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Lightning Injuries

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

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


  • 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.
    • Earth potential rise/ground current (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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Rosen, Peter, et al., editors. "Lightning Injuries." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307229/all/Lightning_Injuries.
Lightning Injuries. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307229/all/Lightning_Injuries. Accessed April 25, 2019.
Lightning Injuries. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307229/all/Lightning_Injuries
Lightning Injuries [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307229/all/Lightning_Injuries.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Lightning Injuries ID - 307229 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307229/all/Lightning_Injuries PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -