ABSTRACT

Electrical forces can inflict injury in various ways that include both thermal and nonthermal mechanisms. Nonthermal mechanisms include membrane electroporation and electroconformational denaturation of membrane proteins. Nonthermal injury mechanisms produce destructive changes on the timescale of milliseconds or less. Thermal burn mechanisms require field exposure on the scale of seconds or more. Nerve and muscle are prime targets for nonthermal mechanisms of injury. Pain and disability are frequent manifestations expressed by survivors. The injury resulting from the combination of thermal and electric effects depends on several variables, including the tissue field strength, duration of exposure, frequency, and current path. This chapter reviews the destructive changes to cellular structure resulting from exposure to commercial electrical power sources and the resulting manifestations at the organ system level. Several important new therapeutic approaches to treat and possibly reverse the molecular alterations of electrical shock are discussed.