Lightning Strike – Mechanisms of Energy Transfer, Cause of Death, Types of Injury: In Reply

Abstract

Introduction: Lightning can injure via a direct hit, a contact effect, a side splash, a ground strike or a telephone/wire-mediated strike. The flash-over phenomenon is not an independent energy transfer mechanism. It is observed in all energy transfer modes described, and accounts for the fact that many humans survive a lightning strike. Methods: Selective literature review. Results and Discussion: The majority of people hit by lightning strike survive. Lightning victims can die immediately after the lightning strike or after a latency period. Death immediately following the event is usually due to a lethal cardiac arrhythmia with ventricular fibrillation and subsequent or immediate asystole. If the lightning strike is survived initially, ensuing myocardial infarction, shock following burns, secondary renal failure and trauma-related cerebral haemorrhage may occur. A lightning strike can cause numerous different lesions in survivors. Injuries to skin, the heart, the nervous system, ears and eyes are most commonly seen. The management of lightning victims is usually interdisciplinary, due to the complexity of potential injuries. Emergency management of apparently lifeless persons should take priority in a mass accident involving lightning, because of the relatively good chances of success in cardiopulmonary resuscitation of lightning victims.