Premergency First Aid, CPR and AED Manual

9 Other Emergencies

Lightning injury Many injuries and deaths occur each year from lightning. People involved in outdoor recreation or sports are at increased risk. If lightning does not strike the ground, it typically strikes the highest object in the immediate area. That object may be the patient or a structure such as a tree, goalpost, or building. The lightning will continue through the object it strikes until it reaches the ground. Even if a person avoids a direct strike, they can still be injured. Electrical current may travel through the object struck and arc, or jump, to the patient. A bolt of lightning contains tremendous energy. Struck objects may splinter or explode, causing danger from missile injury. Strikes directly to or close to the patient will usually throw the patient some distance, causing tertiary injury from impact with other objects or the ground. Always suspect possible head and neck injury in a patient struck by lightning.

First aid for lightning injury combines the first aid for electrical injury (See Chapter 7, Bleeding, Wound and Trauma) with the first aid for musculoskeletal injury (See Chapter 8, Muscle, Bone and Joint Injury). Considerations specific to lightning include: • Lightning can strike the same area or even the same spot twice. Move to a safer location if there is indication of continued electrical activity. • Unlike other electrical injury, you do not need to assess for continued danger from the patient. A patient struck by lightning does not retain an electrical charge. • Reverse the priority of triage normally used for multiple patients. Give priority to patients that require CPR. • Advise any person affected by a lightning strike to seek medical assessment no matter how minor they feel the effect may have been.

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