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Lightning Injuries

By Meg Marinis, Director of Medical Research | Sep 30th, 2010
How many times have you heard the following?

Lightning never strikes the same place twice? If outside in a thunderstorm, you should seek shelter under a tree to stay dry? If you are in a house, you are safe from lightning? Structures with metal, or metal on the body (jewelry, cell phones, Mp3 players, watches, etc), attract lightning?

All myths.

In Episode 702, "Shock to the System," our doctors treat a flag football team all suffering from lightning injuries. When lightning directly struck Warren, it traveled through the ground and indirectly hit the surrounding team members. Many people believe that lightning strikes only cause burns (Or char their victims black like they do in the cartoons!), but in fact, they can cause a variety of injuries such as blown eardrums, dislocations, fractures, arrhythmias, paralysis, even holes in the stomach...

How exactly does lightning work?

According to the National Weather Service, lightning strikes can reach up to five miles in length, make it to temperatures of 50,000 degrees Fahrenheit, and have 100 million electrical volts. When thunderstorms occur, positively charged particles group together along the ground. As the charges increase, these positively charged particles can rise up objects such as tall trees, houses, and electrical poles. They can even climb up people! (You know that feeling when your hair stands up when you're outside in a storm?) These positively charged particles attract the negatively charged particles from the storm to develop a channel. When the electricity transfers along this channel, that phenomenon is known as lightning.

So what's thunder? Well, the lightning channel heats up to such extreme temperatures, that this rapid expansion of heat causes... thunder. And light travels faster than sound, so the sound is heard AFTER you see the lightning.

What kind of injuries can lightning strikes cause?

Lightning mainly affects the nervous system. For example, within the brain, lightning strikes may cause neurocognitive changes, sleep disturbance, personality changes, seizures, learning disabilities, headaches, nausea, and attention deficits. Within the peripheral nervous system, chronic pain or sensory problems can ensue. And within the autonomic nervous system, strikes can mess with the regulation of blood pressure and cardiac response, also affecting the GI system and even causing impotence.

Cardiorespiratory arrest that results from a lightning strike may lead to death, but this symptom is fairly uncommon. Lightning can be seen as defibrillation that sends the heart into asystole—a state of no cardiac electrical activity.

As many people might suspect, burns (deep and superficial) occur from lightning having contact with the skin. And as seen in the episode, burns may appear in fernlike patterns or in linear forms. These burns should be treated as any other high-voltage injury.

Other rare injuries include: fractures due to intense muscle contraction, organ contusions, tympanic membrane rupture (blown eardrum), hearing loss, and cataracts.

But don't worry: The odds of being struck in your lifetime? 1 in 6,250.

Safety measures to reduce risk of being struck

During a thunderstorm, the best plan of action is to get INSIDE a safe building or vehicle. Safe buildings can be described as fully enclosed with a roof, walls and floor, and has plumbing and/or wiring. However, if lightning does in fact directly strike a safe building, the current typically travels through the plumbing or wiring and then into the ground. Therefore, as a forewarning, even in safe buildings, one should avoid showers, sinks, hot tubs, and touching electronic equipment during a thunderstorm.

Safe vehicles are also fully enclosed and metal topped. When driving in a storm, one should always slow down and proceed carefully. And when inside a safe vehicle, avoid contact with electronic devices such as radio communication.

Remember: When thunder roars, go indoors!

For more information on lightning safety, please visit:

http://www.lightningsafety.noaa.gov/outdoors.htm

And for more information on emergency preparedness on weather-related disasters:

http://emergency.cdc.gov/disasters/

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