number Lightning Strikes and Paramedic Care Introduction The discharge of large build ups of static charge in the atmosphere to the ground are known as lightning strikes. Typically, lightning strikes deliver hundreds of thousands of volts to the ground’s surface. Any object on the ground that interacts with the lightning strike becomes a conductor due to the large electric potential involved. Estimates delineate that lightning strikes kill around 24,000 people and injure some 240,000 people each year (Holle). Lightning strikes are the second largest weather event killer in the United States where some 9-10% of lightning strike victims die each year (Cherington).
Effects on Human Body
Lightning strikes do not burn the flesh since the contact with charge is too brief to cause such heating. Instead, lightning strikes affect the human body by electropolation – a process in which cells in the human body produce holes in their cell membranes. Consequently, human muscles and nerves are vastly disrupted by lightning strikes (Ritenour, Morton and McManus). In addition, lightning strikes tend to induce electrical surges within the human body particularly in the nervous system leading to cardiac arrest. Moreover, human hearing is directly affected by the thunder shock wave produced by lightning strikes (Ritenour, Morton and McManus).
Heart and Cardiac Rhythm Effects
Lightning strikes produce diverse cardiac effects ranging from changes in the electrocardiograph (ECG) patterns to cardiac seizures. The victim of a lightning strike may be suffering from cardiac contusion, myocardial infarction, stroke, arrhythmia among other problems (McIntyre, Simpson and Redfearn). Lightning strikes tend to depolarise the myocardium leading to thoracic muscle spasm and respiratory failure as well as asystole (American Heart Association).
Patient Treatment by Paramedics
In case of a lightning strike, the paramedic should take to resuscitation as soon as possible since most lightning strike patients develop respiratory problems. If back injuries are present, it is best to stabilise the victim’s head before proceeding to artificial resuscitation. In addition, it is possible that the victim will have altered levels of consciousness that may lead to ventilator impairment. Often the fundamental cause of ventilator impairment is a blocked pharynx due to a relaxed tongue. The paramedic must check for such blockages immediately after which resuscitation should be continued (Medscape). The first aid team on the scene must initiate cardiopulmonary resuscitation at the earliest since most lightning strike victims die as a result of cardiopulmonary failures.
When providing help to a lightning strike victim, the rescuer must make sure that they are positioned in a safe place where lightning strikes are not going to affect the rescue attempt. It is typical for lightning to strike again within the same zone. Moreover, lightning strike dangers continue roughly up to half an hour after the last lightning strike is seen or thunder is heard (Medscape).
Lightning strikes present a sizable mortality rate in victims largely due to cardiopulmonary failure. The best line of action to rescue a victim of lightning strikes is to provide artificial resuscitation as soon as possible. It is only possible to save lightning strike victims if they do not die out of respiratory or cardiac failures first. Moreover, the paramedic in the field should be careful of lightning strikes that may continue. A safe position must be taken before the victim is administered any care.
American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. 2005. 18 March 2013 .
Cherington, J. “Closing the Gap on the Actual Numbers of Lightning Casualties and Deaths. Preprints.” 11th Conference on Applied Climatology. 1999. 379-380.
Holle, Ronald L. “Annual rates of lightning fatalities by country.” 0th International Lightning Detection Conference. Tucson, Arizona, 21–23 April 2008.
McIntyre, William F., et al. “The Lightning Heart: A Case Report and Brief Review of the Cardiovascular Complications of Lightning Injury.” Indian Pacing Electrophysiology Journal 10(9) ( 2010): 429–434.
Medscape. Lightning Injuries Treatment &. Management. 10 February 2012. 18 March 2013 .
Ritenour, A. E., et al. “Lightning injury: a review.” Burns 34 (5) (2008): 585–594.