Electric Shock in the Fabrication Workshop
At 14:10 in a metal-fabrication workshop, a 34-year-old welder contacts a damaged 415 V extension lead and collapses. A co-worker shouts that the man is 'still shaking' and reaches to pull him away. The welder is now lying face-down on a wet concrete floor, unresponsive, with noisy gasping breaths every few seconds. A second worker runs for water and says they should sit him up. The workshop has a first-aid box, a backboard, and an AED mounted 90 seconds away at the main gate. The supervisor is not on site; you are the trained security guard. The power isolator is 20 metres away, but the area is cluttered with steel offcuts and an angle grinder is still running. The workshop floor is marked 'no mobile phones' because of a gas-cylinder store nearby.
1. What is your immediate sequence, and why must you not pull the welder away or give water?
Read the worked answer
Isolate the power first. Do not touch the casualty while he may still be in contact with a live 415 V lead. Stop the co-worker physically if necessary, go to the isolator, switch off, lock or tag it, and stop the angle grinder. Send someone to call 108 or the site emergency number from outside the marked no-phone zone, because of the gas-cylinder store. Then assess. Check response and breathing. Noisy gasping every few seconds is agonal breathing, not normal breathing; treat it as cardiac arrest. Roll him onto his back as a unit, start chest compressions at 30:2, and send for the AED. Do not pull him away: you risk electrocution and spinal movement. Do not give water: an unresponsive casualty cannot protect his airway and will aspirate. Do not sit him up: it worsens hypoxia and may precipitate arrest. If he starts breathing normally, place him in the recovery position and monitor continuously.
2. The AED arrives. Describe its use in this wet, industrial setting, including what you would not do.
Read the worked answer
Confirm the power is isolated and the area is safe before using the AED. Dry the chest and, if there is standing water, move him a short distance to a drier area or insulate the surrounding floor without delaying defibrillation. Turn the AED on, bare the chest, apply pads as shown, and follow the voice prompts. Clear everyone before analysis and before any shock, then resume CPR immediately after the shock or after the 'no shock advised' message. Do not use water to revive him, do not touch him during analysis or shock, do not place pads over a metal necklace or wet clothing, and do not stop CPR for more than the few seconds needed to analyse or shock. Do not delay defibrillation to search for a backboard, and do not let untrained bystanders move him. Continue until the ambulance crew takes over or he shows signs of life.
3. What should your handover and report include, and what workplace safety failures should be escalated?
Read the worked answer
Handover to the paramedic should include: time of collapse, suspected 415 V contact, time power was isolated, time CPR started, number of shocks and AED prompts, any change in breathing or consciousness, and the wet floor. Keep it factual and brief. The incident report should record the damaged extension lead, whether an RCD was fitted, the wet floor, the unsupervised lone working, the running angle grinder, and the AED's location and access time. Escalate to the factory manager and safety officer, preserve the lead and grinder, and request a lockout/tagout review and portable RCDs. Do not treat the report as the accident investigation itself; the guard's record is evidence, not a finding of fault.