Electric shock

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Scene 1 · Opening

22.50, the workshop at the bottom of the garden. She was rewiring a socket while you put the tools away outside.

You hear a sharp crack, then nothing. She is on the floor, the drill beside her.

A bare cable runs as far as her hand, and the inspection lamp is still lit.

Scene 2 · The first reflex

She is not moving. The cable is against her hand, the lamp is on: so there is still power in this workshop.

The fuse box is on the wall, behind the workbench, six metres away.

She is two metres from you. What do you do?

• Right move : I do not touch her. I go to the fuse box and switch the power off.
  Cut first, touch second : The life-saving actions syllabus sets it out as a question and an answer: anyone touching the casualty can get a shock, and the rescuer has to protect himself in order to be able to help. How do you stop the danger? By switching the power off at the breaker. Protection comes before any rescue action at all.
• Mistake : I grab her by the arm to pull her away from the cable.
  The current has just gone through you as well : The health insurance guidance puts it before anything else: do not touch the casualty with bare hands, because she may still be in contact with the source of the electricity. If you touched her, the current could then pass through you too. The human body is 60 % water: it conducts.
• Not the best choice : I unplug the broadband router in the house, you never know.
  The neighbour loses his series, and she is still on the floor : There is exactly one thing in this house to operate, and it is grey, on the wall, with a switch on it.

Scene 3 · The power is off

Switch down. The lamp goes out, the workshop turns the blue of the night through the window.

Now, and only now, you can touch her.

The power is off. What do you check?

• Right move : I kneel down, I speak to her, I shake her shoulder, and I watch her chest for ten seconds.
  The danger is gone, now you assess : Protection comes before any first aid action, and it is done: the power is off at the breaker. From there, everything goes back to ordinary first aid, and the guidance puts a limit on the time: look for the absence of a response, then assess breathing for ten seconds at most. Does she respond, does her chest rise: two questions, and everything else follows.
• Mistake : I could not find the fuse box: I push the cable away with the broom handle.
  Damp wood protects you from nothing : The civil safety recommendations carry this as a footnote, and it is there for exactly this reason: materials such as damp wood or clothing give no protection at all against electric current. If you truly cannot switch the power off, the Assurance Maladie talks about a DRY, non-conducting object, and about insulating yourself from the ground.
• Mistake : I put my work gloves on and start compressions, time is short.
  Cloth, on a live cable : Clothing gives no protection at all against electric current: it is written into the civil safety recommendations. A rescuer on the floor next to the casualty is rescuing nobody, and he has doubled the crew's work.

Scene 4 · She is not breathing

She responds neither to your voice nor to your hand. Her chest is not moving.

Your sister has just come into the workshop with her phone.

She is not responding and not breathing. What do you do?

• Right move : I shout at her to call 15, and I start chest compressions right now.
  Get someone to call, and press : The fire and rescue services give the procedure in three lines: if the casualty is breathing, put her in the recovery position; if she is not breathing, do chest compressions; call for help on 18 or 112. A bystander with a sharp instruction goes at once; a bystander who has been told nothing just watches.
• Mistake : I put her in the recovery position while I wait for help.
  The recovery position is for someone who is breathing : The procedure splits at exactly that point: if the casualty is breathing, recovery position; if she is not breathing, chest compressions. She is not breathing. On her side, nothing is moving, and the current may have stopped her heart.
• Mistake : I look for burns on her hands and feet so I can cool them.
  What counts is inside, and she is not breathing : The public guidance warns that the marks on the skin can be tiny while the internal injuries are severe: the current can damage the heart, the muscles and the lungs along its path. It is not the skin you treat first, it is the circulation.

Scene 5 · She comes back

After a long run of compressions she takes a sudden breath, coughs, and starts to talk.

She wants to get up. She says she is fine, that she just got a jolt.

She is breathing and talking. What do you do?

• Right move : I keep her lying on her back, I watch her breathing, and I do not let her go: she is going to hospital.
  On her back, and ready to resume compressions : The national syllabus writes the same sentence in each of its four cardiac arrest sheets: if the casualty starts to come round, that is she moves, opens her eyes and breathes normally, stop the chest compressions and the ventilation, keep a constant watch on her responsiveness and her breathing while keeping the casualty on her back, and stand ready to resume CPR because of the major risk that the cardiac arrest comes back. She moves, she opens her eyes, she talks: that is exactly this sentence. The national health insurance body only rolls her onto her side under the heading “If the person is unconscious”, and the fire and rescue page printed further down writes it without that condition: the sources diverge, and on a question of position it is the national syllabus that settles it. On her side you would have to roll her back before starting again, and those are the seconds you do not have.
• Mistake : She says she is fine, I will let her go to bed and cancel the call.
  She has sat back down in the middle of the workshop : The deep injuries from an electric shock show up afterwards: muscle pain and spasms, drowsiness and confusion, an irregular heartbeat. Anyone who has had a shock has to be seen by a medical team, and how fast it happens decides a great deal. “I am fine” is not an examination.
• Mistake : I walk her back to the house, she will be better off in an armchair.
  She has come out of an arrest, she does not walk : Somebody who has just arrested and come back under compressions is not somebody who has recovered. The guidance asks for prompt medical assessment of the internal injuries, and until then she does not get up and she does not walk: you keep her where she is, watched.

Scene 6 · The wait

She is on her back, talking in short sentences. Your sister is on the line with 15.

It has been dark in the workshop since you threw the switch, and nobody can see a thing.

Six minutes to go and there is no light. What do you do?

• Right move : The power stays off. I say so out loud, and I light the place with my phone.
  The danger is not gone, it is held down : The syllabus defines protection as moving aside or removing, PERMANENTLY, any danger that threatens. A switch put back up cancels the protection. The cable is still on the floor, and the crew will arrive in the dark knowing it.
• Mistake : I put the switch back up to get the lamp on, we cannot see anything.
  The cable is still on the floor : Protection has to be permanent: moving aside or removing the danger for good is what makes it protection rather than a pause. The bare cable has not moved, you are kneeling next to it, and the crew is going to walk straight into it.
• Mistake : I go out to wait for the crew on the pavement so I can let them in faster.
  Nobody is watching her breathing any more : She has just come back from an arrest: her breathing can stop again, and that is the one thing somebody has to see coming. Your sister is already on the phone, she can go and open the gate. You stay.

Scene 7 · The crew

Blue light through the workshop window, head torches, four people.

The first question they ask on the way in is about the power. You tell them it is off at the fuse box, and that the cable is there, on the floor.

You spent the first six seconds of this one not touching her. That is the move that made all the difference.