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Concept: Lightning strike


When lightning strikes soil, it may generate a cylindrical tube of glass known as a fulgurite. The morphology of a fulgurite is ultimately a consequence of the energy of the lightning strike that formed it, and hence fulgurites may be useful in elucidating the energy distribution frequency of cloud-to-ground lightning. Fulgurites from sand mines in Polk County, Florida, USA were collected and analyzed to determine morphologic properties. Here we show that the energy per unit length of lightning strikes within quartz sand has a geometric mean of ~1.0 MJ/m, and that the distribution is lognormal with respect to energy per length and frequency. Energy per length is determined from fulgurites as a function of diameter, and frequency is determined both by cumulative number and by cumulative length. This distribution parallels those determined for a number of lightning parameters measured in actual atmospheric discharge events, such as charge transferred, voltage, and action integral. This methodology suggests a potential useful pathway for elucidating lightning energy and damage potential of strikes.

Concepts: Energy, Volume, Lightning, Units of measurement, Cumulative distribution function, Lightning strike, Fulgurite, Lechatelierite


Lightning strike victims are rarely presented at an emergency department. Burns are often the primary focus. This case report describes the improvised explosive device like-injury to the thorax due to lightning strike and its treatment, which has not been described prior in (kerauno)medicine. Penetrating injury due to blast from lightning strike is extremely rare. These “shrapnel” injuries should however be ruled out in all patients struck by lightning.

Concepts: Lightning, Injuries, Wound, Explosive material, Improvised explosive device, Explosive weapons, Bomb, Lightning strike


Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity.

Concepts: Mortality rate, Myocardial infarction, Cardiology, Atrial fibrillation, Lightning strike


Only limited clinical scenarios are grounds for induction of therapeutic hypothermia. Its use in traumatic cardiac arrests, including those from lightning strikes, is not well studied. Nonshockable cardiac arrest rhythms have only recently been included in resuscitation guidelines. We report a case of full neurological recovery with therapeutic hypothermia after a lightning-induced pulseless electrical activity cardiac arrest in an 18-year-old woman. We also review the important pathophysiology of lightning-induced cardiac arrest and neurologic sequelae, elaborate upon the mechanism of therapeutic hypothermia, and add case-based evidence in favor of the use of targeted temperature management in lightning-induced cardiac arrest.

Concepts: Medicine, Electricity, Lightning, Cardiac arrest, Cardiopulmonary resuscitation, Asystole, Drowning, Lightning strike


We aimed to develop a system for controlled exposure of biological samples to conditions they experience when lightning strikes their habitats.

Concepts: Lightning, Lightning strike


We present a case of a middle-aged male struck by lightning while walking in a parking lot. Assessment of the patient’s injuries demonstrated common sequelae of an otologic blast injury. Review of this case should prepare the otolaryngologist to identify and manage otologic blast injuries regardless of their etiology.

Concepts: Lightning, Injuries, Injury, Parking lot, Lightning strike


Lightning strikes cause injuries in multiple systems and organs. Early recognition of lightning injury syndromes and anticipation of harmful complications can improve outcomes for these patients. The author has presented a case report of a patient who was struck by lightning and exhibited extensive soft tissue injury with myoglobinuria. He was treated with delayed fasciotomy and had evidence of severe muscle injury with markedly elevated creatine kinase levels that gradually improved with aggressive fluid infusion. The patient did not require alkalinization of urine, mannitol, or dialysis, and his renal function remained normal.

Concepts: Renal failure, Nephrology, Patient, Lightning, Injuries, Creatine kinase, Strike action, Lightning strike