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Promptly investigate the hypotensive patient for major hemorrhage, spinal shock,
or fluid loss from burns. Internal burns of muscles may result in extensive fluid loss, out
of proportion to the external burns. Burns requiring Burn Center therapy are rarely a
requirement Test vision and evaluate hearing. Tetanus immunization must be current.
Evacuate all patients surviving a lightning strike for definitive medical evaluation and
treatment. These patients have a potential for immediate and delayed sequelae, including
neurological, renal, cardiac, and muscular dysfunction.
