SHOCK

ELECTRIC SHOCK AND EARTH SHOCK IN PHYSIOTHERAPY DEPARTMENT
Shock: Shock is stage of unconsciousness which could be due to so many causes. Examples
are: hypovolemic, neurogenic, psychogenic and electric shock etc.
Electric shock: Electric shock is a painful stimulation of sensory nerves caused by:
1. Sudden flow of current
2. Cessation or pause of flow of current
3. Variation of the current passing through the body




Causes of Electric Shock
1. Poorly designed electromedical apparatus
2. Improper insulation of equipment
3. Improper insulation of wires
4. Badly serviced medical equipment
5. Mishandling of apparatus
6. Improper guidance to the patient
7. Lack of proper safety measures




Severity of Electric Shock
1. In accordance with the Ohm’s Law, resistance is inversely
 proportional to current.
Hence, lower the resistance of the skin the greater the current which passes through
the body. Therefore, if exposed part of the circuit is touched with wet hands, the shock
is more likely to be severe than if the hands are dry.
2. The greater the current passing through the body the more severe is the shock.
3. The severity also depends upon the path taken by the current. A strong current through
the head, neck or heart proves to be more fatal.
4. The severity also depends upon the type of current which passes through the body.
Individuals can be electrocuted by using appliances of as little as 40 volts direct current
in industry.
Types of Electric Shock
According to the severity of the shock, it could be of following types:
1. Minor electric shock
2. Major or severe electric shock
Effects of Electric Shock
1. Minor electric shock: In minor electric shock the victim gets frightened and distressed.
In this type of shock, there is no loss of consciousness.
2. Major or severe electric shock: In major or severe electric shock there is a fall of blood
pressure and patient may become unconscious. There could be cessation of respiration,
followed by ventricular fibrillations and cardiac arrest. These could be diagnosed by
seeing absence of pulse in the carotid artery and with fully dilated pupils.
Treatment of Electric Shock
1. The current should be switched off immediately.
2. The victim to be disconnected from the source of supply.
3. If there is no switch in the circuit, the victim must be removed from contact with the
conductor, but rescuer must take care not to receive a shock himself from touching
the affected person, contact with whom should be made only through a thick layer of
insulating material.

4. Following a minor shock the patient is to be reassured that everything is alright and
allowed to rest.
5. Water may be given to drink, but hot drinks should be avoided as they may cause
vasodilatation.
6. Tight clothing should be loosened and plenty of air allowed.
7. If respiration has ceased, the airway must be cleared and artificial respiration is to be
commenced immediately
by the mouth to mouth or mouth to nose method.
8. Cardiopulmonary resuscitation may also be given.
9. Oxygen therapy may also be administered if required.
10. Patient must be shifted to the hospital after the primary care.
Precautions to avoid electric shock
1. All apparatus should be tested before use.
2. Connections to be checked before application.
3. Controls should be checked to ensure that they are at zero before switching on.
4. Adequate warming up time should be allowed.
5. The current intensity should be increased with care.
6. Patients should never be allowed to touch electrical equipment.
7. All apparatus should be serviced regularly by a competent person.
8. Machine should be properly insulated.
9. Mishandling of apparatus by unqualified person should be avoided.
10. All safety measures should be taken before application to the patient.
Earth shock: When a shock is due to a connection between the live wire of the main and

the earth it is called an earth shock.
Electric power is transmitted by one live cable and one neutral cable which
is connected to earth. The earth forms part of the conducting pathway and any connection
between the live wire of the main and earth completes a circuit through which current
passes. If some person forms part of this circuit he receives an earth shock. Thus an earth
shock is liable to occur if any person makes contact with the live wire of the main while
connected to earth.
Causes of Earth Shock
Earth shock may be caused by the following two reasons:
1. Connection to the live wire.
2. Connection to the earth.
Connection to the live wire
a. When wire is not properly insulated.
b. When, the switch is put in the neutral wire, the neutral wire is disconnected and live
wire is not disconnected.
c. Live wire is touched to metal casing.
d. Live wire is touched to any wet thing.
Connection to the earth
a. If the floor is made up of stone.
b. If the conductor is touching any wire which is connected to the earth, such as gas pipe
or water pipes.
c. If the conductor is touched to any radiated metal casing or metal wire.
Precautions
1. Proper arrangement of the physiotherapy department.
2. Proper flooring should be done with rexin.
3. Insulation should be proper.
4. While treatment patient should not touch any of the machine part.
5. The metal casing of all apparatus must be connected to the earth.
6. The floor should be kept dry.
7. While using water containers, containing water, should be kept on an insulating material,
e.g. a wooden table.
8. Leaky bathtub should not be used.
9. The bathtub should not have fixed taps or water pipes.
Examples
Simultaneous connection to the live wire and earth can occur in a variety of ways,
1. A patient who is receiving treatment with a current that is not earth-free may rest her
hand on a water pipe.
2. A physiotherapist holding an electrode that is connected to the live wire may touch the
earthed apparatus-casing.
3. If someone standing on a damp stone floor touches the casing of apparatus which is
not connected to earth and with which the live wire is in contact, he too will receive an