Damage from a lightning strike

A lightning strike in a person can cause heart failure, loss of consciousness and temporary or permanent neurological disorders. Severe burns and internal injuries are rare. The diagnosis is established clinically. The examination includes ECG-cardiomonitoring. Treatment is supportive.

In the US, 50 to 75 people die every year from lightning strikes, and several times more people are injured. Lightning most often hits high objects. The impact can be direct, directly to the victim and mediated, through the ground or nearby objects located. Lightning can also penetrate from an external electrical network to an electrical appliance located in a house, telephone network. The force of the impact can throw the victim a few meters.

Although the electric current of lightning contains a large amount of energy, its action is extremely short-lived (from 1/10 000 to 1/1000 s). In this regard, lightning is rare, if ever, causing serious skin damage and in rare cases rhabdomyolysis or serious damage to internal organs, in contrast to artificial high voltage sources. Sometimes, the victims may have an intracranial hemorrhage.

Symptoms of damage from lightning

An electrical discharge can disrupt the work of the heart, triggering asystole or various kinds of arrhythmias, brain, loss of consciousness, stunning or amnesia.

When struck by lightning, it is possible to develop paralysis of the limbs, patchiness, coldness of the skin and lack of a pulse on the lower and sometimes upper limbs with motor and sensitive impairments. The reason is the instability of the sympathetic nervous system. Paralysis is typical for lightning injuries and is usually resolved within a few hours, although some degree of residual paresis can persist. Other signs of lightning stroke may include minor skin burns, with a dot or branching pattern, perforation of the tympanic membrane and cataract. Neurological symptoms may include stunning, cognitive deficits and peripheral neuropathy. Neuropsychological problems are also possible (for example, sleep disturbances, anxiety). The most common causes of death after a lightning stroke are heart and respiratory arrest. Cognitive deficits, pain syndromes, damage to the sympathetic nervous system are the most common remote consequences.

Diagnosis and treatment of damage from lightning

The thunderbolt is in many cases obvious, but it should also be suspected when, during or after a hurricane or a storm, people with amnesia or unconscious are found. When cardiac arrest and respiration begin cardiopulmonary resuscitation. All patients are hospitalized, ECG is removed, and cardio monitoring is started. Perhaps prolongation of the interval of QT, sometimes after 24 hours there are arrhythmias. Patients with chest pain, changes in the ECG, or impaired mental status assess the activity of the heart muscle enzymes. Patients with an initially altered mental status or deterioration in a later period, with central general cerebral neurologic symptoms, perform CT or MRI.

Provide supportive treatment. Fluids are usually restricted to minimize the threat of cerebral edema.

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Prevention of damage from lightning

To prevent lightning strikes, you must follow safety rules, know the weather forecast, have a rescue plan that includes evacuation to a safer place, and have enough time for it. If thunder is heard, or the interval between the sound of thunder and flash <30 s, people need to urgently seek refuge and stay there for at least 30 minutes after the last lightning or thunder. The most safe are large, habitable buildings or closed vehicles. Being indoors during a thunderstorm, people should avoid touching water pipes and electrical appliances, staying away from windows and doors and not using wired telephones or a computer. If during a thunderstorm you can not hide in a room it is necessary to avoid elevations, high objects, open spaces and water.