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Q&A

Are there statistics on how often CPR on someone who has been struck by lighting works?

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In all of my Wilderness First Responder classes and books, they have said that people who have been struck by lightning and need CPR have the best chance of it working (in general save rates with CPR are extremely low).

Are there any official statistics on the number of people who got struck by lighting needed CPR and it worked?

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3 answers

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This is a partial answer, without the requested statistics.

Lighting strikes can disrupt the normal electrical signals in the heart. See Cardiac Effects Of Lightning Strikes Assuming that no other life threatening physical trauma has occurred, CPR can maintain oxygen flow until the heart restarts.

CPR by it's self is unlike to restart a stopped heart but people do recover while CPR is being preformed see Cardiopulmonary resuscitation (CPR)

CPR alone is unlikely to restart the heart. Its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage. Administration of an electric shock to the subject's heart, termed defibrillation, is usually needed in order to restore a viable or "perfusing" heart rhythm. Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity. Early shock when appropriate is recommended. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a return of spontaneous circulation (ROSC) or is declared dead. source

The nature of the type of cardiac issues that lighting strikes cause, make them the most survivable. There have been successfully recoveries from CPR last hours (google 'longest successful cpr'). Ultimately survival is dependent on two factors, the exact internal cause of the heart failure and access to machinery to stop the bad rhythm and allow a good rhythm to start. (defibrillator)

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No actual numbers here, but according to the American Heart Association (AHA), patients who receive immediate aggressive bystander CPR after cardiac arrest due to lightning strike actually have a decent chance even without external defibrillation.

This was a surprise to me, as I was always taught that a return of spontaneous circulation (ROSC) after sudden cardiac arrest was unlikely, and that the whole reason for performing CPR was to keep the brain and heart viable until the defibrillator arrived...

This is from the AHA website under "Emergency Cardiovascular Care" (notes in italics and bolded text are mine):

The National Weather Service estimates that an average of 70 deaths and 630 injuries occur due to lightning strikes in the United States each year. Lightning strike injuries can vary widely, even among groups of people struck at the same time. Symptoms are mild in some victims, whereas fatal injuries occur in others.

The primary cause of death in victims of lightning strike is cardiac arrest, which may be associated with primary VF (ventricular fibrillation) or asystole (absence of detectable electrical activity). Lightning acts as an instantaneous, massive direct-current shock, simultaneously depolarizing the entire myocardium. In many cases intrinsic cardiac automaticity may spontaneously restore organized cardiac activity and a perfusing rhythm. However, concomitant respiratory arrest due to thoracic muscle spasm and suppression of the respiratory center may continue after ROSC (return of spontaneous circulation). Unless ventilation is supported, a secondary hypoxic (asphyxial) cardiac arrest will develop.

Lightning also can have myriad effects on the cardiovascular system, producing extensive catecholamine release or autonomic stimulation. The victim may develop hypertension, tachycardia, nonspecific ECG changes (including prolongation of the QT interval and transient T-wave inversion), and myocardial necrosis with release of creatinine kinase-MB fraction.

Lightning can produce a wide spectrum of peripheral and central neurological injuries. The current can produce brain hemorrhages, edema, and small-vessel and neuronal injury. Hypoxic encephalopathy can result from cardiac arrest.

Victims are most likely to die of lightning injury if they experience immediate respiratory or cardiac arrest and no treatment is provided. Patients who do not suffer respiratory or cardiac arrest, and those who respond to immediate treatment, have an excellent chance of recovery. Therefore, when multiple victims are struck simultaneously by lightning, rescuers should give the highest priority to patients in respiratory or cardiac arrest.

For victims in cardiac arrest, treatment should be early, aggressive, and persistent. Victims with respiratory arrest may require only ventilation and oxygenation to avoid secondary hypoxic cardiac arrest. Resuscitation attempts may have high success rates and efforts may be effective even when the interval before the resuscitation attempt is prolonged

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This post was sourced from https://outdoors.stackexchange.com/a/22063. It is licensed under CC BY-SA 4.0.

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From https://jamanetwork.com/journals/jama/article-abstract/403803 Access to the full article requires subscription, but an extract is quoted below:

In their article entitled "Prehospital Cardiopulmonary Resuscitation: Is It Effective?" Cummins and Eisenberg state: "Clinical evidence provides strong support for efforts to increase the percent of persons in cardiac arrests who receive early bystander CPR [cardiopulmonary resuscitation]. These efforts do no harm and clearly save lives." We wish to report a subgroup of patients in whom early bystander-initiated CPR may be dramatically successful.Cardiac arrest induced by lightning or electricity is a unique injury because all patients may survive if CPR is promptly instituted. The potential success rate in this subgroup can be compared with success rates for resuscitation attempts in the hospital and in the community. When CPR is commenced in the hospital, a success rate of 56% has been reported.

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This post was sourced from https://outdoors.stackexchange.com/a/22047. It is licensed under CC BY-SA 4.0.

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