Lightning is one of the most powerful and dangerous natural forces on earth. A lightning bolt carries up to one billion volts of electricity and is five times hotter than the surface of the sun. When lightning strikes a person, the results can be catastrophic and sometimes fatal. But what exactly happens to the human body when it gets hit by lightning? Here is a quick overview of the potential effects.
Electrical Burns
The massive electrical current that passes through the body during a lightning strike can easily burn the skin and underlying tissues. Entry and exit burns will be present on the skin where the electricity entered and left the body. These burns leave behind characteristic fern-like patterns on the skin. The high heat can also damage nerves and lead to paralysis.
Cardiac Arrest
The electrical current can throw the heart into abnormal rhythms like ventricular fibrillation which makes it quiver uselessly instead of pumping blood. This leads to cardiac arrest and loss of pulse. Effective CPR and cardiac defibrillation are needed to try restarting the heart.
Neurological Effects
The brain is very sensitive to electrical disruption. The lightning current can injure the brain leading to immediate loss of consciousness. It can also damage the centers that control breathing, heart function and other vital functions and cause death. Survivors may experience permanent neurological disabilities like memory deficits.
Secondary Injuries
The intense muscle contractions caused by the lightning current can tear muscle fibers and cause kidney damage or even spinal fractures as the body gets hurled by the current. Falls from lightning strikes can also cause fractures and head injuries. Burn injuries can lead to dangerous fluid and electrolyte imbalances. Infection risk is high in electrical burns which penetrate deep into the body. Serious injuries to multiple organs can complicate the recovery.
Detailed Effects on the Body
Let us take a more detailed look at how the many systems and organs of the human body can get affected when struck by lightning.
The Nervous System
The brain is highly susceptible to disruption of its electrical signaling by the external lightning current. Immediate effects include loss of consciousness and seizures. Certain areas of the brain like the brainstem which control breathing and circulation can get damaged leading to death. Survivors may be left with permanent neurological disabilities like:
- Memory and cognitive deficits
- Difficulty concentrating, multi-tasking and processing information
- Chronic pain syndromes
- Movement disorders
- Balance problems
- Headaches
- Ringing in the ears
- Personality changes
The current can also travel down the spinal column and nerves leading to paralysis, numbness or altered sensations in the arms and legs. Nerve damage can be permanent.
The Heart
The heart’s electrical system keeps it pumping in a coordinated rhythm. The external lightning current overwhelms this system and causes chaotic quivering of the heart known as ventricular fibrillation. This causes loss of pulse and death unless cardiopulmonary resuscitation (CPR) and defibrillation are quickly done. Heart block, damage to heart valves and abnormal heart rhythms may also occur.
The Lungs
Lightning strikes can cause the chest muscles to suddenly contract leading to blast injuries or a bruise like condition called commotio cordis which can stop the heart. The current itself can paralyze the breathing center in the brainstem. Lack of oxygen rapidly damages other organs including the heart and brain. Acute respiratory distress syndrome can occur hours to days later due to fluid buildup and inflammation in the lungs.
The Skin
The high voltage current enters and exits through the skin causing characteristic linear burns called Lichtenberg figures. These reddish fern-like patterns reflect the path of the electrical current. The injured areas may be numb due to damaged nerves beneath the skin. Blistering, peeling and necrosis of the skin occur with deep burns.Singed hair and nail damage can also occur. Lightning burns carry a high risk of bacterial contamination and infection.
The Ears
The acoustic shock or blast injury from the nearby explosive lightning strike can tear the delicate eardrums. There may be hearing loss or ringing ears. Rupture of the small blood vessels in the ear can cause bleeding into the ear structures. Ear damage may cause dizziness, balance problems and nausea.
The Eyes
Very bright lightning flashes can damage the retinas. This causes spots or streaks in the vision along with blindness. The effect may be temporary or permanent.
Other Effects
- Damage to small blood vessels and bleeding in muscles or internal organs.
- Acute kidney damage
- Fractures or dislocations due to concussive blast forces or uncontrolled falls
- Damage to testicles in males and breast tissue in females
- Loss of or altered consciousness
- Amnesia regarding the event
Long Term Consequences
Those who survive severe lightning strikes may be left with debilitating long term consequences such as:
- Chronic pain from nerve injuries, headaches, back pain, arthropathies
- Parkinson’s disease like movements and tremors
- Partial paralysis
- Brain disorders and neurocognitive deficits
- Psychological issues like anxiety, fear of storms, post traumatic stress
- Heart and lung diseases
Mortality Rate
About 10% of people who suffer lightning strikes are killed, often due to cardiac arrest and brain injuries. The mortality is higher in developing countries. With prompt CPR and first aid, many lives can be saved.
Mechanism of Lightning Injuries
Let us look at how lightning exactly affects the body.
Types of Lightning Strikes
There are several mechanisms by which lightning can strike a human:
- Direct strike – The person is part of the direct path traversed by the main lightning bolt.
- Contact injury – The person was touching an object like a wired fence or telephone pole which was hit by lightning.
- Side flash – A side branch of the lightning flash hits the person.
- Ground current – Lightning hits the ground nearby and the current spreads out underground and passes through the legs.
- Upward streamer – A leader stroke from the ground meets a downward stroke halfway.
