Injuries, Sequelae, and Treatment of Lightning-Induced Injuries: 10 Years of Experience at a Swiss Trauma Center
Lightning is a powerful force in nature that occurs as a result of the transfer of electrical charges and is estimated to strike the earth approximately 8 million times per day. The investigators performed a retrospective chart analysis for all lightning-strike injuries that presented to an emergency department at a trauma center in Switzerland. Charts were selected for patients who were at least 16 years old and were seen from January 2000 to December 2010. The main outcomes were where the lightning-strike injury occurred, site of injury, and length of hospital stay.
Nine patients were seen for lightning-related injuries during the 10-year period with ages ranging from 24 to 58 years. Four of the patients were struck in the outdoors, whereas 3 of the patients were struck in enclosed spaces while in a house or car. Six patients experienced neurological injuries including paresthesias, transient paralysis, vertigo, headache, and unreactive pupils. Five patients had cardiac symptoms, the most common being arrhythmia that was not further described in the paper. One patient experienced prehospital cardiac arrest and was successfully resuscitated with intermittent bradycardia afterward. Other injuries included skin burns, myoglobinuria, deafness, and severe muscular contractions. Four of the 9 patients were admitted to the hospital, with 2 patients requiring the intensive care unit.
This research article supports prior literature that the neurovascular and cardiovascular systems are commonly injured during lightning strike injuries. Additionally, the investigators recognize a need for an international registry of lightning strikes to better understand their injury pattern and treatment. Limitations of the study include incomplete medical records owing to retrospective chart review in addition to exclusion of the pediatric population.
(Emerg Med Int. 2012:167698). CA Pfortmueller, Y Yikun, M Haberkern, E Wuest, H Zimmermann, AK Exadaktylos
Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA