Lightning Injuries

Lightning Injuries is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Lightning is a discharge of energy that occurs cloud to cloud (90%) or cloud to ground (10%)
  • Exposure to lightning:
    • Brief duration (1–100 ms)
    • Typically occurs during outdoor activity
    • Highest incidence in summer months, between 3 and 6 PM
    • Fatality rate of 8–10%

Etiology

  • Mechanism of injury—electrical:
    • Direct strike (5%)
    • Contact potential (15–25%):
      • Current passes through an object the victim is touching
    • Side splash (20–30%):
      • Current jumps from nearby object to the victim
    • Step voltage, or ground potential (40–50%):
      • Current moves through the ground surface and may injure multiple victims
      • Current moves through hard-wired telephone lines, metallic pipes, or a structure's electrical equipment, causing lightning injury to victims indoors
    • Upward streamer (10–15%):
      • Negatively charged lightning strikes from a cloud and induces positive current from the ground to rise and meet it to complete the lightning channel
  • Mechanism of injury—trauma:
    • Barotraumas
    • Blunt trauma:
      • Muscle contractions can throw the victim and/or cause a fall
    • Thermal burn

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Basics

Description

  • Lightning is a discharge of energy that occurs cloud to cloud (90%) or cloud to ground (10%)
  • Exposure to lightning:
    • Brief duration (1–100 ms)
    • Typically occurs during outdoor activity
    • Highest incidence in summer months, between 3 and 6 PM
    • Fatality rate of 8–10%

Etiology

  • Mechanism of injury—electrical:
    • Direct strike (5%)
    • Contact potential (15–25%):
      • Current passes through an object the victim is touching
    • Side splash (20–30%):
      • Current jumps from nearby object to the victim
    • Step voltage, or ground potential (40–50%):
      • Current moves through the ground surface and may injure multiple victims
      • Current moves through hard-wired telephone lines, metallic pipes, or a structure's electrical equipment, causing lightning injury to victims indoors
    • Upward streamer (10–15%):
      • Negatively charged lightning strikes from a cloud and induces positive current from the ground to rise and meet it to complete the lightning channel
  • Mechanism of injury—trauma:
    • Barotraumas
    • Blunt trauma:
      • Muscle contractions can throw the victim and/or cause a fall
    • Thermal burn

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