Lightning injuries in a pregnant woman : a case report and review of the literature

Lightning injury is the leading cause of weather-related death after tornadoes, flash floods and hurricanes. Reviewing the literature, between 100 and 300 people die every year, and between 1000 and 1500 people sustain injuries associated with lightning strike in the United States [1,2]. The main cause of death derived from this type of injury is secondary to cardiopulmonary arrest. It is, therefore, recommended to perform prompt and aggressive resuscitation maneuvers [3,4]. The incidence is probably higher since there is no referral and information center where all these data are collected. What is more, many patients affected do not develop secondary pathology to this type of accident and do not require inpatient care suggesting an actual rate of 50% higher [5]. Lightning is an electric discharge which strikes the earth. It arises from the polarization among the water particles of a cloud whose negative charges have been attracted by the positive charge of the earth, bringing about a mass movement of electrons into the earth. Positive charges are commonly located in the upper part of the cloud whereas the negative ones are in the lower part. When this charge concentration (be it positive or negative) arrives at a critical level called breakpoint, it is generated as a luminous discharge of electric charges between cloud and earth. This discharge can move up to 13 km, cause a temperature of 50,000 F (about 28,000 8C, which means three times the colour temperature of the sun), an electric potential of more than 100 million volts and an intensity between 12,000 and 20,000 A. Lightning causes injury through five mechanisms [6]: