1. Lesson 14: Lightning

2. Objectives Describe how lightning can cause injury/death
Describe the prevention of a lightning induced injury
Describe the emergency treatment & care for lightning injuries
Describe when evacuation is necessary in lightning cases

3. Lightning Overview
Lightning strikes can cause harm in the following ways:
Direct strike: person receives a direct hit
Splash: when strike jumps from its direct target to a person
Ground current: electrical charge from lightning radiates from strike point through the ground
Long conductor: object person is touching is hit (such as a pole or fence)
Blast injury: object such as tree is hit and explodes

4. Types of Lightning Injuries
Lightning strikes are dangerous & can affect all parts of the body
Types of injuries:
Cardiac or pulmonary arrest
Neurological problems, loss of responsiveness, paralysis, seizures
Blindness, often temporary
Burns, typically superficial & feathery or fern like. Potentially at entrance & exit points
Trauma from strike itself, or being thrown (i.e. fractures, internal bleeding, etc.)

5. Caring for Lightning Injuries
When scene is safe, do primary and secondary assessment, do a SAMPLE history & check vital signs
Start CPR immediately, if needed
Treat other injuries as required
Be ready to treat secondary issues, such as hypothermia for patients who are wet

6. Guidelines for Evacuation
GO FAST for anyone struck by lightning
Even when person appears to recover. Serious problems sometimes develop later on, after a lightning strike

7. Preventing Lightning Injuries
What things should you avoid during a lightning storm?

8. Preventing Lightning Injuries
Things/places to avoid during a storm:
High places & high objects such as tall trees, towers, etc.
Open places (i.e. lakes, fields, areas above timberline)
Damp, shallow caves and tunnels
Overhangs
Flood zones
Long conductors such as fences
Places obviously hit in the past

9. Preventing Lightning Injuries
Know local weather patterns
Plan turn around times (time needed to get back to the patient). Stick to your plan (don’t over extend)
Plot storms using these methods:
Distance to lightning is 5 seconds/mile
Follow rule: seek safe location, if storm < 6 miles away. Wait 30 minutes after storm passes

10. Finding a Safe Spot Activity: Break into 2 groups
Come up with rules for the safest available location

11. Finding a Safe Spot (cont’d.)
Move downhill
Move out of meadows
Seek uniform cover such as rolling hills, or trees all about the same size, low spot among rocks, etc.
Take shelter in a metal framed building. Avoid telephones, power wires or touching metal. Remove metal frame packs

12. Finding a Safe Spot (cont’d.)
Take shelter in hard topped motor vehicles
If boating, get to land and move away from shore
Pick safe campsites (see above rules)
Provide instruction to all members of group
Lightning CAN strike twice in the same location!

13. Assuming a Safe Position
If available, stand on an insulator (i.e. life jacket, sleeping pad, etc.)
Take off metal framed packs & move away from them
Squat or sit in tight body position (get low minimize contact to ground)
Do not lie down
Cover ears with hands, close eyes, get head close to knees
Spread out, at least 100 feet between individuals