When a storm approaches,
take cover indoors

Lightning Storms Cause Death Due to Cardiac and Respiratory Arrest

August 12, 2009
by Lynn Shapiro, Writer
Summer is prime time for thunder and lightning storms, which can cause injury and more likely death, warns Shreni Zinzuwadia, M.D., an ER physician at UMDNJ-The University Hospital and instructor of Emergency Medicine at the UMDNJ-New Jersey Medical School.

She tells DOTmed News that lightning kills 200 people on average yearly in the U.S. One strike delivers more than 10 million volts of electricity. Being struck by lightning is fatal in about 30 percent of cases, Dr. Zinzuwadia says.

Recent lightning strikes in Newark have resulted in one death and injured three others. Respiratory or cardiac arrest are the leading causes of death.

There are four different types of lightning strikes, she says. The first is a direct strike, where a victim gets hit directly by lightning; a second type of strike is called a side flash where lightning jumps from the initial point of contact (for example, a tree) to the victim.

A third type of strike is the contact strike where an object that the victim is holding (say, a pair of eye glasses) is struck by lightning. The victim gets hit secondarily. The fourth type of strike, called step potential, "happens when a current traveling through the ground goes up your leg, travels through you and then goes down the other leg and back into the ground," Dr. Zinzuwadia says.

She says that a common Boy Scout practice is to stand on one leg during a storm. "They are trying to decrease their chances that the current will go through them by having only one foot on the ground," she explains.

Dr. Zinzuwadia notes that the direct strike represents 3 to 5 percent of injuries; the side strike 30 percent of injuries; and a contact strike 1 to 2 percent of injuries.

She adds that many people who aren't directly hit may suffer from the "blunt force of being thrown some distance by the sheer force of the lightning." Some people might get superficial burns on their skin or their clothing may burst into flames or be torn away from their bodies.

Beware of Tall Objects

Dr. Zinzuwadia warns that lightning is attracted to the tallest objects in the area and advises people to stay as far away as possible from these structures.

"For instance, lightning likes to find the tallest structure within a 30 to 60 yard radius," she tells DOTmed, comparing a mountain top half a mile away, a TV tower 300 yards away, or a tree 75 yards away.

She adds, "the least amount of your body should be touching the ground as possible to decrease the risk of getting hit. Keeping one foot off the ground, as the Boy Scouts do, may save your life."

Complications and Mortality

Most survivors suffer other injuries, she says. Half of people struck by lightning will suffer rupture of the tympanic membrane in the ear. Very commonly survivors go on to develop cataracts.

People who are hit by lightning die from ventricular fibrillation, cardiac arrest or respiratory arrest, Dr. Zinzuwadia notes.

She says bystanders who see someone hit by lightening should immediately check the victim for a pulse and for spontaneous breathing. If a person is in respiratory arrest--has a pulse but is not breathing--provide rescue breaths until the victim resumes spontaneous breathing, she advises.

"And immediately call 911 for help if someone is hit by lightning," she adds.

If the victim goes into cardiac arrest, where the heart stops due to the impact of the intense electrical current, CPR should be administered. "Give cardiac compressions and provide respiratory support for them," she says.

Seek Cover As Soon As a Storm Starts

Lightning seems to be concentrated at the forefront of a storm, says Dr. Zinzuwadia, so there tends to be a greater risk of being hit by lightning at the storm's outset.

"If you are outside during a storm, crouch down and try to touch as little of the ground as you can," she advises. "Even if you are hit by the current, the less contact there is between you and the ground, the better your chances of survival," she says.

Source: UMDNJ-The University Hospital