Page 133 - PJ MED OPS Handbook 8th Ed

Lightning Injury
Prevention:
Avoid being the tallest object in an open area. Do not take shelter under a single tall tree or next to
metal/conducting objects. Stay clear of antennas/radios during thunderstorms. Inside an enclosed
vehicle is relatively safe. Seek shelter in a grove of trees if possible. If caught in the open, crouch low
with feet together. Team should spread out so a single strike will not hit all team members (hand
grenade rules).

Signs and Symptoms:
1. Victims may be confused, paralyzed (especially lower extremity paralysis), have fluctuating blood
pressure, be unconscious but have vital signs or be in cardiopulmonary arrest.
2. Other injuries can include ruptured TMs, temporary blindness or deafness, altered mental status
or amnesia.
3. Most symptoms will resolve by themselves over hours to days.

NOTE: Victims of lightning strike ARE NOT electrically charged and may be touched immedi-
ately after injury.

Treatment:
1. Single Casualty:
a. CPR and ALS as required
b. Dress any burns
c. Evacuate ASAP
2. Multiple Casualties:
a. REVERSE TRIAGE (treat the apparently dead personnel FIRST, rather than last)
b. Patients who are awake, able to move or talk will likely survive
c. Patients in cardiopulmonary arrest may only need 1–2 minutes of CPR to regain pulse and
respirations
d. Treat any blast injuries or burns and evacuate ASAP

Chapter 8. Tactical Medical Emergency Protocols (TMEPs) n 131