Thunderbolt and Lightning, Very Very Frightening
Freddie Mercury wasn’t wrong when he said, ‘thunderstorm and lightning very very frightening’, because lightning strike injuries are actually frightening. Lightning strike can disrupt any organ system through varying mechanisms of injury and can cause serious disruption of physiological functions. There are many components of lightning strikes. These are described below along with associated impairment: • Light component Light component typically damages eyes; the problems may range from anterior chamber disorders like uveitis, keratitis, and cataracts to posterior chamber defects such as retinal detachment. • Heat component Heat component of the lightning strike usually causes first degree burns. It can also torrefy hair. • Electrical component The characteristic Lichtenburg figures are attributed to electric component of lightning strike. Severe arrhythmias are also a consequence of electric part. The neurological symptoms are also ascribed to electric portion; brain edema may occur secondary to hyponatremia. There may also be altered mentation. • Pressure Component The most common presentation is conductive hearing loss secondary to tympanic membrane rupture. Pressure component may also damage viscera, particularly lungs and gastrointestinal tract. The first and foremost step of management of lightning strike injuries is transfer of victim to the safe environment, followed by first aid. ATLS approach should be followed. Once the victim is stabilized, further assessment is necessary which employs biochemical testing as well as imaging modalities. All the organ systems should be examined closely in order to diagnose any related complication timely. Source: Injuries and deaths from lightning https://jcp.bmj.com/content/early/2020/08/12/jclinpath-2020-206492 Image shows Lichtenburg Figures (taken from https://www.successlifelounge.com/heres-what-happens-to-your-skin-when-you-survive-being-struck-by-lightning/)
