Lightning - Part 1

Because lightning strikes have caused some serious injuries recently, an article in the "Journal of Emergency Medical Services" should prove interesting, and is abstracted below.Lightning causes over 1,000 injuries annually in the United States and accounts for more deaths (about 200 to 300 per year) than any other weather phenomenon. Seventy to 80 percent of those struck by lightning survive.

Most lightning strikes occur between May and September. High-risk groups for lightning injuries include outdoor enthusiasts, such as campers and golfers, and those with predominantly outdoor occupations, such as farmers, construction workers and forest rangers.

**Types of injuries

Cardiac injuries. Cardiopulmonary injury after a lightning strike is fairly common, with cardiac arrest of major concern.

Neurologic injuries. These, too, are common following lightning strikes. Half of the victims are rendered unconscious and nearly two-thirds have temporary lower extremity paralysis. Seizures may occur.

Burns. Resulting burns tend to be very superficial. The "lightning print" has been described as a spidery, feathery, branching, very fine superficial burn. Damage to the skin or deep muscles is unusual. It is rare to have entry and exit wounds with lightning injuries. Sometimes, thermal burns may occur due to ignition of clothing or superheating of metal objects in contact with the victim.

Blunt trauma. Victims may be thrown a considerable distance from the strike site. The resultant force - the so-called "sledgehammer effect" - can cause head injury, intercranial bleeding, spine fractures, dislocations, fractures and chest or abdominal trauma.

Other injuries. Eardrum rupture occurs in half of all victims of lightning injury. Blood and/or cerebrospinal fluid may be noted in the external ear canal. Loss or change in vision and delayed cataract formation occur in over half the victims.

**Prevention

Prevention represents the best treatment for lightning injuries. Although the chance of being struck by lightning is slim, the most effective way to prevent being struck is to avoid dangerous situations during rainstorms and electrical storms. During thunderstorms, stop outdoor activities.

Hair on the neck standing on end, though not always present before lightning strikes, indicates the increased potential for being struck since the difference of electrical energy between the cloud and the earth is mounting.

If caught in a sudden electrical storm, seek shelter in a building or a car. If no shelter is available, stay away from objects that project from the ground. Avoid standing near tall structures and metal poles or beneath metal shelters. A grove of trees that is shorter than nearby taller trees is preferable to wide-open fields. If caught in a wide-open field, seek the lowest available area.

Discard all metal objects such as golf clubs and umbrellas. Do not fly a kite in the rain. It is also extremely dangerous to swim during a thunderstorm; a water strike can occur and water can conduct electricity.

If several people are caught in an electrical storm, they should spread out if adequate shelter is unavailable to avoid multiple victim involvement.

Lightning does strike twice in the same place, so if one strike has happened, it may not be safe to venture out of a proper shelter.

Note: Next week's column features first aid for lightning-strike victims.

**Alton Thygerson is a professor of health sciences at Brigham Young University.