and, if standing, might have a large surface area burn complicated by a fractured skull or back, caused by falling. | I have seen patients chatting away gaily in apparent good con- dition go into profound shock in the flash of a second.

Severe burn cases have, in ad- dition, increased shock potential

clostridial form of bacteria al- ways present in large amounts in the gastrointestinal tract and ac- tivated by such a burn.

This is why all major burn cases routinely . receive tetanus

prevent shock, as well as to re- duce pain, sedation is given im- mediately along with oxygen (if indicated), avoidance of external heat, antibiotics, etc.

Burns Are Deep Most electrical burns are deep

DEAD...

SAFETY

OCCUPATION: Loading engineer,

AGE: 25

EXPERIENCE: five years.

The loading engineer was working alone at the landing splicing some line. He was not seen for approximately three hours, and when a search was instituted, a pike pole was found floating in the water together with a box of matches,

His body was found at the

five feet of water. It is presumed that the workman fell into the lake in trying to push a log into position for tonging.

‘As a loading engineer, the workman did not wear buoy- ancy equipment or caulked boots.

bottom of the lake in twenty-

—at the local burned area there is a loss of whole thickness of skin. The typical electrical burn has a cooked appearance and is very painful, calling for immedi- ate treatment and early skin graft to cut down the period of treatment as well as to afford re- lief to the patient.

The path of the current usu- ally can be traced by a burn pat- tern with various parts of the body being more susceptible. The flash type burn usually is not as serious a problem. Small electri- cal burns are readily treated be- fore medical attention by the usual first-aid measures of vase- line gauze and pressure dress- ings.

Omitted from this discussion are the effects on the kidneys, liver, adrenals, and resulting peptic ulcers secondary to severe burns.

Electrical Shock

We have all had the tingling sensation produced by sticking our finger into an empty light socket or the unpleasant jump while attempting a do-it-yourself project on the bridge lamp with an uninsulated screwdriver.

The shock that kills — the bolt of lightning, the mishand- ling of live power lines, the short circuited electric guitar or TV set—all these hinge on a heart that is rapidly thrown into ventricular fibrilation (a term that has almost become a household word.)

What Happens

Exactly what takes place in the heart that causes instant death? The heart is composed of four chambers—two on top and two on the bottom, divided by walls with small valves. al- lowing blood to flow into the chambers. The two top cham- bers are called the right and left auricles divided by the walls, the bottom are called the ventricles, with a corresponding wall.

The heart muscle is peculiar in that it can beat by itself. Its beat is regulated by a special- ized nerve tissue called the AV node. The impulse travels over the wall between the two, caus- ing the auricles to contract, After the contraction, blood is forced through the openings in the auricles to the ventricles, which swells the right ventricle. When a certain pressure is

reached, the heart ventricular muscle contracts, forcing the blood into general circulation.

The right auricle squirts blood into the chamber of the right ventricle where it goes into the lungs when the ventricle’ goes

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into systole. Blood coming from the left auricle (again treating this as a single entity) and blood is forced into the left ventricle.

Urder normal condition, there is a split second sequence in the filling of the chambers with the opening and closing of valves fol- lowing an extremely -accurate small time interval. In severe el~ ectrical shocks the impulse dis- torts the normal sequence, caus- ing the auricles and ventricles to beat independently of each other,

Heart Failure

Probably there is a combina- tion of interference with the nerve pathway and the heart muscle function with the loss of heart chamber coordination and failure of the heart pumping ac- tion—shock, convulsive seizures, and death. Therefore, in fibrjla- tion of the lower chamber, the functional blood-pushing force is abolished, circulation comes to a speedy end, and death follows in a few minutes.

It is axiomatic that any meth- od devised for resuscitation of such a heart is of no practical importance, as too brief a time exists wherein the heart could

survive, even assuming that every available means of rescue were at hand. se

Feeding Oxygen

This same fibrillation may. re- sult from other causes, such as severe chest wall or heart trau- ma, coronary occlusion, and elec- trie shock, The problem in treat- ment of less severe shock lies in feeding oxygen without the aid of heart coordination momentar- ily by artificial and mechanical resuscitation aids. A constant supply of oxygen must be fed to body tissues and the heart it- self (coronary circulation) and particularly to the delicate brain cells. If these cells are deprived of food for even a few seconds there is anoxia (loss of oxygen) and death of essential cerebral and life-processing cells.

Different Subject

In some cases of lesser shock impulse, immediate artificial res- pitation and oxygen may keep alive the respiratory centre of the brain as well as generalized circulation. This is a most diffi- cult subject to discuss briefly, as thick medical tomes have been written on all phases of the sub- ject.

Minor shocks, like minor burns, respond readily to ther- apy and are. not problems as such. The problem lies in pre- yention and constant vigil on the part of safety and electrical en- gineers, aS well as on the part of the public.

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Workmen's Comp