LIGHTNING INJURIES

NCM 118 ED

Mary Juli-An P. Taylor, MAN

Instructor
  Visible electrical discharge from a cloud. This happens when there is an
imbalance of charges between a region of the cloud and another surface
(usually the ground, a building, another region of the same cloud, or
LIGHTNING another cloud) that is significant enough to break through air resistance.
 Begins as static charges in a rain cloud. Winds inside the cloud are very
turbulent. Water droplets in the bottom part of the cloud are caught in the
updrafts and lifted to great heights where the much colder atmosphere
freezes them. Meanwhile, downdrafts in the cloud push ice and hail down
from the top of the cloud. Where the ice going down meets the water
coming up, electrons are stripped off.
 It's a little more complicated than that, but what results is a cloud with a
negatively charged bottom and a positively charged top. These electrical
fields become incredibly strong, with the atmosphere acting as an
insulator between them in the cloud. When the strength of the charge
overpowers the insulating properties of the atmosphere.
LIGHTNING
INJURIES
 Lightning can injure a person in several ways:
1. Lightning can strike a person directly.
2. Electricity from lightning can reach a person who is touching
or near an object that has been struck.
3. Electrical current can reach a person through the ground.
4. The shock can throw a person, causing blunt injuries.
 RISK FACTORS OF
LIGHtNING INJURIES
 Failure to acknowledge that lightning poses a threat.
 Lightning safety and injury prevention are not convenient.
 Lack of knowledge of lightning danger and the
mechanisms of injury also contribute to the risk.
 Popular belief of nothing attracts lightning.
 • Direct strike: uninterrupted connection between lightning bolt and object or
person (rare)
• Contact injury: lightning strikes object which the patient is touching (such as
car)
TYPES OF LIGHTNING
INJURIES: • Side splash/flash: lightning strikes nearby object or person and current splashes
or jumps onto the patient
• Ground current (step voltage): lightning strikes ground near the patient and
passes through ground into the patient
• Upward streamer
o strong negative charge in the atmosphere during storm induces a strong positive
charge in objects (such as towers, trees, or a person) underneath it on the ground
o the positive charge is pulled upward towards the negatively charged atmosphere
(upward streamer)
o injury occurs if there is contact between the upward streamer and lightning
strike but upward streamers without lighting contact can also cause injury
 Patients may also suffer from blast injury (nonelectrical) due to lightning's
blast effect (shock waves and thunder)
• primary blast injury usually manifests as ruptured tympanic membranes
• tertiary blast injury usually presents as blunt trauma when patient falls or is
thrown
  Lightning injuries can cause mild to severe signs and symptoms. They might be
temporary, or they might be permanent. Asystole and other arrhythmias, and
symptoms of brain dysfunction like amnesia, confusion, or loss of consciousness, can
all be brought on by an electrical charge.
 Keraunoparalysis: It is characterized by sensory deficits, lower and occasionally
upper extremity paralysis, mottling, coldness, and pulselessness. The sympathetic
SYMPTOMS OF LIGHTNING nervous system is most likely to blame for the injury. Keraunoparalysis is frequent and
INJURIES typically goes away in a few hours, though it can occasionally cause some degree of
permanent paresis. Additional signs of lightning damage include:
 Loss of vision or hearing.
 Chest pain or an erratic or rapid heartbeat
 Breathing difficulty.
 Muscle aches, stiffness, weakness, or momentary paralysis.
 Weak or absent pulse, fainting.
 Punctate or feathered, branched, minor skin burns
 Perforation of the tympanic membrane

 Cardiopulmonary arrest is the most frequent  Cataracts (within days)

cause of death during the strike. The most • Confusion, poor cognitive function, and peripheral neuropathy are possible
frequent long-term sequelae are cognitive neurological issues. In addition, there may be neuropsychological issues, such as sleep
disturbances, attention deficit, and memory issues.
deficits, pain syndromes, and sympathetic
nervous system damage (including erectile
dysfunction).
DIAGNOSTIC PROCEDURES • ECG (electrocardiogram) to check the heart
• Heart monitor to watch for arrhythmias (rhythm disturbances of the
heart)
• CT scan of the brain or abdomen
• X-rays
• Laboratory tests such as blood count and chemistries including
enzymes that may indicate heart damage
 1. Call for medical emergency help immediately.
2. The victim will not have any electrical charge on them. It is safe
for you to touch them.
FIRST AID FOR A LIGHTNING
STRIKE 3. Follow the DRSABCD protocol.
4. Check if the person is conscious and responsive. If they are not
responsive, look, listen and feel for breathing.
5. If their breathing is normal, place the person in a recovery position
and continue to monitor their condition for signs of deterioration.
6. If they are not breathing normally, commence CPR.
7. Continue CPR until help arrives or the person begins breathing
normally.
8. If they have sustained electrical burns, place the burnt area under
cool running water for 20 minutes. Cover the burns with a sterile
gauze bandage or a clean cloth. Do not use a towel as the loose
fibres can stick to the burns.
LIGHTNING SAFETY TIPS  Avoid water. Do NOT bathe, shower, wash dishes, or have any other contact
with water during a thunderstorm because lightning can travel through a
building’s plumbing.

 Don’t touch electronic equipment. Do NOT use anything connected

to an electrical outlet, such as computers, laptops, game systems, washers, dryers,
or stoves. Lightning can travel through electrical systems, radio and television
reception systems, and any metal wires or bars in concrete walls or flooring.
Indoor Safety  Avoid windows, doors, porches, and concrete. Stay away from
Tips windows and doors, and stay off porches.

 Don’t use corded phones. Corded phones are NOT safe to use during a
thunderstorm.
  Be aware. Check the weather forecast before participating in outdoor
activities.

LIGHTNING SAFETY TIPS  Go indoors or seek shelter immediately, even if caught out
in the open. Remember the phrase, “When thunder roars, go indoors.”
 Separate from others. If you are in a group during a thunderstorm,
separate from each other. This will reduce the number of injuries if lightning
strikes the ground.

 If you are out in the open water and a storm rolls in, return
Outdoor Safety to shore immediately.
Tips  Don’t stay in open vehicles.
 Don’t stay in open structures and avoid open spaces.
 Don’t stay near tall structures.