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Lightning injuries.

Medley O'Keefe Gatewood1, Richard D Zane

  • 1Harvard University School of Medicine, The Massachusetts General and Brigham and Women's Hospitals, 75 Francis Street, Neville House Room 226, Boston, MA 02115, USA.

Emergency Medicine Clinics of North America
|May 28, 2004
PubMed
Summary
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Lightning strikes are a leading cause of death. Understanding lightning injuries requires dispelling myths and recognizing unique medical aspects, including reverse triage for resuscitation. Long-term effects of lightning are common.

Area of Science:

  • Environmental Health
  • Emergency Medicine
  • Toxicology

Background:

  • Lightning is a significant cause of weather-related mortality.
  • Misconceptions about lightning injuries complicate treatment.
  • Understanding the unique pathophysiology of lightning is crucial.

Purpose of the Study:

  • To clarify the pathophysiology and treatment of lightning injuries.
  • To differentiate lightning injuries from other high-voltage electrical injuries.
  • To emphasize the need for addressing unique injuries and long-term sequelae.

Main Methods:

  • Literature review to address myths and misconceptions.
  • Analysis of the fundamental differences between lightning and high-voltage electrical injuries.
  • Discussion of triage and resuscitation strategies, including reverse triage.

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Main Results:

  • Lightning exposure duration is a key differentiator from high-voltage injuries.
  • Reverse triage is proposed for lightning victims, prioritizing those in cardiopulmonary arrest.
  • Unique injuries and long-term consequences are characteristic of lightning incidents.

Conclusions:

  • Dispelling myths is essential for effective lightning injury management.
  • Reverse triage may be beneficial for resuscitation in lightning strike victims.
  • Anticipating and managing unique, long-term sequelae is critical for patient outcomes.