Lightning Injuries

Kimberly N. Treat Janet M. Williams Ann S. Chinnis

Pathophysiology Clinical.Features

Cardiovascular Injury

NeurolOffli.C.Jniu.ry

ResRiratoryJnjMry Peripheral, VasCMla.r . . Effects DermatologiC .Injury Ocularjnjury Otologicjnjury Gastrointestinal. Injury Renaljnjury

Muscujoskeleta!, .Injury

Psychosocial .Problems

Pregnancy

Diagnosis Treatment

Prehospital ..Treatment Emergency .Department ..Treatment

Disposition Prevention Acknowledgment Chapter. References

Lightning injury is one of the most frequent injuries by natural phenomenon and, although accurate data is lacking, is likely to result in several hundred deaths per year in the United States.12 Mortality rates associated with lightning have been estimated to range from 20 to 30 percent but are thought to be overestimated, because medical databases are biased toward collecting information on only the most severe and fatal cases and exclude the many less severe injuries that occur. 1 Nonfatal lightning injuries are more common, with estimates of several hundred to several thousand cases per year. I3,,4 As many as 75 percent of survivors sustain significant morbidity and permanent sequelae.

A significant number of lightning injuries are associated with transportation. 5 The majority of transportation-related lightning injuries occur when victims are struck while standing near a vehicle. Aircraft are at risk for lightning strike that injures or kills the occupants. Between 1963 and 1985, the National Transportation Safety Board recorded 40 lightning-related aircraft accidents (10 commercial and 30 private aircraft), with 290 fatalities and 74 serious injuries. 6

Sports are associated with increased risk of lightning injury. Among all outdoor activities, the largest number of injuries and fatalities have occurred during water sports.7

Even though lightning is electrical energy, lightning injuries differ substantially from high-voltage electrical injuries seen from human-generated sources: different injury patterns, different injury severity, and different emergency treatment.

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