Lightning injury management at the Emergency Room - a case report of an unusual ground current injury during a local family fest.

Abstract

Lightning injuries are one of the most rare type of injuries that are admitted to the ER. They are presenting a wide spectrum of symptoms with less or more dangerous evolutions. The most severe of them are complicated by: rhabdomyolysis, acute kidney injury and danger cardiac arrythmias. Treatment of those patients is challenging for every personnel of emergency ward. In this paper we present a case of 34 years old male which suffered from lightning injury during family fest organized on a public square. Over time, patient status was changing from almost lack of symptoms to severe complications, including: rhabdomyolysis, compartment syndrome, hyperkaliemia and cardiac arrythmias. Treatment process las for 18 days and includes: ER, ICU, Operating Room and Internal Medicine Ward. In the discussion, author analysis retrospectively diagnostic process and is making a questions about improvement methods for dealing with this kind of “unusual” cases that are presented at the ER.

Keywords

• lightning injury
• critical care management
• rhabdomyolysis
• heart rhythm disorders.