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Sharp Health News

When lightning strikes

Aug. 10, 2017

When lightning strikes

Lightning strikes in the U.S. approximately 25 million times a year, according to the National Weather Service (NWS). Hundreds of people are severely injured by lightning — a high-voltage electrical discharge between a cloud and the ground — and it kills an average of 47 Americans each year.

While lightning-related injuries and deaths are not as common in California as in states such as Florida, Texas and Colorado, they do occur.

“In the majority of lightning strikes, the victim doesn’t sustain a direct hit, but is instead ‘splashed’ on the outside of their body by electricity,” says Lee Tomatsu, an emergency medicine physician assistant with Sharp Grossmont Hospital and volunteer member of the San Diego Mountain Rescue Team. “The force can instantly vaporize moisture on the body surface and even blast away clothing.”

Tomatsu says that most strikes don’t result in extensive burns, but tend to be more superficial injuries that are feather- or fern-like in appearance, often following areas of sweat concentration. However, the voltage can disrupt the electrical functioning of the brain and heart, particularly in the respiratory center.

According to Tomatsu, roughly 70 percent of people struck by lightning lose consciousness for some period of time. Although cardiac arrest can occur when someone is shocked by electricity, there is usually a spontaneous return of heart function.

The brain, however, needs more time to recover, so the victim may not be able to breathe on their own for 20 to 30 minutes. Arms and legs can appear to lose pulses and turn blue, but this will typically resolve within hours. Short-term paralysis can also occur. More than 50 percent of lightning-strike victims rupture one or both ear drums, resulting in a temporary loss of hearing.

“Fortunately, most lightning survivors don’t suffer from significant, long-term disabilities,” says Tomatsu. “There can be short-term memory loss that often recovers in a few days, although they may never remember details of the accident itself.”

Getting struck by lightning is a tragedy that can be avoided. What many may not know is that most lightning injuries and fatalities occur before or after storms, when rain has not yet arrived or has already ended. If you can hear thunder, lightning is close enough to be dangerous, even if the skies above look clear.

The NWS offers the following safety tips to avoid being struck by lightning:

  • Check the forecast before planning outdoor activities and reassess plans if a thunderstorm is expected.
  • Once outside, look for signs of a developing or approaching thunderstorm, such as towering clouds, darkening skies or flashes of lightning.
  • When you hear thunder, immediately move to safe shelter, such as a substantial building with electricity or plumbing, or an enclosed, metal-topped vehicle with the doors and windows closed.
  • Stay in the safe shelter for at least 30 minutes after you hear the last sound of thunder.
  • Stay off corded phones, computers and other electrical equipment that put you in direct contact with electricity.
  • Avoid plumbing, including sinks, baths and faucets.
  • Stay away from windows and doors, and stay off porches.
  • Do not lie on concrete floors and do not lean against concrete walls.

If you are caught outside with no safe shelter anywhere nearby, the following actions may reduce your risk:

  • Immediately move off elevated areas such as hills, mountain ridges or peaks.
  • Never lie flat on the ground; shelter under an isolated tree or use a cliff or rocky overhang for shelter.
  • Immediately move out of and away from pools, ponds, lakes and other bodies of water.
  • Stay away from objects that conduct electricity (barbed wire fences, power lines, windmills, etc.).

If someone is struck by lightning, call 911 and begin to administer CPR. Unlike in a typical cardiac arrest where chest compressions are the first intervention, in a lightning strike, it’s generally recommended to administer rescue breaths first.

You cannot be electrocuted by touching someone who has been struck by lightning. The human body does not store electricity and it is perfectly safe to touch a lightning victim to give them first aid. However, you should first move them to a safe place, if possible — lightning can strike twice in the same location and you need to protect yourself.

“Anyone struck by lightning should be evaluated by a medical provider following the incident,” says Tomatsu. “It is important to ensure there is no development of delayed effects, such as neurologic, cardiac or muscular dysfunction.”

For the news media: To talk with Lee Tomatsu about lightning-related injuries and deaths for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.

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