Lightning Injuries Causes, Symptoms, Diagnosis, And Treatment Process

Lightning injuries occur when a person is struck directly or indirectly, leading to various immediate and long-term effects. These injuries can include cardiac arrest, respiratory failure, neurological damage, burns, and mechanical trauma from the explosive force of a strike.

Lightning Injuries Causes

• Direct strike: The person is directly hit by lightning, one of the most direct and severe forms of lightning injury.
• Contact voltage: A person may be injured by touching or being near an object struck by lightning, such as metal fences or poles.
• Ground current: One of the most common forms, where lightning strikes an object or the ground, and the resulting electrical energy spreads out from the strike point, impacting people nearby.
• Conductive discharge: Occurs when lightning strikes a taller object near a person, and part of the current jumps to the person, often through a nearby object they are touching.

Lightning Injuries Symptoms

• Cardiac issues: Immediate effects can include cardiac arrest (the heart stops beating) or erratic heartbeats. In cases where the heart restarts, if breathing has not resumed, there can be oxygen deprivation.
• Neurological impact: Lightning strikes can cause immediate loss of consciousness. Severe brain injury might lead to coma, and survivors often experience confusion, memory loss, and slower thought processes.
• Physical injuries: The skin might show no visible marks or might exhibit minor burns with a distinctive feathering pattern. More severe internal burns are less common but possible.
• Sensory damage: Eardrums might be ruptured, and various eye injuries, including cataracts, can occur post-strike.
• Temporary paralysis: Both legs often experience temporary paralysis, becoming blue and numb, known as keraunoparalysis.
• Peripheral neuropathy: Damage to the peripheral nerves can lead to long-term numbness, tingling, and muscle weakness.

Lightning injuries Diagnosis

• Physical Examination: A comprehensive physical exam assesses visible injuries and symptoms. This might include checking for burns, examining the eyes and ears for injuries, and evaluating neurological responses.
• Electrocardiogram (ECG): An ECG is performed to evaluate the heart for abnormalities. This test is crucial as lightning can cause immediate cardiac issues, such as arrhythmias or cardiac arrest.
• CT Scans and X-rays: Imaging tests such as CT scans or X-rays check for internal injuries, including fractures, bleeding, or damage to internal organs.
• Laboratory Tests: Blood and urine tests are conducted to detect any chemical imbalances or organ damage. These tests can help assess the extent of muscle damage and other internal injuries.
• Neurological Assessments: Detailed neurological exams may be performed, given the high risk of neurological damage from lightning strikes. These assessments help determine any cognitive impairments or motor function anomalies that may have resulted from the strike.

Lightning Injury Treatment Process

Immediate Response and Stabilization:

• Emergency CPR: Initiate cardiopulmonary resuscitation if the victim is unresponsive and not breathing to preserve vital functions until emergency medical help arrives.
• Emergency Medical Services (EMS): Immediate contact with EMS is crucial. Upon their arrival, EMS will undertake further resuscitation efforts, if necessary, and transport the victim to a medical facility.

Hospital Treatment:

• Comprehensive Assessment: Once at the hospital, the patient undergoes a full assessment, which may include an electrocardiogram (ECG) to evaluate cardiac activity and various imaging tests like X-rays or CT scans to identify internal and skeletal damages.
• Medical Observation: Victims often require close observation in a hospital setting to monitor potential delayed effects of the strike, such as cardiac abnormalities and neurological issues.

Specific Interventions:

• Cardiac Care: Monitoring and managing heart conditions with medications or interventions to address arrhythmias or other cardiac injuries.
• Wound and Burn Care: Treating burns and other physical injuries may involve using burn creams, antibiotics to prevent infection, and surgeries for severe cases.
• Neurological Care: Management of neurological symptoms includes medications to reduce brain swelling and supportive therapies to recover function.

Supportive Treatments:

• Physical and Occupational Therapy: Rehabilitation services to help recover mobility and functional ability if the victim has experienced paralysis or other motor impairments.
• Psychological Support: Mental health support to address the psychological impact of the traumatic experience, which might include counselling or therapy for post-traumatic stress.

Follow-Up Care:

• Routine Monitoring: Regular follow-up visits with healthcare providers to monitor the recovery process, adjust treatments, and manage any long-term complications.
• Ongoing Rehabilitation: Continuous rehabilitation efforts may be required, depending on the severity of the injuries and the individual's recovery pace

Prevention of Lightning Injuries

• At the first sound of thunder, find a safe place indoors, such as a substantial building with electricity and plumbing. If no buildings are available, a metal-topped vehicle with windows up can also offer protection.
• Do not use corded phones, computers, or electrical appliances during a storm. Avoid baths, showers, and faucets, as plumbing can conduct electricity.
• Remain indoors for at least 30 minutes after the last thunderclap. This duration ensures the storm has moved sufficiently far away to reduce the risk of strikes.
• Avoid open fields, the top of hills, or ridges if caught outside. Stay away from tall, isolated trees or other tall objects.
• If you cannot reach shelter, make yourself the smallest target by squatting low to the ground on the balls of your feet. Place your hands over your ears and your head between your knees to minimize contact with the ground.

When to Contact Your Healthcare Provider?

• Persistent Pain: If you experience pain that doesn't improve with over-the-counter pain relievers.
• Trouble Breathing: Any difficulty breathing or shortness of breath that occurs after being outdoors during a storm.
• Changes in Physical or Mental Status : Confusion, difficulty remembering, or behavioral changes that could indicate neurological damage.
• Signs of Infection: Increased redness, swelling, pus, or fever around a burn or wound.
• Heart Rhythm Problems: Feelings of a fast, irregular, or pounding heartbeat.