Lightning

Aside from flooding, death from lightning is the highest storm related fatality. It normally occurs in the summer months during times of athletic and outdoor activity.  Most often occurs to individuals who are alone, rather than in a large group. The greatest form of preparation is becoming educated and aware of unsafe surroundings.  People must be cognizant of the risks of lightning producing storms and the appropriate steps to reduce the risk of lightning related injury.

Studies have shown that people suffering from lightening injuries were only a few feet away from safety, but chose to not leave their unsafe environment.  15-30% of the deaths from lightning occur during recreational activities and sporting events.  Lightning producing storms are more likely to occur from early spring to fall, with a higher frequency in the southeast part of the United States.

 

How can lightning strikes be prevented?

  • “If thunder roars – GO INDOORS!”  Everyone should be in safe zones BEFORE lightning reaches the playing field.
  • If a storm is suspected or lightning/thunder is observed all outdoor activities should be suspended and athletes/spectators should head to “lightning safe” facilities until the weather clears.
    • A “lightning safe” facility is a fully enclosed building with both plumbing and wiring.
    • Concession stands, pavilions, standing under trees, equipment sheds, and tents are not considered lightning safe and lightning can still strike people within these locations.
    • If a fully enclosed building is not available, people should go inside a car or bus with the windows fully closed and doors shut.
  • Establish a lightning policy within the venue’s emergency action plan. The policy should include the following:
    • A chain of command to alert appropriate personnel of an impending storm
    • Designation of “lightning safe” facilities for evacuations
    • Plan for evacuating athletes and spectators, accounting for large crowds
    • Monitoring local weather forecasts
    • Know the phone number for the LOCAL weather service to have up-to-date weather updates
    • Specific criteria for the suspension and resumption of play
  • Educate athletes, parents, coaches, referees, etc. about the dangers of lightning producing storms and the appropriate actions to take in the event of a storm.
  • Establish several methods for alerting spectators of an incoming storm including a speaker system, text messages, staff announcements, etc and give pre-event warnings, make patrons aware of visual signs to safe zones, etc.

Lightning

When do you suspend/resume play during a storm?

  • All activity should be suspended upon the first observable lightning strike or sound of thunder
  • A proactive approach can also be taken using the local weather service and listening to warnings. If a warning is given by a weather service it is recommended to suspend activity even if lightning/thunder has not been observed at the playing field.
  • Play may resume 30 minutes after the last sound of thunder/observable flash of lightning. The 30-minute clock restartsEVERY TIME A NEW LIGHTNING FLASH OR THUNDER SOUND IS HEARD.

 

Look for these symptoms in athletes when a lightning strike is suspected:

Table 1. Signs and symptoms of a lightning victim.

Minor

Moderate

Severe

Temporary to no LOC

Disorientation, combative, or comatose

Brain damage

Possible blindness, deafness, tympanic rupture

Possible temporary paralysis of extremities (may be pale, blue, pulseless)

Hypoxia secondary to cardiac arrest

Confusion/amnesia

Hypovolemtic shock àlook for blunt abdominal trauma

Blunt trauma fractures and intracranial injuries

Stable vitals (possible hypertension)

Temporary cardiopulmonary standstill

Possible parasthesia, muscle pain, headache lasting days to months

1st and 2nd degree burns usually occur a few hours after injury

Adapted from: Walsh K, Cooper MA. Lightning. In: Casa DJ, ed. Preventing Sudden Death in Sport and Physical Activity. Sudbury, MA: Jones & Bartlett Learning. 2012: 332.

 

How do you treat a lightning strike victim?

There is no need to worry about getting an electric shock from the victim. The flow of electricity traveled through the victim and there is no charge that is stored.  In the event of a lightning strike the following steps should be taken to ensure your safety and to treat the appropriate people:

  1. Make sure the scene is safe to treat the lightning victims. You should not place yourself in harm if danger is imminent.
  2. Activate EMS (or have someone else activate EMS if you are the one providing care)
  3. Be prepared to treat people in cardiac arrest, have severe burns, shock, fractures another trauma.
  4. Treat the victim that appears dead first (if there are more than one victim). This victim is in the most severe condition and timely care needs to be taken to maximize chances of survival
  5. If needed and capable move the victim to a safe area for treatment

 

When can a lightning strike victim return to activity?

Once the individual has been treated and followed up and cleared by appropriate medical personnel, the athlete may begin a gradual return to activity protocol. The timeline for return to play is dependent upon the severity of the lightning strike and the inflicting injuries. The table below describes some possible neurological damage that may occur with a lightning strike victim.

Minor

Moderate

Severe

May have neurological disorder or PTSD

Possible temporary or permanent sequelae, sleep disorders, parasthesias, general weakness, personality changes, and fine motor/mental function difficulties

Recovery is poor unless treated rapidly with resuscitation

Adapted from: Walsh K, Cooper MA. Lightning. In: Casa DJ, ed. Preventing Sudden Death in Sport and Physical Activity. Sudbury, MA: Jones & Bartlett Learning. 2012: 332.

 

What equipment do you need to be prepared for a possible lightning strike?

  • Cell phone
  • The ability to check local weather conditions (weather pages, smartphone with a weather app, text/mobile alerts from the local weather station)
  • Blankets, splints, burn treatment kit
  • Automated External Defibrillator (AED)
  • Appropriate means to inform the public of safe locations
    • Megaphone or PA system to make announcements for spectators
    • Proper signs and clear, prewritten directions to safe zones in the event of lightning

References

  1. National Weather Service. Lightning Safety: Large Venues. Available at: http://www.lightningsafety.noaa.gov. Accessed on May 24, 2012.
  2. Thomson EM, Howard TM. Lightning injuries in sports and recreation. Curr Sports Med Rep. 2013;12(2):120-124.
  3. Walsh KM, Bennett B, Cooper MA, Holle RL, Lopez RE. National Athletic Trainers’ Association position statement: lightning safety for athletics and recreation. J Athl Train. 2000;35(4):471-477.
  4. Walsh K, Cooper MA. Lightning. In: Casa DJ, ed. Preventing Sudden Death in Sport and Physical Activity. Sudbury, MA: Jones & Bartlett Learning. 2012: 157-168.