Aggressive ABC's with CPR if needed.
Standard ACLS with good ventilation.
Be aware of potential for blunt trauma injuries.
Consider other environmental injuries...hypothermia
Note: lightning strike victims seldom have significant underlying tissue
destruction, and in contrast to other electrical injuries, fluid loading is NOT
necessary and may be harmful.
History may be poor or difficult to obtain
enzymes, CBC, chemistries, UA
Xray: plain films prn, CT, others as needed.
Fluid restriction may be of benefit.
Meds: High Dose steroid use has been useful in blindness
secondary to lightning strike (controversial).
Depending on injuries, subspecialty F/U or close primary
care F/U may be needed. Psychiatric problems, eye or ear problems or long-
term autonomic/neuro problems will require close following.
NO absolute safe place from lightning!!!
For group activities, develop a lightning action plan.
Know Risk Factors...see above in epidemiology.
Learn about thunderstorms and the three stages:
Be weather wise and weather alert...watch the sky.
Flash to Bang Method
A study in Florida found the mean distance between
successive strikes from the same storm to be about 2-3 miles. Since each
storm and flash varies, if you are within 2-3 miles of a flash, the next flash
could be at your location. When you see a flash, count the seconds to the
initial bang of the thunder, and then divide the number of seconds by 5 to