Ions leaking across membranes by electrodiffusion are pumped back in by ATP-driven pumps. The cell membrane properties which limit this leakage include resistance to ion transport, which in turn serves to conserve energy. When contact is through an electric arc, thermoacoustic blast force can significantly add to the injury. All these mechanisms lead to increased cell membrane permeability and energy depletion. The higher the temperature, the shorter the exposure time required for adverse effects.
Thermoacoustic blast can also cause a significant blunt trauma and associated fall injuries.
The molecular physics of the process is not completely understood, but in effect, the strong electric fields established within the cell membrane by large, induced transmembrane potential attract water into the membrane until large pores or defects form. Electroporation occurs in less than one millisecond, and most cell membranes rupture when more than 0.8 to 1 V of transmembrane potential is imposed. The pattern of tissue injury is also a consequence of the body's electrical properties. All tissues except the skin are relatively good conductors. Large currents can then pass and produce tissue damage, especially to skeletal muscle and nerve.