What kind of damage is caused by a lightning strike?
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Lightning injuries are injuries caused by a lightning strike.[3] Initial symptoms may include heart asystole and respiratory arrest.[1] While the asystole may resolve spontaneously fairly rapidly, the respiratory arrest is typically more prolonged.[1] Other symptoms may include burns and blunt injuries.[1] Of those who survive about 75% have ongoing health problems as a result, such as cataracts and hearing loss.[1] If death occurs it is typically from either an abnormal heart rhythm or respiratory failure.[1]
Lighting injuries are divided into direct strikes, side splash, contact injury, and ground current.[1] Ground current make up about half of cases and occurs when the lightning strikes nearby and travels to the person through the ground.[1] Side splash makes up about a third of cases and occurs when lightning strikes nearby and jumps through the air to the person.[1] Contact injury occurs when the person is touching the object that is hit.[1] Direct strikes make up about 5% of injuries.[1] The mechanism of the injuries may include electrical injury, burns from heat, and mechanical trauma.[1] Diagnosis is typically based on history of the injury and examination.[1]
Prevention includes avoiding being outdoors during a thunderstorm.[2] If avoiding being outdoors is unavoidable crouching low is recommended.[2] When indoors the use of devices connected to electrical outlets and contact with water is not recommended.[2] Among those who appear in cardiac arrest and have no central pulse, cardiopulmonary resuscitation (CPR) should be started.[1] In those who have a central pulse but are not breathing artificial ventilation, such as mouth to mouth, is recommended.[1][4]
It is estimated that lightning injuries occur 240,000 times a year with 24,000 deaths.[1] Areas with mountainous terrain and moisture-heavy airflow, such as Central Africa, have the highest rates of lightning strikes.[5] Among pregnant women who are hit by lightning, the death of the baby occurs in about half.[1] In the United States about 1 in 10,000 people is hit by lightning during their lifetime.[1] Males are affected 4 times more often than females.[1] The age group most commonly affected is 20 to 45 years old.[1]