Effects of Electricity on the Body
The effects of an electric shock depend on:
- Amount of current flow through the body (amperes)
- Path taken by the current
- Duration of contact
- Phase of the heartbeat when electrocuted
Low amounts of current can cause tingling and muscle contractions. More current can freeze muscles in spasm and burn tissues. High current causes cardiac arrest, internal organ damage and neurological effects. Continued current flow causes more damage.
Electrical Injuries
Lightning current causes several types of injuries:
- Electroporation – Pore formation in cell membranes disrupts cell function.
- Vascular damage – Blood vessels constrict and then dilate excessively.
- Tissue damage – Thermal injury and cell death due to intense heat.
- Neuromuscular injury – Nerve stimulation and tetany. Muscle damage leads to breakdown products in the blood.
- Electrolyte imbalances – Changes in blood minerals affect heart rhythm.
Thunderbolt Injuries
The explosive shock wave from the massive lightning discharge also contributes to injury by:
- Blast pressure causing lung and gut injuries
- Tympanic membrane rupture
- Missiles from exploded objects
- Sudden falls from the concussive force
- Potential fires and burns
Factors Affecting Lightning Fatality
Some factors influence how severe the damage from a lightning strike may be:
Strike Location
- Head strikes are more likely to be fatal.
- Higher voltage current enters through the head and leaves through the legs causing severe neurologic and cardiovascular injury.
Lightning Type
- Direct strikes cause more damage than indirect hits.
- Upward streamers from ground objects allow some voltage to be shunted around the body decreasing injury.
Body Resistance
- Less resistant paths like nerves and blood vessels transmit more current resulting in greater trauma.
- Callus formation may increase resistance and reduce some skin burning.
Ground Conditions
Damp ground has lower resistance allowing more earth currents to enter the body. Dry sandals and insulation when outdoors decreases risk.
Situational Factors
Being enclosed in a car or house offers some protection. Quick medical care and CPR improve survival.
First Aid for Lightning Strike Victims
Prompt first aid can help prevent deaths and improve outcomes in lightning strike victims.
Safety First
- Avoid becoming another lightning victim. Wait until the strike threat has passed before approaching the victim.
- Lightning may strike again in the same area so be alert.
- Move the victim carefully to a safer location if needed.
Start Resuscitation
- Activate emergency medical services immediately.
- Check airway, breathing and circulation. Rescue breathe and do CPR if required.
- Defibrillate if possible using an AED to try restoring a normal heart rhythm.
First Aid Measures
- Manage any major bleeding and dress burns or wounds.
- Immobilize fractures safely if present.
- Give oxygen if available.
- Monitor vital signs frequently.
- Perform CPR continuously until advanced life support arrives.
Lightning Position
If multiple victims are struck at once and resources are limited, the lightning position can be used. The victim is placed on their side with the head lower than the heart. This helps drain fluid from the lungs and may improve breathing.
Transfer to Hospital
- Transfer to hospital should be done as soon as possible.
- Monitor heart rhythm, oxygen levels, neurological status closely.
- IV fluids and medication may be needed.
Treatment of Lightning Injuries
Treatment of lightning strike victims focuses on supporting vital organs and preventing complications.
Airway and Breathing Support
- Maintain open airway and give oxygen via mask or intubation.
- Machine ventilation may be required if victim cannot breathe adequately.
- Drain fluid collection and air leaks in the chest using intercostal tube drainage.
Cardiovascular Support
- Give intravenous fluids to counter shock. Monitor urine output.
- Treat arrhythmias with appropriate drugs and electrical cardioversion.
- Insert temporary pacemaker if there is heart block.
- Use vasopressors and inotropes to maintain blood pressure and cardiac contractility.
- Treat associated myocardial ischemia or infarction.
Neurologic Care
- Treat seizures, raised intracranial pressure and other neurologic complications.
- Avoid drugs that lower blood pressure and cerebral perfusion.
- Monitor for autonomic storm which requires sedation, cooling protocols.
- Rehabilitate cognitive, motor, sensory and functional deficits.
Wound Management
- Debride necrotic tissue thoroughly and dress burns.
- Perform fasciotomies or escharotomies for compartment syndrome.
- Promptly treat infections with antibiotics.
- Later do split skin grafting, flap closures or amputations if required.
Other Organ Support
- Treat muscle breakdown, electrolyte abnormalities and kidney injury.
- Do bladder catheterization if urinary retention.
- Treat gastrointestinal bleeds, paralytic ileus.
- Provide good general nursing care, nutrition and physiotherapy.
Preventing Lightning Strikes
Lightning strikes are preventable. Some strategies to avoid being struck include:
- Check the weather report before outdoor activities.
- Seek shelter in a building or vehicle at the first sign of a storm.
- Avoid open areas, hilltops, tall isolated trees, wet areas, water bodies and open structures.
- Stay away from electricity poles, towers and fences.
- Keep low during thunderstorms. Crouch down if hair stands on end.
- Suspend activities for 30 minutes after last thunder.
- Wear rubber soled shoes.
- Ditch the umbrellas, mobile phones and long objects during storms.
Proper lightning protection measures for buildings, electric lines and towers can prevent damage. Public education is vital to decrease lightning deaths and injuries.
Conclusion
Lightning is an extremely powerful electrical force capable of causing severe, multi-system trauma to the human body. Prompt first aid and medical care improve the odds of survival and better recovery. Preventive strategies can help individuals avoid lightning strikes. Public health efforts are needed, especially in developing nations, to reduce lightning related morbidity and mortality. Increased public awareness and preparedness will go a long way in conquering this natural hazard.
