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PubMed1993

Deaths caused by lightning.

Though a rare cause of death, lightning is reported to be responsible for more fatalities each year in this country than any other type of natural disaster. Lightning injuries differ significantly from other high voltage electrical injuries because of the high current flow, but extremely short duration, of the lightning stroke. We present a series of cases over the period of 1985 to 1991 in Cook County, Illinois in which lightning was the direct cause of death. Our discussion reviews the nature of lightning, the effects it may have on humans, and the ways in which deaths due to lightning might be prevented.

Adolescent↗
PubMed2004

Epidemiology of electrical and lightning related deaths and injuries among Canadian children and youth.

Among burn injuries, electrical injuries constitute a small but devastating fraction. To describe the epidemiology of electrical injuries in Canadian children, data on deaths and emergency department visits related to electrical injuries, including lightning strikes, were obtained from provincial coroners' offices and the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) respectively, for the years 1991-96. Twenty one deaths and 606 emergency visits highlight that electrical related deaths, more frequent among school age children, are more likely the result of high voltage and lightning strike, while emergency department visits, more frequent among younger children, are more likely the result of low voltage. While the introduction of legislated standards for child safe outlets and educational programs for parents, children, and youth are recommended strategies toward reducing the frequency of these incidents, these strategies require further evaluation before their effectiveness can be estimated.

Accidents, Home↗
PubMed1992

Electrical injury from Tasering and miscarriage.

A case report is presented of a woman who was "Tasered" by law enforcement personnel while 12 weeks pregnant. The Taser (Thomas A. Swift's Electric Rifle) is an electronic immobilization and defense weapon that has been commercially available since 1974. The Taser was developed as an alternative to the .38 special handgun. The patient was hit with Taser probes in the abdomen and the leg. She began to spontaneously miscarry 7 days later and received a dilatation and currettage procedure 14 days later for incomplete abortion. The world's literature on electrical and lightning injury to pregnant women is reviewed, and the mechanism of action of Taser injury is discussed. As use of the Taser becomes more common, obstetrical clinicians may encounter complications from the Taser more often.

Abortion, Spontaneous↗
PubMed1977

Lightning-strike disaster among children.

A lightning strike involving 47 children is described. Four cases demonstrate the most common and serious resulting pathology: burns, myocardial infarction, and neurological symptoms varying from feelings of fear and nightmares to brain death. The pathophysiology of lightning injury is described. The importance of immediate resuscitation of the victim who appears dead after a lightning strike is emphasized, and procedures to prevent lighting injury are presented.

Adolescent↗
PubMed1990

Lightning strikes.

Lightning strike is a natural phenomenon with potentially devastating effects. The physics of lightning strike and the physiology of lightning injury are discussed. Three cases are reported and the clinical features are described. Aspects of the management of such patients are discussed with particular emphasis on assessment and resuscitation in the Emergency Department.

Adult↗
PubMed1988

Intracranial pressure (ICP) monitoring as a guide to prognosis in a lightning-injured, comatose child.

Every year there are many deaths due to lightning injuries in the United States. A case is presented of a young child who suffered cardiopulmonary arrest following being struck by lightning strike and in whom ICP monitoring was utilized. We postulate that ICP and CPP measurements may be useful as prognostic indicators for comatose lightning victims and, therefore, may help in the management of the patient.

Cerebrovascular Circulation↗
PubMed1988

Death by lightning.

Deaths from lightning injuries are infrequent, amounting to 0.2-0.8 per million people per year, and are associated with climatologic conditions. The victims are mostly young, active people who are struck during various outdoor activities during the summer months. Even though many people can be struck by the same bolt of lightning, multiple casualties are uncommon. Among the fatalities, various types of skin burns are regularly present, often at an entry site on or near the head, and at an inferiorly located exit site. These skin injuries often consist of superficial burns and singed hair; deep burns and charring are uncommon. Arborescent skin marks seem to occur less frequently. Internal findings at autopsy are nonspecific.

Adolescent↗
PubMed1982

Neurologic, psychiatric, and cardiovascular complications in children struck by lightning.

The neurologic changes following lightning injury include coma with cerebral edema, inappropriate secretion of antidiuretic hormone (ADH), seizures, cerebellar ataxia, and painful sensory disturbances. Deteriorating neurologic status may warrant the use of intracranial pressure monitoring devices. Myocardial injury and transient hypertension are generally evident at the onset. Monitoring of the cardiac rhythm may be needed for as long as a week for late onset arrythmia. Abnormalities of memory, mood, and affect noted on recovery of consciousness may persist for months, necessitating close psychiatric and neurlologic follow-up.

