If a member of your party were struck by lightning while you are camping, hiking, canoeing, or kayaking in the “wilderness” of north Georgia, would you know what to do that might save their life? Lighting has been much in the news lately. The Atlanta area has had a rash of house fires started by lightning, and a young girl was struck while in her house in her bed!

In July, two Boy Scouts were killed by lightning in the high Sierra in California, and about two weeks later, a Boy Scout was killed while in a log shelter in Utah. I have heard a personal account of a man driving in Montana when his car was hit by lightning, striking his wife in the face.

There is a documented case of a man hit by a bolt of lightning that came from a totally clear sky; it was later found to have originated as the ONLY bolt from a storm in a neighboring valley 10 miles away.

So, you get the idea — lightning can be nasty and unpredictable, and maybe no place is really safe, but when you are outdoors, hiking or camping in the woods, or paddling on a river or lake, you feel really vulnerable. The good news is that there are some things you can do to minimize your risk, and the better news is that a lightning strike may be survivable, especially if those with the victim know what steps to take.At a recent meeting of The Wilderness Medical Society, the following facts were provided:

1. Lightning is 4 times hotter than the sun, and can travel up to 100,000 miles a second.
2. Voltages can be in the range of 10 million to 100 million volts.
3. Current can be as high as 50,000 amps.
So… how can a body possibly withstand this???? Because the duration is exceedingly short, in the range of 0.01 to 0.0001 seconds.
4. Lightning kills about 100 people per year in the US, and injures about 400, although actual numbers are probably higher.
5. Over 90% of casualties occur between May and September, with the peak in July; over 70% occur between noon and 7PM.
6. Most victims are males (84%).
7. Risky locations include mountain tops/ridges and trees (Colorado), and a location near water or trees (Florida). Open fields are also risky. Florida, by the way, leads the list with the most injuries and the most deaths.
8. A direct strike is the most dangerous injury, with ground current and “splash” or side flash injuries less so.

So, if you witness a person hit by lightning, this is an instance where CPR in the wilderness situation may be beneficial. The injured person may have sustained a cardiac arrest (not to be confused with a heart attack) as well as a respiratory arrest (not breathing). They may appear dead. Start CPR immediately if practical. This may be difficult in the midst of a thunderstorm with heavy rain and continued lightning; also be mindful of the dictum not to endanger your own life to rescue another.

Many bodily processes work with very small electrical currents — just like your computer. When lightning hits, it throws the switch and depolarizes everything, and the heart and breathing stop. But just like re-booting your computer, the heart has a pacemaker, and it may (not a guarantee) spontaneously restore a normal heartbeat. Spontaneous resumption of breathing may also occur, but may take up to 30 minutes. So start CPR immediately; if the pulse returns on its own, all you have to do is continue the breathing part of CPR and you may save a life!After 30 minutes, if there is no heartbeat and no breathing, further efforts at resuscitation are probably futile.

Time is of the essence! If the victim does not get assistance with breathing, the heart gets no oxygen, and will go into cardiac arrest again. Also, permanent brain damage occurs after three minutes of no oxygen. If the victim lives, they may have other injuries, and transport to a medical facility becomes your next order of business.A word about CPR in the wilderness is appropriate, because it is much different from the situation you have at home or at the shopping mall. The biggest difference is that you don’t have any backup: 911 is either not available at all, or is many hours or miles away. Since CPR is an expedient until the Medics arrive, and since they are not going to arrive in a timely fashion if at all, it is legitimate to question whether CPR in this setting is worthwhile.

I got the distinct impression at the WMS meeting that it is certainly worthwhile for lightning strike victims and near drownings (who have healthy hearts!) but perhaps not so for other conditions. I would feel compelled to go all out for a friend or family member but if you don’t have them back by 30 minutes, you’re going to have to stop unless help is just around the bend. This is a difficult area that people should work through mentally before the situation ever arises. Since there is no perfect strategy for preventing a lightning injury — even your home and car are not safe — the best option is to be aware of the risk factors, and be aware of the weather when you are out doors.

There is lightning detection equipment available, but for most of us a simple “rule of thumb” is more practical. The 30-30 Rule: If the time from flash to bang (thunder) is less than 30 seconds, seek shelter, and do not venture out until 30 minutes after the last thunder. You can estimate your distance from the strike by counting the flash to bang in seconds, and dividing by 5 to derive the distance in miles. If the strike is 3 miles or less from your location, you are in the hot zone!If you are on a river or lake when this happens, get off the water onto shore, and get well away from the water (I’m not sure how far is far enough, because of ground surge and side splash, so let’s say as far as practical). Avoid metal objects (metal gunwales on canoes or metal paddle shafts), isolated tall trees, shallow caves, and open fields (you don’t want to be the tallest object). If you hair stands on end, or you hear a crackling noise or smell ozone, or objects develop a blue glow of St. Elmo’s fire, this indicates a strike is imminent, and you should assume The Lightning Safety Position: Crouch on the balls of your feet, preferably on your PFD or some insulated pad, keeping your head down; do not touch the ground with your hands. Personally, I am not aware of any studies as to how this was derived. Getting experimental subjects would likely be difficult.

As a practical matter, I don’t think maintaining my balance on the balls of my feet in a driving rainstorm with wind, hail, and lightning all about would be easy for more than a few minutes, but then again there would be strong motivation!Having said all this, I am not aware of anyone in the GCA or anyone on a GCA trip having been hit by lighting, but the risk is always there, and if you are paddling with me, I want everyone on the trip to know what to do in case someone gets hit.See you on the river!

by Dick Hurd, MD
From The Eddy Line, June 2006

Also see:
Near Drowning