202 CARE OF PATIENT IN DIAGNOSTIC RADIOGRAPHY

makes the victim unable to release his hold of a 'live' electric conductor.
If current flows through the body for a long enough time, irreversible
damage to the body cells will occur.
The first thing to do immediately for the victim of an electric shock if
he is still in contact with the circuit is to switch off the supply at the mains
switch, so that the apparatus is no longer 'live'. In the X-ray department
it will generally be possible to do this.
If for some reason it is not possible to cut off the supply and the patient
has to be pulled away from the apparatus while it is still 'live', unless the
rescuer is insulated from the current there will quickly be two victims of
electric shock. The rescuer should therefore stand upon some insulating
material — a cork or rubber mat or a thick blanket. This is particularly

important if the floor is wet. A dry wooden floor and a dry floor with a
rubber surface both provide reasonable insulation for mains voltage. A
dry floor made of polyvinyl tiles provides insulation for voltages below
iooo volts, and therefore gives protection at mains voltage level.
The patient should be pulled away by the clothing and the rescuer's
hands should be protected by insulating material, for example rubber or
cloth. All articles used for the purpose of insulation must be dry. In the
X-ray department lead rubber aprons and gloves may be readily available,
and may suggest themselves as suitable material for insulation. Lead
rubber will be adequate for voltages up to 400 volts, but is not reliable
protection in the case of high voltage sources. It would be reasonable to
use it if the electrical apparatus concerned were operating on the 230 volt
mains supply. It should be realized that in the case of a.c. supplies the
stated mains voltage is not the highest value reached during the a.c. cycle.
The voltage increases to a peak value which is equal to the stated value
multiplied by the factor 1.41. In the design of equipment, insulation
requirements are based on peak values of voltage.
Once the patient has been rescued from the source of the current, the
treatment required will depend upon the injury sustained. The conditions
which may be present are:

arrest of the heart beat,

(ii) (i)

suspended respiration,
(iii) burns,
(iv) shock.
The rule in all first aid procedures to treat the most serious condition
is

first, and and clearly require immediate medical assistance; (iii) and
(ii)
(i)

(iv) are of less urgency.