Brain Diseases↗
PubMed1985

Lightning-induced myocardial injury. A case report with management.

A young patient of lightning induced myocardial injury with chest pain is described. Electro-cardiogram mimicked true myocardial infarction (due to coronary artery disease). Practical aspects of case management is discussed. Use of short course of steroid helped in early recovery.

Adult↗
PubMedDate not supplied

Electrical injuries: a 20-year review.

Electrical injuries continue to present problems with devastating complications and long-term socioeconomic impact. The purpose of this study is to review one institution's experience with electrical injuries. From 1982 to 2002, there were 700 electric injury admissions. A computerized burn registry was used for data collection and analysis. Of these injuries, 263 were high voltage (> or =1000 V), 143 were low voltage (<1000 V), 277 were electric arc flash burns, and 17 were lightning injuries. Mortality was highest in the lightning strikes (17.6%) compared with the high voltage (5.3%) and low voltage (2.8%) injuries, and mortality was least in electric arc injuries without passage of current through the patient (1.1%). Complications were most common in the high-voltage group. Mean length of stay was longest in this group (18.9 +/- 1.4 days), and the patients in this group also required the most operations (3 +/- 0.2). Work-related activity was responsible for the majority of these high-voltage injuries, with the most common occupations being linemen and electricians. These patients tended to be younger men in the prime of their working lives. Electrical injuries continue to make up an important subgroup of patients admitted to burn centers. High-voltage injuries in particular have far reaching social and economic impact largely because of the patient population at greatest risk, that is, younger men at the height of their earning potential. Injury prevention, although appropriate, remains difficult in this group because of occupation-related risk.

Accidents, Occupational↗
PubMed2002

Abnormal electroretinogram and abnormal electrooculogram after lightning-induced ocular injury.

PURPOSE: To report a case of abnormal electrooculogram and abnormal electroretinogram after lightning-induced ocular injury. DESIGN: Interventional case report. METHODS: A 39-year-old man was struck on the left forehead by a bolt of lightning. After resuscitation, he regained consciousness. RESULTS: Ophthalmic examination disclosed a best-corrected visual acuity of right eye (RE): 20/25 and left eye (LE): 20/50, burned eyelashes, punctate keratitis, iridocyclitis, anterior subcapsular lens opacity, missing foveolar reflex, and macular pigment epithelial defect LE. Fluorescein angiography revealed only an area of punctate leaking in the left eye. Electrooculogram showed reduced amplitudes, in the left eye. Arden ratio was RE: 2.04 and LE: 1.52. The amplitudes of scotopic and photopic electroretinogram b-waves were reduced in the left eye. After uneventful cataract surgery in the left eye, the follow-up electrooculogram and electroretinogram still showed reduced amplitude in the left eye. CONCLUSION: Lightning is an uncommon cause of ocular injury. This is the first report of abnormal electro-oculogram and abnormal electroretinogram after lightning-induced ocular injury.

Adult↗
PubMed2005

Autonomic nervous system dysfunction in lightning and electrical injuries.

Autonomic nervous system (ANS) dysfunction is a serious complication of lightning and electrical trauma (L/ET). The ANS regulates the normal vegetative functioning of many organ systems. When ANS is compromised after lightning and electric trauma, patients are vulnerable to serious medical problems. Three conditions of ANS dysfunction of particular concern for L/ET patients are complex regional pain syndrome (CRPS), cardiovascular abnormalities, and keraunoparalysis (KP). The patient with CRPS presents with pain, hyperpathia, sweating, and edema hours to days after trauma. Neurorehabilitation is exceedingly important. A primary goal is to keep the affected extremity mobile and functional. Some patients benefit from sympathetic blockade. Cardiovascular abnormalities associated with lightning and electrical trauma can be life threatening. Care for these patients require a multidisciplinary team including a cardiologist. Keraunoparalysis is a frightening and distressing complication of lightning strikes. The syndrome consists of limb paralysis, sensory symptoms, pallor, coolness and absent pulses. Release of excessive catecholamines is said to be responsible for these findings. Fortunately, the condition is transient.

Arrhythmias, Cardiac↗
PubMed1999

Lightning: the multisystem group injuries.

In this article, we present our experience of group lightning injury. Individual injuries are most common after single strikes. The largest group previously reported was 10 patients. In our series, 17 victims were hit by a single strike; 11 were admitted to the hospital and 6 were discharged from the accident and emergency department. Although injured under the same circumstances, these patients presented with a wide range of symptoms and signs. We also describe a characteristic burn pattern, the "tip-toe sign."

Adolescent↗