SHOCK

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shock ppt

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Slide 1:

Dr. CH. BHARGAVI MPTh (NEURO ) SHOCK

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Electric shock A shock is a painful stimulation of sensory nerves caused by a sudden flow or variation in the current passing through the body. It can be caused by poorly designed Thor badly serviced electro medical apparatus. Severity of shock The greater the current which passes through the body the more severe is the shock. In accordance with Ohm's law the magnitude of the current depends on the electromotive force EMF and the resistance. A high EMF is liable to producing large current.

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The EMF available for the patient is limited to the maximum likely to be required for the treatment. Most operators used in Physiotherapy department is plugged into the main supply of 240 volt and frequency 50 Hertz. This therefore represents a hazard has a source of electric shock. The lower the resistance of the skin the greater the current which passes through the body. The severity of the shock also depends on the path taken by the current. Strong current through the head neck heart or whole body might prove fatal. Shocks are also generally more severe with alternating than with direct current because of the intensity. It may also produce muscular contraction which make it possible for the victim to let go of the conductor.

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Effects of the electric shock Following a minor shock the victim may be frightened and distressed but does not lose consciousness. After a more severe electric shock there is a fall in blood pressure and sometimes loss of consciousness. In extreme cases there is a cessation of respiration which may be accompanied by cardiac arrest due to ventricular fibrillation resulting from electrical stimulation of the heart. Cessation of respiration is recognised by lack of respiratory movements and cyanosis cardiac arrest by absence or abnormality of respiratory movements absence of pulse in the carotid artery and fully dilated pupils.

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Treatment of electric shock In the event of a shock occurring the first step is to disconnect the victim from the source of supply. The current should be switched off at once. If there is no switch in the circuit the victim must be removed from contact with the conductor. The rescue 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. Following a minor show the patient is reassured and allowed to rest. Water maybe given to drink but hard ring should be avoided as the cause vasodilation and sweating. If the shock is more severe the victim is laid flat in such a position that respiratory passages are clear.

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Tight clothing is loose end and plenty of air allowed. If the patient is unconscious nothing is given by mouth and medical officer is summoned without delay. If respiration has ceased the Airway is cleared and artificial respiration commenced immediately by the mouth to mouth or mouth to nose method or oxygen administrated by a bag and mask. In the event of the cardiac arrest external cardiac massage must be applied in addition to the above. In all cases of respiratory failure or cardiac arrest it is essential to call immediately for medical help. Causes of shock and precautions A patient may receive a shock in the course of an electrical treatment as a result of a sudden Increase in the current.

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This may occur if a low frequency current is switched on with the controls turned up. It can also occur if the intensity control is turned up unduly during the intervals in the flow of an interrupted or surged current or if the patient touches and exposed part of the circuit. To avoid the occurrence of shocks from this causes all operative should be tested before use and connections checked. Control should be checked to ensure that they are at 0 before switching on adequate warming up time should be allowed in the current intensity increased with care. Patient should never be allowed to touch electrical equipment and all operators should be serviced regularly by a competent electrician.

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The physiotherapist may receive a shock when handling equipment if two life path of the circuit are touched at the same time. Apparatus should always be disconnected from the source of supply before Faults or investigated. When light contact is made between two conductors which I change to different electrical potential spaces between them. Such sparking may occur on touching short wave diathermy electrodes to which current is applied. Sparking causes unpleasant sensory stimulation but is not dangerous and should not really be classed as an electric Shock. Earth shock When a shock is due to a connection between the live wire of the main and Earth is known as Earth shock.

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The earth circuit Electrical power is transmitted by 1live cable and 1 neutral cable which is connected to the earth. The earth forms part of the conducting pathway and any connection between the livewire of the main and Earth completes is circuit through which current passes. Connection to the live cable A patient who is receiving treatment with a current that is not Earth free is connected to the live cable. Such a connection can also be made by touching and exposed part of the circuit. If the switch breaks only the neutral wire the connection can be made even when the switch is turned off.

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Connection to earth This may be made by touching any conductor which is connected to the earth such as gas or water pipes radiators or stone floors particularly if they are damp. A metal bed on such a Floor or one which is in contact with a pipe or radiator forms and earth connection. Examples of earth shock Simultaneously connection to the live wiring to the earth can occur in a variety of ways a patient who is receiving treatment with a current that is not Earth free main rest or hand on a water pipe. A physiotherapist holding an electrode that is connected to the live wire main touch the earth Apparatus causing. If someone standing on the damp stone floor touches the causing of Apparatus which is not connected to earth find with which the live wire is in contact he too will receive the earth shock.

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Precautions against the shock Physiotherapy department should be arranged so that there is minimum danger of anyone making an earth connection while in contact with apparatus. Water and gas pipes should be out of reach of the Apparatus and of patients receiving treatment. The floor should be insulating material and should be kept dry. If the floor is not of insulating material a non conducting mat should be placed under the patient's feet during electrical treatments. Switches must be break the livewire so that define electric circuit is maid and a large current passes the fuse blows and stops the current flow. Special care must be taken when current are administered in bath as in the circumstances and earth connection is easily made.

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The bath must be of insulating material iron leaking bath must not be used The bath must be of insulating material and leaking baths must not be used Water should not be added to the bath but during treatment Current used for the treatment of patients should always be Earth free The current obtained from batteries is always Earth free .

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Types of electric shock Electric shocks can be of three types depending upon the nature and amount of current flow and can also be classed has two types depending upon the severity. Depending upon the nature and the amount of current flow electric shocks can be. Macroshock Micro shock Macro shock Is the current flows is from the body surface through the skin into the body a relatively large amount of current is needed to produce a harmful shock called macroshock . Micro shock If the current by passes the surface of the body and enters the heart by way of myocardial electrodes.

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For example therapies may be handling the patient with electric monitoring device on the heart. If at the same time he connects his hand to end faulty table lamp or some device with a broken ground connection whilst palpating the patient's chest then he could give the patient in micro shock and cause ventricular fibrillation. Depending on the severity of shock Mild shock Severe shock Mild shock When the intensity of the current that give rise the shock is up to 20 milliamperes. The patient may only get a painful sensory stimulation. There is no loss of consciousness.

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Severe shock If the current law is more than 20 milliamperes IT results in difficulty in letting go. Muscle paralysis fall in blood pressure loss of consciousness ventricular fibrillation cardiac arrest in a few cases resulting in death. Death usually occurs with the current that is above 100 milliamperes and is must with a current of 200 milliamperes and above. Depending upon the faulty wiring of houses and equipments. The shock could be. Earth shock.

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Dr. CH. BHARGAVI MPTh (NEURO)

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