Do you know what to do to help a lightning strike victim? Our Emergency Room Physician, Dr. Christopher L. Huerta, MD, details the causes, prevention methods, and how to help victims of lightning strikes.

By Dr. Christopher L Huerta, MD

Over the past 35 years working in the emergency room (ER), I have treated a lot of patients with lightning-related injuries. I’ve worked as a physician first responder, trauma physician, and worked in emergency centers for decades.

Here are some key lessons I’ve learned.

Risk from Lightning

Working in the oil fields of West Texas and Eastern New Mexico there are certainly risks from lightning.

The season where we are most at risk is spring and early summer. Many people who work outside don’t take this very seriously but lightning is the third leading cause of death in the United States from an environmental injury.

If you are directly struck by lightning you will die. Fortunately, most people are not directly struck by lightning. How close is too close? Nobody knows for certain but of the survivors that I’ve cared for, most were within about 100 yards.

Lightning Injuries Are Unique

What is important to know, is the injury pattern is extremely unique. When someone goes into cardiac arrest and their heart is beating irregularly, we use a device called a defibrillator to reset the heart rhythm.

That is what an AED (automatic electrical defibrillator) does. Now imagine medical doctors using this huge device to automatically reset the electrical activity of your entire body, not just your heart.

Everything in the body is electrically reset.

Your brain stops working, your entire nervous system stops working, your heart stops working and your intestinal tract also stops working.

The heart is usually the first major organ system to restart but it may take several minutes. Breathing usually takes much longer to recover.

What to Know About Victims of Lightning Strikes

When you first get to the victim, they will be pale (i.e. no color), not breathing, pulseless, and have diffuse upper and lower limb flaccid paralysis.

Even if the heart starts beating, they will be pulseless because their autonomic nervous system has stopped working and there will be no blood pressure.

How You Can Help a Lightning Strike Victim

1. Start Immediate Chest Compressions
   Immediately start chest compressions. Good quality Basic Life Support with a rate (100-120/min), depth (2-2.4 inches), and full chest recoil.Usually, within 2-12 minutes the heart will start beating on its own.
2. Roll them On their Side
   Then you need to make certain the victim has a non-obstructed airway by rolling them onto their side and assist with ventilation. The victim may not start breathing on their own for 30 minutes to an hour. Even when a good heartbeat and breathing is returning they will look extremely strange.

The victim will be twitching and jerking involuntarily and be unconscious.It looks a lot like a seizure but unlike a seizure, it can go on for hours. After that stops, they will still be confused and have no recall for quite some time.

Effects of Lightning Strikes

1. Immediate Loss of Hearing
   Even when they recover neurologically, they cannot hear you. Both of their eardrums have ruptured. The sound of thunder can travel miles. Imagine being right at the source of the sound waves. Most will have permanent hearing loss.
2. Burns
   Burns from lightning tends to be very superficial. There is a feather-like burn pattern across the skin even if they were wearing clothing. It may look bad but these are usually not significant.

What to Do If You Are Stuck Outside During a Lightning Storm

1. Get off and away from the drilling platform.
2. Get into your truck and drive at least 100 yards from the drilling rig.
3. Park your truck facing away from the rig and not at a 90-degree angle. If you are at a 90-degree angle you risk all four tires blowing out.
4. Don’t park close to any pipeline or storage tank.
5. Roll up all windows
6. Don’t touch any metal inside the vehicle.

What to Do If a Lightning Strike Does Occur

Account for all your crew members. Call for help and initiate resuscitation even in the pouring rain.

Being a victim of a lightning strike is preventable but even if injuries do occur, the person can be saved.

A person who looks dead after a lightning strike most likely isn’t.

Other Articles by Dr. Christopher L Huerta, MD.

• Snake Bite: ER Physician Details What to Do

Dr. Christopher L Huerta, MD, is a board-certified emergency room physician with over 35 years’ experience treating various illnesses, including snake bites. He obtained his medical degree from Washington University School of Medicine in St. Louis. Dr. Huerta is currently an ER physician at SignatureCare Emergency Center in Midland, TX.