Lineman, Shawn Spiwak’s was working when he was hit by 7,200 volts of electricity by what was thought to have been a dead wire. His elbow had brushed against the line when electricity ran through his body, sparks flying from his chest.  He fell backwards and was left dangling upside down from his safety harness.  His arm had been burned through and through.  There were entry and exit points left by the electricity.  He was severely burned and eventually lost his right leg at the hip and his right arm and shoulder well into his clavicle.

Electrical injuries often lead to amputation as well as a multitude of other problems which result with the nervous system of the body is short circuited.  The electricity literally burns from the inside out.  What you see on the outside is far worse on the inside.  Treating a patient with electrical burns is very complex and usually have a host of other issues which come up during the treatment.  The body is unable to regulate temperature.  The dead tissue (eschar) has to be cut away daily.  Typically the patient is placed on a ventilator and oftentimes placed into a medical coma.  Feeding tubes are placed to help provide the increased protein needed for wound healing.

These injuries leave an individual with many deficits.  Mr. Spiwak’s walked with a limp secondary to the prosthetic limb.  He is stared out and children often ask about his prosthesis to which he replies, “robot parts”.  Like others with severe injuries, Mr. Spiwak notes it takes more time to do everything.  Simple things like buttoning your clothes, putting on your shoes, opening a bottle, brushing your teeth; all require additional effort and sometimes assistive devices in order to complete the tasks.  Scar management is life long which requires multiple surgeries, compressive devices, and therapy.

Electrical amputation is one of the many topics of an upcoming Nurse Life Care Planning conference scheduled for October 2010.  As a Nurse Life Care Planner and Nurse Case Manager, I am often called on to coordinate care for or develop a life care plan for persons suffering amputation injuries.  If you want to learn more about this devastating injury, please join us in Boston on October 8-110, 2010.

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