[The dangers of lightning and protection from lightning in the mountains].
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Accident Prevention↗
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Telephone-related lightning injury.
OBJECTIVE: To review reported telephone-related lightning injuries, outline the mechanisms of injury and suggest treatment strategies. DATA SOURCES: Cases notified to Telecom Australia and an extensive search of the literature. DATA SYNTHESIS: There is a dearth of literature on telephone-related lightning injury. Some reports note it in passing, others describe single incidents. Case reports from Australia provide detail sufficient for review, and the general principles which govern management of such injuries are presented. CONCLUSION: Telephone-related lightning injury is not rare. Practitioners should be aware of the uniqueness of lightning injury and the complexity of its assessment. A research program aimed at further elucidation of the detail of this injury is proceeding.
Australia↗
Lightning eye movements.
Physiologic studies were performed on a patient who demonstrated lightning eye movements, palatal myoclonus and myoclonic jerks of the left platysma and sternocleidomastoid muscles. The myoclonus and lightning eye movements were separate phenomena with no defined relationship to each other. Analysis of this ocular dyskinesia identified strictly horizontal saccadic oscillations, 2 to 5 Hz in frequency, with amplitudes varying greatly but often reaching 25 degrees. A brief stationary period between each saccadic oscillation was frequently observed. They were particularly induced by vertical or horizontal ocular pursuit as well as sustained upward or downward ocular deviation. Caloric nystagmus abolished the oscillations but they persisted, irregularly, during optokinetic nystagmus. Thus a faulty visual fixation mechanism is postulated to precipitate lightning eye movements. Constrast studies revealed a mass lesion arising from the right dorsolateral portion of the medulla. These results indicate that lightning eye movements occur with caudal as well as rostral brain-stem lesions. From the clinical findings cerebellar pathway involvement is likely.
Adult↗
Electrical injuries and lightning.
Prolonged cardiopulmonary resuscitation is key to the resuscitation of lightning strike victims. Multiple accounts exist of successful revival of victims thought to be "dead" or in patients who have what is often believed to be unresuscitatable cardiac dysrhythmia. Victims of lightning injury may, in addition to their electrical injury, have secondary injuries that require expedient care if significant morbidity is to be avoided. They should be treated as any victim of trauma, that is, with a complete and thorough evaluation including hospitalization if warranted. In the absence of a cardiac arrest or serious secondary injury, care for the lightning strike victim is generally supportive in nature.
Electric Injuries↗
Acute polyneuropathy due to lightning injury.
The case of a 19 year old man struck by lightning is described. He sustained quadriplegia for several months and fully recovered. It is suggested that his weakness was due to extensive peripheral nerve damage. In addition, he displayed many well recognised medical complications of lightning injury including acute renal failure, rhabdomyolysis, respiratory distress syndrome, autonomic dysfunction, perforated ear drum, uveitis and cataract. The literature relating to the neurology of lightning strike is briefly reviewed.
Acute Disease↗
Cutaneous manifestations of lightning injury.
This report calls attention to a bizarre, almost pathognomonic, cutaneous feature of lightning injury. It has been variously described as "lightning prints," "arborescent" burns, or "feathering," and has long been neglected in the dermatologic literature. Its recognition may be lifesaving in the unaccompanied comatose patient and is important because even delayed resuscitation of lightning victims can be very successful.
Adult↗
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↗
Lightning strikes: nature of neurological damage in patients evaluated in hospital emergency departments.
Emergency physicians and staff are usually the first to evaluate and manage victims of lightning strikes. Damage to the nervous system is often the most devastating consequence of lightning strikes. Contrary to most articles in the literature in which neurological disorders are said to be either transient or delayed, we report the cases of six patients with severe, immediate, and in at least three, permanent clinical problems. Patients with signs of spinal cord lesions are most likely to have permanent disabilities.
Adolescent↗
Lightning injuries.
