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What to do when lightning strikes
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What to do when lightning strikes

While lightning strikes can cause moderate injuries like seizures, in severe cases, they could also cause cardiopulmonary arrests
Photo by Philippe Donn

Rajesh (name changed to protect identity), who hails from a small village in the Palamu district of Jharkhand, has still not gotten over the shock of losing his 16-year-old sister to a bolt of lightning in May 2020. His sister and his mother were picking up lotus seeds which were kept on the terrace to dry when it started to rain. Suddenly, a lightning bolt hit his sister. She collapsed and breathed her last. The mother who witnessed the death suffered from a massive mental shock and is yet to recover from the trauma.

According to global estimates, about 65 people are killed every day due to lightning strikes and 657 people get injured. The article, Summary of Recent National-Scale Lightning Fatality Studies, published in the journal, Weather, Climate and Society, states that about 24,000 people are killed globally every year due to lightning strikes and 240,000 people suffer from injuries.

Rajesh tells Happiest Health, “My mother was talking to my sister and witnessed the lightning bolt striking her. It has been two years since the incident and none of us are able to recover from it. Though lightning hitting people is common in our village, there is very little awareness about the safety measures one should take. Now, I spread awareness among people by sharing our story as an example. If only my mother and my sister hadn’t stepped out that night and had taken shelter inside the house, my sister would have been with us today.”

What is lightning?

Lightning is a sudden high-voltage discharge of electricity that occurs within a cloud, between clouds, or between a cloud and the ground. Globally, there are about 40 to 50 flashes of lightning every second, or nearly 1.4 billion flashes per year. These electrical discharges are powerful and deadly.

Dr Satyanarayana Rao, senior general physician, Kamineni hospital, Hyderabad, says that moderate lightning injury may beget seizures, respiratory arrest or cardiac deadlock, which spontaneously resolves with the resumption of normal cardiac exertion. Severe lightning injury generally presents with cardiopulmonary arrest, frequently complicated by the prolonged period in which the person didn’t receive CPR (cardiopulmonary resuscitation).

“The inattention may be because the individual is in an isolated position when injured or because of the myth that the person retains an electrical charge, making him or her dangerous to touch. Survival is rare in this group unless an observer begins CPR instantly,” he says.

According to the National Crime Records Bureau 2020, in India, at least seven people are killed due to lightning per day, and lightning caused the highest number of deaths in ‘accidental deaths due to forces of nature’ in the year 2020 with 2,862 deaths across the country.

According to the Annual Lightning Report 2020-2021, there has been a 34 per cent rise in lightning strikes in India. The report jointly prepared by multiple organisations including the Indian Meteorological Department and the Ministry of Earth Sciences, Government of India, points out that Odisha with the highest strikes of over 14.20 lakh has recorded 207 deaths. However, the highest number of fatalities was in Bihar (401), followed by Uttar Pradesh (238).

Signs and symptoms

Lightning strikes can also induce a transient paralysis known as ‘keraunoparalysis.’ Signs and symptoms of keraunoparalysis include lack of pulse, pallor or cyanosis, and motor and sensory loss in the extremities. However, keraunoparalysis usually resolves within a few hours.

Dr Rao points out the signs and symptoms of a person struck by lightning. They are:

  • Cold body temperature
  • Mottled body (marked with spots or smears of colours)
  • Faint pulse
  • Confusion
  • Amnesia (loss of memory)
  • Palsy (paralysis)
  • Loss of knowledge

“There could also be tympanic membrane rupture (a small hole or tear in the eardrum), hypotension (low blood pressure), muscle weakness, fixed and dilated pupils which generally occurs because of flash autonomic disturbances. The visible signs are clothing that’s seared and tattered, shoes that appear to have exploded from the inside and melting of brass grommets, zippers and watches,” says Dr Rao.

Treatment for lightning strike

Busting the common myth, Dr Rao says that it is safe to touch a lightning strike victim and they do not carry a charge. Original treatment should start with evaluation and stabilisation of the airway, breathing and rotation. Start CPR if there is no pulse.

Recommendations as per the Centers for Disease Control and Prevention, in case of lightning, are as follows:

  • Call for help – Call emergency numbers and ask for help. 911 (US, Canada), 112 (India, UK, all EU countries).
  • Assess the situation – If the person struck by lightning is in a high-risk area (isolated tree or open field) shift them to a safer area.
  • Respond – Lightning often causes a heart attack. Check to see if the victim is breathing and has a heartbeat.
  • Resuscitate – If the victim is not breathing, immediately begin mouth-to-mouth resuscitation. If the victim does not have a pulse, start cardiac compression as well as CPR. Continue resuscitation efforts until help arrives. If the area is cold and wet, putting a protective layer between the victim and the ground may help decrease hypothermia (abnormally low body temperature).

Do’s and Don’ts during lightning

  • Go indoors.
  • Seek shelter immediately if caught out in open.
  • Get off elevated areas such as hills, mountain ridges or peaks
  • Never lie flat on the ground. Crouch down in a ball-like position with your head tucked and hands over your ears so that you are down low with minimal contact with the ground.
  • Never shelter under an isolated tree.
  • Never use a cliff or rocky overhang for shelter.
  • Immediately get out of and away from ponds, lakes and other bodies of water.
  • Stay away from objects that conduct electricity (barbed wire fences, power lines, windmills, etc).
  • Do not lie on concrete floors during a thunderstorm. Also, avoid leaning on concrete walls. Lightning can travel through metal wires or bars in concrete walls or flooring.
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