8/18 Wilderness Medicine Wednesday

Today's post is about lightning, this is a cumulonimbus cloud, if you see one of these it's time to start taking precautions!

​by Coach Nick
Happy Wednesday everyone I hope you are all having a great week! Looking at the weather for the weekend and in light of the time of year today’s Wilderness Medicine Wednesday post is going to be about lightning! The focus of this post is going to be on some brief science behind lightning, general safety guidelines/myth busting, and injury treatment. Montana lies in a part of the country with a high frequency of lightning storms as I’m sure most of you know. Most of us like to spend a lot of time outside and lightning can come out of nowhere especially when hiking, it’s always good to be prepared.
First, what’s going on with lightning, what is it? Basically, lightning is the earth’s way of balancing itself electrically. Rapid changes in heat and pressure create large clouds called cumulonimbus clouds. These clouds carry two different electrical charges, the top holds a positive charge, the bottom holds a negative charge, and the earth itself holds a positive charge. Inside the cloud there are constant collisions of air, water, and ice that build an electric charge that must be released. In order to do this the cloud releases a negatively charged leader that is met by a positively charged leader from the earth. When these two small currents of energy meet a connection is formed and what we know of as a lightning strike happens. Interestingly, lighting actually travels from the earth, UP into clouds. The lightning heats the air to over 50,000 degrees which creates a pressure differential and a loud boom that we know as thunder. The way that lightning travels is also interesting. Lightning travels over the surface of an object unless there is something within it that’s a conductor. In our case nerves and blood vessels are conductors, which is why lightning strikes are so dangerous to humans. Like most things in life, lightning prefers the path of least resistance. This is why there is some credence to the thought that lightning strikes the highest object around. While this is mostly true it’s important to note that this is not always the case!
Taking this forward let’s think of a scenario in which we are exposed to lightning. Let’s say we’re hiking on the ridge in the Bridgers and we see a cumulonimbus cloud approaching. There’s a few things that need to be going through our minds at this point. First, a lightning storm does not have to be directly overhead to be dangerous, there’s a phenomena called blue sky lightning in which lightning can actually strike as far as 15 miles ahead of a storm, we should start taking precautions immediately. The worst places you can be in a lightning storm are mountain peaks, ridges (uh-oh), or near tall trees, cell towers, or any other really tall objects. Also stay away from open fields (where you’re the tallest thing around). It can be tempting to take shelter under natural overhangs or in shallow caves but resist this urge as the lightning can travel into these areas and still harm you. The best thing you can do is come off the ridge back into the treeline and take shelter in a low spot away from as many of the above mentioned objects as possible and sit on some sort of insulator like a foam pad. Put on your rain jacket and get ready to ride out the storm! It’s worth mentioning that if you’re in a group sit away from each other to minimize the possibility of multiple injures from one strike. As the lightning begins to approach you there’s a pretty simple system to determine how far away the storm is. When you see a bolt of lightning count the time between that instance and hearing the thunder then divide it by 5, this will tell you how far away the storm is. For example, if you see lightning then hear the thunder ten seconds later, the storm is 2 miles away. A good rule of thumb is if the time difference is less than 30 seconds the storm is about 6 miles away and you need to take precautions immediately.
Before we get into treatment, let’s talk some other guidelines for lightning. If you are on water in a storm you are not safe. It is important to get to shore but even more important to go at least 100 yards inshore as the shoreline is one of the most dangerous places to be. If you’re on fresh water lightning is absorbed into it due to the lack of conduction, however lightning will travel through salt water due to the presence of the sodium. There’s two other ways (other than direct strike) to be struck by lightning called splash and step voltage strikes. After lightning hits it can jump from something like a tree to you, it can also travel over the ground or through water to strike you. That’s why it’s important to shelter somewhere as dry as possible and away from tall objects. Finally, after the storm passes ensure that you wait at least 30 minutes before resuming your activities (again with the blue sky lightning phenomena).
I hope this is never the case for any of you but if you, or a member of your group are struck by lightning there’s a few important things to do and remember. First, a person struck by lightning will not hold and electrical charge so do not hesitate to help them. Always remember the D in DRGXABCDE, make sure the scene is safe before treating a patient, be especially watchful for falling trees or newly started fires. The good news of a lightning strike is that 90% of people actually survive direct lightning strikes believe it or not. The most likely injuries you will come across are severe burns, skull fracture (look for fluid coming from the ears or Battles sign which is bruising around the ears) , and disorientation. The moral of the story here is that the patient needs to be evacuated immediately if they are struck by lightning. Do your best to treat any injuries in accordance with DRGXABCDE but you need to focus on getting them to a hospital. Also, lightning can commonly trigger cardiac arrest. If the patient doesn’t have a pulse and is not breathing this is likely what is happening, begin to administer CPR immediately. When evacuation a patient who suffered a lightning strike it is important to assume that their spine was compromised, do your best to immobilize their neck and back on the way out.
As we enter a part of the summer where temperatures vary greatly through the day lightning become and ever-present danger. Keep these recommendations in mind as you venture out and you will be prepared (always carry a waterproof jacket!). In mountainous areas lightning storms can come out of nowhere and come and go within 30 minutes. As you are hiking constantly think to yourself where you would go if you were about to get stuck in lightning storm so that you always have a plan! Do not tempt fate, if you see a storm forming don’t go for that summit, turn around and live to fight another day!
As always I hope this post was helpful and relevant to you all!

Click Here for the WOD!