A 25-year-old electrician survives a high-voltage electrical injury. He has a small circular entry wound on his right palm with central charring and surrounding blanched skin (Joule burn). Where would the EXIT wound MOST likely be located, and what would its appearance be?
- A Upper arm — explosive, larger than entry
- B Lower abdomen — identical in appearance to entry
- C Neck — arc marks with feathering
- D Right foot sole — crater-like, typically larger and more irregular than entry ✓
Explanation
High-voltage electrical current travels the path of least resistance through the body; when entering through the hand, it typically exits through the feet which are in contact with the ground. The exit wound (ground contact point) is typically larger, more irregular, and "blown out" or crater-like compared to the entry wound, because current exits explosively over a small ground-contact area. The entry wound (Joule burn) has a classical round/oval shape with central charring, blanched margins, and elevated edges. Arc marks (flash burns) from electrical arcing do not require body contact and produce feathering/fernlike patterns.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.