Treatment of lightning injury: III. Intensive care management

Lightning injuries generally can be grouped into three classes of severity: mild, moderate, and severe. The prognosis and treatment depend on the severity of injury and the presenting signs that the patient exhibits. The mildly injured patient is often just stunned by the stroke. They usually are awake and able to respond to questions, although they may be confused and amnesic for the event, and continue to have difficulty with short-term memory assimilation for a few hours or days after the incident. The moderately injured patient may be disoriented, combative, or comatose. They often have keraunoparalysis, with paralysis of the lower and sometimes upper extremities that lasts for several hours. Severely injured victims often present in cardiac arrest with either ventricular standstill or fibrillation. Cardiac resuscitation may, on occasion, be successful. The victim of lightning stroke may suffer a range of injuries, from being temporarily stunned to full cardiac arrest