Lightning

Preventing Lightning Injuries

  1. Monitor weather: Watch for building cumulonimbus clouds, increasing winds, and darkening skies. Follow the rule: “When thunder roars, go indoors.”
  2. Seek shelter early: The safest options are enclosed buildings or hardtop vehicles. In the wilderness, seek deep caves, dense forest, or deep ravines. Avoid ridgelines, summits, isolated trees, open fields, shallow caves, and tents.
  3. Time your activities: Be off peaks and ridgelines by early afternoon (“up by noon, down by two”).
  4. Remove metal objects: Discard ski poles, trekking poles, and remove watches, belt buckles, and necklaces to reduce contact burn risk.
  5. Wait it out: Do not resume outdoor activity until at least 30 minutes after the last thunder or lightning.
  6. Lightning position (last resort): If a strike is imminent (hair standing up, crackling sounds, blue haze, ozone smell), crouch with feet together on an insulating surface such as a dry sleeping pad or backpack (metal removed).

Treating Lightning Strike Victims in the Field

  • Scene safety first: Victims do not carry residual electrical charge — it is safe to touch and treat them immediately.
  • Reverse triage: Unlike standard mass casualty triage, prioritize victims who appear dead (pulseless, apneic). They have the best chance of recovery with immediate CPR.
  • Begin CPR immediately: Cardiac arrest from lightning is often reversible. Support ventilation aggressively — the respiratory center may remain paralyzed even after the heart restarts, risking a second arrest.
  • Use an AED if available: Ventricular fibrillation may be present and is a shockable rhythm.
  • Spinal precautions: Assume spinal injury, especially if the victim was thrown or fell.
  • Assess for associated injuries: Check for fractures, burns, tympanic membrane rupture, and hypothermia.
  • Evacuate: All lightning strike victims require hospital evaluation, including ECG monitoring for at least 24 hours, even if initially asymptomatic, due to the risk of delayed cardiac complications. See: https://cvhikingclub.net/initiating-a-rescue-2/

(Sources: Wilderness Medical Society (WMS) Practice Guidelines for lightning injury prevention and treatment, supplemented by clinical reviews on lightning injury management and the National Athletic Trainers’ Association position statement on lightning safety.)                                                                                                       The information provided on this CVHC page is for general informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.