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PubMedDate not supplied

Lightning-related mortality and morbidity in Florida.

Cases of lightning-related deaths and injuries that occurred in Florida in 1978-87 were reviewed to determine the factors involved, to quantify the morbidity and mortality related to lightning strikes, and to describe epidemiologically the injuries and circumstances involved. Statewide information on deaths was obtained from death certificates, autopsy reports, and investigative reports. Information about morbidity was obtained from the Florida Hospital Cost Containment Board data base and the National Climatic Data Center data base for all Florida counties, as well as from hospitals in selected counties. Lightning-related deaths totaled 101 in Florida during the period 1978-87, an annual average of 10.1. Eight percent of the victims were from other States. The overall yearly death rate for State residents was 0.09 per 100,000 population, with the highest rate being that for men aged 15-19 years, 0.38 per 100,000. Thirteen percent of victims were females. The ratio of lightning-related injuries to deaths in Florida was estimated at about four to one. Thirty percent of all deaths were occupationally related. The first strikes of lightning from a thunderstorm may be the most dangerous, not in terms of impact, but because of the element of surprise. During thunderstorms, people may seek shelter under isolated trees because they believe erroneously that a tree offers protection from lightning, or perhaps because their top priority is to escape from rain rather than lightning. People may not seek adequate shelter during thunderstorms because they do not know the dangers of remaining outdoors or their judgment is impaired by drugs or alcohol.

Adolescent↗
PubMedDate not supplied

[Misinterpretation of fetal high voltage and lightning accidents].

From medicolegal practice it is known that in deaths caused by low voltage, electric marks may be absent or inconspicuous so that they may remain undetected during the scene examination. That this may happen even in fatal high-voltage accidents is demonstrated by 4 examples from our own autopsy material. The cases reported shared the following features: The decedents were found outdoors under a high-voltage line with a several metres long conductive object being in the immediate vicinity of the body; no extensive burns as those seen after the impact of an electric arc; inconspicuous electric marks on the hands; clearly visible electrothermal skin lesions limited to body regions covered by clothing (especially soles of the feet). Another case report demonstrates that even fatal lightning accidents are not always recognized correctly.

Accidents, Occupational↗
PubMed1991

Lightning and its effects on the auditory system.

Patients struck by lightning can present with a wide variety of unusual otologic problems including burns to the external auditory canal, tympanic membrane rupture, middle ear injury, and sensorineural hearing loss. Four patients who incurred various otologic problems, including one patient with previously unreported bilateral oval window fistulas following lightning injury, are presented. Audiologic, otologic, and surgical findings are reviewed as well as patient follow-up and outcome.

Adult↗
PubMed1993

Electrical shock and lightning strike.

Cardiac arrest from electrical shock or lightning strike is associated with significant mortality and requires modification and extension of standard advanced life support measures to achieve successful resuscitation. Patients who experience electrical shock or lightning strike may sustain cardiac and respiratory arrest secondary to the direct effects of current. However, the majority of victims have associated multisystem involvement, including neurologic complications, cutaneous burns, and associated blunt trauma. As a result, a combination of advanced cardiac life support measures and advanced trauma life support techniques is indicated. Victims with cardiac arrest from electrical shock or lightning strike require prompt, aggressive resuscitation using standard methods for airway control, ventilation, and chest compressions, as well as usual measures for defibrillation and cardiac pharmacotherapy. Unique considerations include vigorous fluid resuscitation and spinal immobilization for victims of electrical shock and reversal of normal multiple casualty triage priorities when managing several lightning strike victims. Because the majority of victims are relatively young and seldom have significant underlying cardiac disease, the chance for successful resuscitation may be greater for patients who experience sudden death from electrical shock or lightning strike than for those with other causes of cardiac arrest, even among patients with initial rhythms traditionally unresponsive to therapy. Although numerous specialized aspects are required for the successful management of victims of electrical shock and lightning strike, the following article focuses on the unique considerations necessary for immediate care of cardiac arrest victims, with emphasis on the underlying mechanisms of sudden death and currently recommended guidelines for resuscitation.

Electric Injuries↗
PubMed1989

[Infarct ECG following a lightning accident].

A 17-year-old man was resuscitated after being struck by lightning. The ECG showed a development similar to anterior infarction. The patient died on the 12th day due to irreversible brain damage. Autopsy showed normal myocardium.

Adolescent↗
PubMed1997

A survey of lightning policy in selected division I colleges.

OBJECTIVE: The purpose of this research was to investigate the hazards of lightning for participants in outdoor athletics and to determine the existence of, and assess the nature of, lightning safety policy at the collegiate level. DESIGN AND SETTING: We used data from the National Severe Storms Laboratory in Norman, Oklahoma, and from a survey of Division I institutions. SUBJECTS: The 48 National Collegiate Athletic Association Division I (football) universities in Florida, Michigan, Pennsylvania, North Carolina, and New York. MEASUREMENTS: Athletic trainers at all of the selected 48 Division I institutions responded to the telephone survey. RESULTS: Florida, Michigan, Pennsylvania, North Carolina, and New York led the country in lightning deaths and injuries from 1959-1994. Only 8% (n = 4) of the institutions surveyed in these states have a written policy regarding lightning safety. CONCLUSIONS: This study demonstrated the lack of lightning safety policy in the surveyed universities and the need for a systematic plan of action to make fields safer for all who are involved in outdoor sport activities.

Journal Article↗
PubMed1990

Children's defensive responses and emotional upset following a disaster: a projective assessment.

Projective stories were used to assess the defense mechanisms of 27 preadolescent boys who were victims of a lightning strike in which one boy died. Denial, projection, and identification, in combination, were found to be inversely related to clinical upset, as was the age and sex-appropriate individual defense of projection. In addition, low-defensive boys' self-reports of fears agreed more often with their parents' reports of sleep and somatic disturbances than did high-defensive boys' self-reports. The findings provide support for the validity of the Defense Mechanism Manual (Cramer, 1982) and raise the issue of defense mechanisms as moderator variables in self-report questionnaires.

Adaptation, Psychological↗