Lightning Injuries, Lightning Injuries Management, Lightning Injuries Prevention

1. LIGHTNINGINJURIES
NCM 118 ED
Mary Juli-An P. Taylor,
MAN

2.  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 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

3. LIGHTNINGINJURIES  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.

4. RISKFACTORSOFLIGHtNINGINJURIES
 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.

5. TYPESOFLIGHTNINGINJURIES:
• 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)
• 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

6. SYMPTOMSOFLIGHTNINGINJURIES
 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 nervous system is most likely to blame for the injury.
Keraunoparalysis is frequent and 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
 Cataracts (within days)
• Confusion, poor cognitive function, and peripheral neuropathy are possible
neurological issues. In addition, there may be neuropsychological issues, such
as sleep disturbances, attention deficit, and memory issues.
 Cardiopulmonary arrest is the most
frequent cause of death during the strike.
The most frequent long-term sequelae are
cognitive deficits, pain syndromes, and
sympathetic nervous system damage
(including erectile dysfunction).

7. DIAGNOSTICPROCEDURES • 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

8. FIRSTAIDFORALIGHTNINGSTRIKE
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.
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.

9. IndoorSafetyTips
 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.
 Avoid windows, doors, porches, and concrete. Stay away
from windows and doors, and stay off porches.
 Don’t use corded phones. Corded phones are NOT safe to use
during a thunderstorm.
LIGHTNING SAFETY TIPS

10. OutdoorSafetyTips
 Be aware. Check the weather forecast before participating in
outdoor activities.
 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 to shore immediately.
 Don’t stay in open vehicles.
 Don’t stay in open structures and avoid open spaces.
 Don’t stay near tall structures.
LIGHTNING SAFETY TIPS