Lightning strikes are a leading weather-related cause of death and injury worldwide. An estimated 24,000 people are killed by lightning strikes each year, and about 240,000 are injured. But lightning strikes don’t have to be fatal – with proper treatment, most lightning strike victims can survive.
How does lightning injure and kill?
When lightning strikes a person, the massive electrical current passes through the body, causing severe burns both externally and internally. The electrical current can also cause cardiac arrest and neurological damage. Specifically, lightning strikes can lead to:
- Cardiac arrest due to the electrical shock to the heart
- Burns to the skin and deeper tissues
- Damage to the brain and nerves
- Broken bones due to violent muscle contractions
- Loss of consciousness
- Blunt trauma from being thrown by the lightning strike
Cardiac arrest and neurological damage are the main causes of death in lightning strike victims. Burns and trauma can also be fatal if extensive. But death is not always instant – in up to 30% of lightning fatalities, the victim initially survives the strike but later dies of their injuries.
What factors influence chances of survival?
Not every lightning strike is fatal. Several factors influence an individual’s chances of survival:
- Proximity to the strike: The closer the strike, the more severe the impacts.
- Strength of the current: Currents over 200,000 amps are often fatal.
- Duration of exposure: The longer the exposure, the greater the damage.
- Flashover burns: Current traveling along the surface causes more severe burns.
- Ground currents: Current traveling through the ground into the body increases injuries.
- Individual susceptibility: Health conditions may increase risk.
Lightning currents are massive, but largely pass around and over the body. Direct strikes are rare. Even close strikes usually only last milliseconds. These factors limit exposure and improve chances of survival.
What first aid increases survival odds?
Prompt first aid can greatly improve the odds of surviving a lightning strike. If you see someone struck by lightning:
- Call emergency services immediately.
- If possible, move the victim safely indoors or under shelter – half of lightning deaths occur after the initial strike.
- Give CPR if there are no signs of life.
- If breathing stops, provide rescue breaths.
- Check for burns and provide first aid.
- Treat any injuries you can until paramedics arrive.
CPR is critical for reviving victims of cardiac arrest. Rescue breathing maintains oxygen levels. Treating burns, wounds, and fractures can improve outcomes. Getting prompt emergency medical treatment is vital.
What medical treatment helps survival?
At the hospital, lightning strike patients receive aggressive resuscitation and treatment of their injuries:
- CPR and heart monitoring: CPR is continued and heart rhythm assessed. Irregular rhythms may require defibrillation.
- IV fluids and medication: Large volumes of IV fluids help stabilize blood circulation and medication treat cardiac and neurological issues.
- Cooling: Cooling blankets and ice packs help reduce neurological damage and body temperature.
- Burn care: Burned areas are cleaned, debrided, and dressed. Skin grafts may be required.
- Respiratory support: Oxygen, intubation, and mechanical ventilation support breathing.
- Additional care: Fractures, internal injuries, and wounds are treated as needed.
This intensive medical management helps counteract the cardiac, neurological, respiratory, and circulatory impacts of a lightning strike. With advanced life support, survival is possible even after prolonged cardiac arrest.
What are the long-term effects?
Those who survive a lightning strike may be left with long-term effects:
- Chronic pain from nerve damage
- Muscle injuries, weakness, and loss of coordination
- Skin discoloration, scars, and scar tissue
- Hearing loss, tinnitus, and ear damage
- Neurological disorders such as seizures, memory loss, and personality changes
- Post-traumatic stress disorder (PTSD)
- Other psychological and mental health issues
Long-term issues depend on the extent of injuries and where current passed through the body. Permanent disability is not uncommon. Psychological impacts like anxiety, depression, and PTSD are also seen in many lightning strike survivors.
Case Studies of Lightning Strike Survival
While each lightning strike is unique, case studies of survivors provide some insights into the factors involved in survival:
Case Study 1: Direct Strike Survival
A climber in the Scottish Highlands was directly struck by a lightning bolt while wearing a metal helmet and using ice axes. He collapsed with cardiac arrest but his climbing partner performed CPR. At the hospital, his heart restarted after defibrillation. He suffered severe neurological impairment but slowly recovered after weeks in intensive care.
Case Study 2: Indirect Strike Survival
A 27-year-old man was struck indirectly while in a park under a tree during a thunderstorm. He lost consciousness briefly but suffered no cardiac arrest. However, he had severe burns to his arms and chest as the current passed through his body into the ground. After two weeks in the ICU and two months in the hospital, he survived with permanent scarring and numbness on one side of his body.
Case Study 3: Delayed Death
A 17-year-old football player was struck by lightning during practice and collapsed. At the hospital he was alert and stable, with only small external burns. However, two days later he suffered cardiac arrest and brain swelling. Despite intense treatment, he died 10 days after being struck by lightning. This highlights the risk of delayed death after an initially survivable strike.
These cases illustrate the diversity of lightning strike scenarios and outcomes. While death is common, survival is possible with prompt first aid, intensive medical intervention, and some luck. Ongoing issues are likely, but survivors can recover and adapt.
Survival Tips
While there are no guarantees with lightning strikes, some strategies may improve your chances of survival:
- Get to safe shelter immediately when storms approach.
- Avoid being the tallest object in an open area.
- Don’t shelter under isolated trees or in shallow caves/overhangs.
- If your hair stands on end or skin tingles, lightning may strike – crouch low immediately.
- Avoid contact with conductive surfaces (water, metal, graphite).
- Don’t use wired phones – use mobile phones only in emergencies.
- If someone is struck, call 911 and give immediate first aid.
- During storms, have a planned evacuation route and safety plan.
Situational awareness and protective actions are your best defenses. But if lightning strikes, remember – with quick action and medical care, survival is possible.
Conclusion
Lightning strikes cause injuries through cardiac arrest, burns, neurological damage, trauma, and respiratory failure. With prompt first aid in the field, resuscitation and intensive treatment at the hospital, and rehabilitation, patients can survive. However, permanent disabilities are common. Some cases may initially appear survivable but progress to delayed death days later. Prevention through situational awareness and safe practices during lightning storms is key to avoiding potentially fatal strikes. By understanding the first aid, medical interventions, and factors that influence chances of survival, we can improve the odds for those affected by these devastating electrical injuries.