20.5 Electric Shock First Aid & CPR

Electric Shock First Aid & CPR

Quick Answer: Follow DRSABCD. Make it safe, check response, send for help, open the airway, check breathing, and if not breathing normally start CPR at 30 compressions to 2 breaths, one third of chest depth, 100–120 per minute. Apply an AED the moment it arrives. Every electric shock casualty needs medical assessment.

Why Both Knowledge and Skill Are Required

EPC 47 is unusual in the critical list: it requires you to describe the first aid requirements and demonstrate the knowledge and application skill of CPR. Queensland reinforces it at the licensing level — you must be trained in and competent to carry out resuscitation, with training completed within the last 12 months (Section 1.3).

Electric current across the chest can cause ventricular fibrillation, where the heart quivers instead of pumping. Without CPR and defibrillation, survival falls rapidly with every minute. You are frequently the only person present who knows what happened and what to do.

DRSABCD — the Australian Action Plan

Gasping is not breathing. Agonal gasps are common in the first minutes of cardiac arrest and are frequently mistaken for breathing. If in doubt, start CPR.

Performing CPR

Compressions:

• Casualty on their back on a firm surface.
• Heel of one hand in the centre of the chest, on the lower half of the breastbone; other hand on top, fingers interlocked.
• Arms straight, shoulders directly over the hands.
• Compress about one third of the chest depth — roughly 5 cm in an adult.
• Rate 100–120 compressions per minute.
• Allow full recoil between compressions; leaning on the chest prevents the heart refilling.
• Minimise interruptions — every pause reduces the chance of survival.

Rescue breaths:

• Head tilt, chin lift; pinch the nose closed.
• Seal your mouth over theirs and blow steadily for about 1 second, enough to see the chest rise.
• Two breaths, then straight back to compressions.

If unwilling or unable to give rescue breaths, perform continuous compressions at 100–120 per minute. Compression-only CPR is far better than no CPR.

Continue until the person responds and breathes normally, a health professional takes over, it becomes unsafe to continue, or you are physically unable. Swap operators about every two minutes if help is available — compression quality drops fast with fatigue.

Using an AED

An automated external defibrillator is designed for untrained bystanders, and it will not shock a heart that does not need it.

1. Turn it on and follow the voice prompts.
2. Expose and dry the chest; remove or cut through clothing.
3. Apply pads as shown on the pads: one below the right collarbone, one on the left side below the armpit.
4. Stand clear while it analyses and, if instructed, while it shocks — ensure nobody is touching the casualty.
5. Resume compressions immediately after the shock or after a "no shock advised" message.
6. Leave the pads attached until handover.

Special cases: shave excessive chest hair if a razor is in the kit; remove transdermal patches and wipe the skin; place pads at least 8 cm from an implanted pacemaker; dry a wet chest before applying pads.

Electrical Burns

Electrical injuries produce burns that are far worse than they look:

• There is usually an entry and an exit wound. Find both.
• Current travels through tissue, so deep muscle, nerve and organ damage can exist under near-normal skin.
• Muscle breakdown can cause kidney injury hours later.
• Arc flash produces thermal burns and flash burns to the eyes, plus blast injury from the pressure wave.

Treatment:

1. Ensure the area is safe and isolated first.
2. Cool the burn with cool running water for 20 minutes — do not use ice.
3. Cover loosely with a non-stick, non-fluffy dressing or clean plastic wrap.
4. Do not apply creams, ointments, butter or ice, and do not break blisters.
5. Remove constricting jewellery and watches early, before swelling.
6. Treat for shock, keep the casualty warm and monitor breathing continuously.

Always Seek Medical Assessment

Every electric shock casualty requires medical assessment, even where they feel completely well:

• Arrhythmias can develop hours after the event.
• Internal damage may be extensive with minimal external signs.
• The casualty must not drive themselves to hospital.

Report the incident, preserve the scene where it is a notifiable incident, investigate the cause, and confirm the installation is safe before anyone works on it again.

Keeping Current

Queensland requires rescue and resuscitation training completed within the last 12 months for an electrical work licence. Certificates are not lodged with the application but the ESO may request them at audit, and exemptions are available only on medical grounds. Book the refresher on a fixed annual cycle so it never lapses in the week you need to renew.