Lightning injury can cause systemic deterioration, including neurologic deficits. We present a case of lightning injury with reversible neurologic deficits in a 49-year-old man. Clinical manifestations of neurologic deficits due to lightning injury vary from lightheadedness to paralysis. In order to achieve a favorable outcome, immediate respiratory support and careful neurologic examinations are key elements during initial resuscitation. If secondary injuries due to any type of trauma following lightning were suspected, emergency physicians should make a decision regarding use of advanced diagnostic and therapeutic modalities.
Dizziness ; Emergencies ; Humans ; Lightning Injuries* ; Lightning* ; Middle Aged ; Neurologic Examination ; Neurologic Manifestations* ; Paralysis ; Resuscitation

Lightning injury is uncommon, as evidenced by the fact that most physicians never see or treat such a victim. To our knowledge, there were no reports of lightning burn with flame burn. We report a case of lightning burn with flame burn. On a rainy day, a 64-year-old woman with an umbrella in her left hand was walking along a road. When lightning struck the tip of her umbrella, her clothes were flamed. She threw herself into the water in a nearby field. The fire was extinguished. Then she lost consciousness, but she regained consciousness immediately. She was transported to our hospital. On arrival at our emergency center, her physical examination was remarkable. The patient had an entrance wound of the left palm and an exit wound of the left foot as well as 25 % total body surface burns, which were present in the flexor surface of the left hand, left arm, left leg and left flank. Histopathology showed epidermal and dermal necrosis. Three months later the burns were healed spontaneously, with some remaining scars.
Arm ; Burns* ; Cicatrix ; Consciousness ; Emergencies ; Female ; Fires ; Foot ; Hand ; Humans ; Leg ; Lightning Injuries ; Lightning* ; Middle Aged ; Necrosis ; Physical Examination ; Walking ; Water ; Wounds and Injuries

BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.
Burn Units ; Burns* ; Humans ; Inhalation ; Lightning ; Renal Insufficiency ; Resuscitation ; Smoke Inhalation Injury ; Wound Healing

BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.
Burn Units ; Burns ; Humans ; Inhalation ; Lightning ; Renal Insufficiency ; Resuscitation ; Smoke Inhalation Injury ; Wound Healing