What is the first aid protocol for an adult in contact with a live electric wire?

First Aid for Electric Wire Contact

Do not touch the victim while they remain in contact with the live electrical source—ensure the power is turned off at its source before approaching, as touching an electrocuted victim while power is on places the rescuer at risk of electrocution. 1, 2

Immediate Scene Safety (Priority #1)

• Turn off the power at its source (typically at the circuit breaker/fuse box in homes) before approaching the victim 2
• If power cannot be immediately disconnected, use a non-conducting object (wood, plastic) to separate the victim from the electrical source 2
• Never approach or touch the victim while they remain in contact with live electricity 1, 2

Initial Assessment and Resuscitation

Once the scene is safe and power is disconnected:

Check Responsiveness and Breathing

• Shout for nearby help and activate emergency services immediately 1
• Check for responsiveness by talking to the victim and gently shaking their shoulders 2
• Simultaneously assess for normal breathing (or only gasping) and check for a pulse within 10 seconds 1

If No Pulse and No Breathing (Cardiac Arrest)

• Begin CPR immediately with standard C-A-B sequence: 30 chest compressions followed by 2 rescue breaths 3, 2
• Push hard (at least 2 inches/5 cm depth) and fast (100-120 compressions/minute) with complete chest recoil 1
• Apply an AED as soon as available and follow prompts 1, 2
• Continue CPR until advanced life support arrives or the victim starts to move 1
• No modifications to standard ACLS protocols are required for electrical injury victims 2

If Breathing Absent but Pulse Present (Respiratory Arrest)

• Provide rescue breathing immediately: 1 breath every 6 seconds (10 breaths per minute) 1, 2
• Check pulse every 2 minutes; if pulse disappears, start full CPR 1
• This scenario is particularly important in lightning strikes, where victims may have spontaneous cardiac recovery but persistent respiratory failure requiring ventilatory support to prevent secondary hypoxic cardiac arrest 3, 2

If Breathing Normally with Pulse Present

• Monitor the victim continuously until emergency responders arrive 1
• Maintain spinal precautions if the mechanism suggests trauma or loss of consciousness occurred 3, 4

Special Considerations

Multiple Victims (Lightning Strikes)

• Reverse normal triage: Give highest priority to patients in respiratory or cardiac arrest, as they have the best chance of survival with immediate intervention 2

Airway Management Precautions

• Use caution with airway manipulation due to potential cervical spine injury from falls or tetanic muscle contractions 3, 4
• If vomiting occurs, turn the victim to the side (logroll if spinal injury suspected) and clear the airway 2
• Be aware that progressive soft-tissue swelling may occur, particularly with facial burns 3, 4

Cardiac Monitoring

• Cardiac arrhythmias (ventricular fibrillation, asystole, ventricular tachycardia) are the primary cause of immediate death from electrocution 3, 4, 2
• Alternating current (AC) is more dangerous than direct current (DC) because it causes tetanic muscle contractions that "lock" victims to the electrical source, prolonging exposure 2

Critical Pitfalls to Avoid

• Never approach the victim while power remains on—this is the most critical safety error that can result in multiple casualties 1, 2
• Do not underestimate internal injury based on external appearance—electrical burns often cause extensive deep tissue damage beneath minimal skin changes 3, 4
• Do not delay resuscitation to perform non-essential assessments 2
• Recognize that even low-voltage injuries (220V household current) can cause cardiac arrest and severe complications 5, 6

What to Expect from Emergency Services

Once professional help arrives, they will:

• Obtain a 12-lead ECG within 10 minutes to assess for cardiac injury 2
• Initiate aggressive IV fluid resuscitation with normal saline for significant tissue destruction 3, 4
• Continue cardiac monitoring for at least 24 hours 3, 2
• Assess for compartment syndrome, deep tissue injury, and burns requiring specialized care 3, 4