Electrocution is not always an easy diagnosis to make. The history and circumstances of death are vitally important because low-voltage deaths frequently cause no injuries on the body. On the other hand, high-voltage deaths are easier to diagnose because of obvious burns.
The cause of death from electrocution is related to the amount of current (or amperage) flowing through a body. Although both direct and alternating currents can be lethal, most deaths occur from contact with alternating currents having low voltages such as 110 or 220 usually found in homes.
There needs to be a complete circuit from the power source to the ground for death to occur. A person will not become electrocuted if insulated from the ground. The direction the path takes in the body determines whether shock will be fatal. An arrhythmia is likely if current travels through the heart.
External injuries may vary tremendously. The extent of external wound damage is dependent upon the amount of current and its duration. If a current is spread over a wide contact area for a short duration there will not be any injuries to the skin. Clothing may be damaged so it must be retained for examination. The skin may be secondarily injured by burning clothes.
Low voltage tends to cause easily overlooked small burns especially on the hands and the feet. The lesions may be red, black, or white and inconspicuous, with depressed firm white centers. High-voltage deaths usually leave easily recognizable, deeply charred areas. Lesions may be present at the entrance and/or exit sites.
If a death occurs due to working with electrical equipment, the equipment will need to be tested by a qualified individual.
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