Injuries from lightning relate to its potential to impart electrical as well as mechanical, thermal, acoustic, and photic forces to victims. Lighting creates mechanical energy in two ways: through the direct force of the strike or as a result of the rapid expansion of the surrounding air, which may cause victims to fall or be struck by flying debris. Blunt injury has been reported in 32 percent of lightning victims. 8 Lightning may inflict thermal injury as moisture on the victim's skin is transformed into steam, reaching temperatures between 8000° and 30,000°C. An individual found dead with tattered clothing nearby might even be mistaken for a crime victim when, in reality, the rapidly expanding steam blew clothing and shoes off. Lightning can also heat metal objects such as jewelry, watches, and coins in pockets and cause burns through direct skin contact. Sound waves caused by the thunderclap may rupture tympanic membranes and lead to other acoustic injuries. Photic injury caused by the bright flash may cause retinal damage and cataracts.
The nature and severity of injury also vary according to the type of lightning strike. There are five basic types of lightning strikes. A direct strike occurs when a victim is struck directly by a lightning discharge; this is the most serious form of lightning injury. The risk of a direct strike increases when individuals carry a metal object such as an umbrella or golf club or wear metal accessories such as hairpins, jewelry, hearing aids, or shoes with metal cleats. The side flash occurs when a nearby object is struck and current then traverses through the air to strike a victim. A side flash may injure multiple victims simultaneously, such as a softball team in a huddle near a structure that is struck. A contact strike occurs when lightning strikes an object that an individual is touching and current is directly transferred to the person. A ground current occurs when the lightning hits the ground and is transferred to a person standing near the strike site. The amount of current reaching a victim decreases as the radius between the victim and the strike point increases. A stride potential or step voltage occurs when lightning strikes the ground and encounters a potential difference between the legs of a person. The current enters the closer leg, traverses the lower body, and exits through the farther leg. This may result in keraunoparalysis, which is characterized by temporarily paretic, cold, insensate, and pulseless legs.
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