First Aid, CPR, and Electrical Emergency Response

Why First Aid and Emergency Response Matter for Lineworkers

Electrical lineworkers face hazards that can kill or cause serious injury in seconds. Electrocution, arc flash, and falls can all render a coworker unresponsive in the field, often far from a hospital. Your ability to respond correctly in the first few minutes—before emergency medical services (EMS) arrive—is the difference between life and death. That is why First Aid/CPR certification is a required credential in this program and on most utility worksites.

Electrical Contact Injuries: What Happens to the Body

When a person contacts an energized conductor, electrical current passes through the body. The effects depend on the voltage, current path, and duration of contact. Common results include:

• Cardiac arrest – current disrupts the heart's electrical system, causing it to stop pumping effectively
• Respiratory arrest – current can paralyze the muscles that control breathing
• Internal burns – current travels through tissues, destroying muscle and nerves along its path; external wounds may look small while internal damage is severe
• Surface burns – at the entry and exit points of the current
• Trauma injuries – a victim thrown by the shock may suffer fractures or head injuries from the fall

Do not assume that low voltage means low danger. Even household-level current can cause cardiac arrest under the right conditions.

Approach Safety: Do Not Become a Second Victim

The single most critical rule when a coworker contacts an energized conductor is: do not touch the victim until you are certain the circuit is de-energized and locked out. Rushing in without verifying this kills rescuers every year.

Use this sequence:

1. Call out — shout to alert the crew and get someone calling 911 immediately

2. Identify the hazard — determine what conductor or equipment is involved

3. De-energize and lock out/tag out (LOTO) — the qualified person or switching operator must open the circuit, lock it, and confirm it is de-energized before anyone approaches the victim

4. Maintain safe distance — if a downed conductor is still live, stay well back and keep bystanders back; do not approach until the utility confirms the line is dead

5. Verify before contact — only then approach the victim and begin care

Remember: approach-safety is not optional even when every second counts. A dead rescuer cannot help anyone.

Activating the Emergency Action Plan

Every utility jobsite must have a written Emergency Action Plan (EAP). Before work begins each day, every worker should know:

• The location of the nearest AED and first aid kit
• The emergency contact number for the worksite and the nearest hospital
• Who is authorized to open the circuit (switching operator)
• The assembly or staging area for emergency vehicles

When an emergency occurs, one person calls 911 and one person leads first aid—these do not have to be the same person. Send someone to the road to flag down and guide the ambulance.

Hands-Only and Full CPR

Hands-only CPR (compression-only) is appropriate when a bystander is not trained or is not comfortable with rescue breaths. Push hard and fast in the center of the chest at a rate of 100–120 compressions per minute and a depth of at least 2 inches (but no more than 2.4 inches) for an adult.

Full CPR adds rescue breaths: 30 compressions followed by 2 breaths (30:2 ratio). Tilt the head, lift the chin, form a seal over the mouth, and give each breath over about one second—just enough to see the chest rise.

Key quality points:

• Allow the chest to fully recoil after each compression; do not lean on the chest
• Minimize interruptions; keep pauses to under 10 seconds
• Switch compressors every two minutes to maintain quality
• A metronome or the beat of a well-known song at 100–120 BPM helps hold the right rate

Continue CPR until an AED is ready, EMS takes over, the victim shows obvious signs of life, or you are physically unable to continue.

Using an Automated External Defibrillator (AED)

An AED delivers a controlled electrical shock to restore a normal heart rhythm in cases of ventricular fibrillation or pulseless ventricular tachycardia. Steps:

1. Power on the AED (open lid or press the power button)

2. Attach the pads as shown in the diagrams on the pads—one on the upper right chest, one on the lower left side

3. Ensure no one is touching the victim while the AED analyzes the rhythm

4. If a shock is advised, confirm everyone is clear, then press the shock button

5. Immediately resume CPR for approximately two minutes before the AED re-analyzes

Do not delay or interrupt CPR unnecessarily while setting up the AED. Have a team member attach pads while compressions continue when possible.

Bleeding Control

Electrical injuries and associated trauma can cause serious bleeding. Use standard bleeding-control steps:

1. Apply direct pressure with a clean cloth or sterile dressing and hold firmly

2. For a limb wound with life-threatening bleeding, apply a tourniquet 2–3 inches above the wound; note the time of application and do not remove it in the field

3. For wounds where a tourniquet cannot be applied (shoulder, groin), use a wound-packing technique with a pressure bandage

4. Maintain pressure and keep the victim calm and warm until EMS arrives

Always wear latex-free gloves before providing care to protect yourself and the victim.

Burn Care for Electrical Injuries

For electrical burns, cover the wound loosely with a dry, sterile dressing or burn dressing. Do not apply water, ice, or any ointment to serious electrical burns in the field. Keep the victim still and monitor airway and breathing continuously, as electrical injury victims can deteriorate rapidly.

Always transport electrical contact victims to a hospital even if they appear uninjured—internal damage and delayed cardiac events are common.