The course of three patients apparently struck by lightning is reviewed. The circumstances of the injury and the power of the lightning discharge are uncontrollable variables affecting morbidity and mortality. Immediate cardiopulmonary resuscitation followed by careful clinical monitoring and aggressive treatment of involved organ systems will help most patients to complete recovery.
Adult↗
Successful management of an adult lightning victim using intracranial pressure monitoring.
Serious central nervous system injuries after lightning strikes are fortunately rare. Optimal neurological and neurosurgical management has not been firmly established. We describe the successful neurological resuscitation and critical care management using intracranial pressure monitoring of an adult who sustained a lightning strike. The role of intracranial pressure monitoring in this setting is discussed.
Coma↗
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↗
Lightning injury with lung bleeding in a tracheotomized patient.
A 68-year-old man, who had undergone laryngectomy six months earlier, was struck by lightning and developed pulmonary hemorrhage. This was attributed to pulmonary barotrauma due to a lightning blast via his tracheostoma.
Aged↗
Lightning fatalities in North Carolina 1972-1988.
Individuals who are outdoors during thunderstorms are at risk for death from direct and indirect lightning hits. Death is more likely from 3:00 p.m. to 8:00 p.m. during the months of May through September. The fatality pattern in North Carolina is similar to that reported for the nation as a whole. Physicians are urged to discuss with their patients simple strategies for reducing exposure to lightning.
Adolescent↗
Intracranial haematoma resulting from lightning stroke.
Intra-cerebral haemorrhage due to lightning stroke is extremely rare. We report a 45 year old woman who developed intracranial haemorrhage due to a direct lightning stroke. This was proved by CT scan. The haematoma was evacuated surgically, resulting in full neurological recovery of the patient.
Brain Edema↗
[Neuropsychiatric and electroencephalographic studies of the course of patients accidentally struck by lightning].
Five patient (one adult and four children) hit by lightning strokes were examined clinically and electroencephalographically. One child died immediately after the accident. For the four survivors, data are available which were collected during several years' examinations. It was possible to confirm the results of previous investigations which showed that pathologic EEG changes can be associated with a weak neuropsychiatric symptomatology following the gradual disappearance of the acute lightning-stroke syndrome and can be observed even in the case of freedom from complaints and symptoms. Finally, the authors also deal with the problems associated with the making of statements by medical experts.
Adolescent↗
Lightning injury: management of a case with ten-day survival.
A boy, injured by lightning, had cardiopulmonary arrest. Following resuscitation and during the course of hospitalization, he developed further cardiac arrhythmia, cerebral edema, generalized seizures, and upper gastrointestinal bleeding. Despite efforts to combat these complications, the patient's condition deteriorated, and he died on the tenth day of hospitalization. The pathologic findings are described and the treatment discussed.
Adolescent↗
Lightning and electrical injuries.
Lightning and electrical injuries are similar in that both produce immediate tissue injury from burn and trauma induced by fall and both can arrest the heart and respiratory center. Immediate support of circulation and respiration is life-saving. Subsequently the nervous system may show signs of injury, and seizures, cerebral edema, and muscle and nerve lesions should be handled as the indications arise. Prevention of the injury is more effective than any postinjury treatment. Outdoors hikers and campers must take shelter to minimize their exposure; indoors properly installed equipment and attention to the relation of the equipment user to the electrical ground are the key elements in avoiding electrocution.
Electric Injuries↗
[Deaths in swine by a lightning strike in the sty].
It is reported on deaths of pigs due to lightning stroke in the barn. During a severe thunder storm 11 clinically healthy pigs with an average weight of approx. 22 kg died simultaneously and suddenly in the barn. The animals were kept on a floor of metal slats. The pens were separated by metal bars. A water pipe leading into the barn from outside had contact to the bars. Two pigs were submitted for an examination approx. three hours post mortem. The macroscopic and microscopic necropsy findings are described.
Animals↗