Navari-González C

Language: Spanish
References: 25
Page: 63-69
PDF size: 331.08 Kb.

ABSTRACT

Lightning is a large-scale global atmospheric phenomenon characterized by millions of annual discharges that pose a constant risk to public health worldwide. A lightning strike can cause profound and potentially fatal systemic effects by inducing injury from atmospheric electricity—a phenomenon known as fulguration. This review article aims to analyze the pathophysiological mechanisms, the spectrum of clinical manifestations, and initial emergency management strategies in order to establish recommendations based on current evidence. Through a synthesis of scientific literature and an analysis of global lightning detection systems, the fundamental pillars for strategic clinical monitoring are identified, highlighting that an understanding of the physics of lightning strikes and the precise identification of injuries are critical determinants of prognosis. It is concluded that a mastery of these mechanisms by healthcare personnel is imperative to standardize management recommendations and optimize patient survival rates.

REFERENCES

1. Vaisala Xweather. Annual Lightning Report 2025 [Internet]. Helsinki,Finlandia: Vaisala; 2025 [citado el 9 de ene 2026]. Disponibleen: https://www.xweather.com/annual-lightning-report-2025#behind-the-data

2. Hewitt PG. Física conceptual. 10ª ed. México: Pearson Educación;2007.

3. Hinkelbein J, Spelten O, Wetsch WA. Blitzschlag und Blitzunfällein der präklinischen Notfallmedizin. Relevanz, Folgen und praktischeImplikationen [Lightning strikes and lightning injuries in prehospitalemergency medicine. Relevance, results, and practicalimplications]. Unfallchirurg. 2013 Jan; 116(1): 74-9. German. doi:10.1007/s00113-011-2084-9. PMID: 21909737.

4. Cooper MA, Holle RL. Reducing Lightning Injuries Worldwide.Cham, Suiza: Springer; 2019.

5. Gomes C, editor. Lightning: Science, Engineering, and EconomicImplications for Developing Countries. Singapore: Springer Nature;2021.

6. Ritenour AE, Morton MJ, McManus JG, Barillo DJ, Cancio LC.Lightning injury: a review. Burns. 2008 Aug; 34(5): 585-94. doi:10.1016/j.burns.2007.11.006. Epub 2008 Apr 18. PMID: 18395987.

7. Jaramillo A, Dominguez C. Mapping Lightning Risk in Mexico:Integrating Natural Hazard and Social Vulnerability. Weather,Climate, and Society. 2024; 16(4): 563-579. Doi: 10.1175/WCAS-D23-0163.1

8. Takajashi Medina FE, Pompeyo MS, García Dolores F, CárdenasCamacho J. Medicina forense. México: Editorial El Manual Moderno;2019.

9. Meza Rojas FG, Rodríguez Cázares LC. Lesiones por fulguración:aspectos clínicos y médicos legales. Presentación de dos casossimultáneos no mortales. Rev Fac Med. 2021; (1): 25-31.

10. Ouviña J, Gallino P, Hernández N, Silva J, Aramendi I. Fulguraciónpor rayo: A Propósito de un Caso. Rev Arg Quemaduras. 2024;34(1): 1-4.

11. Murillo Godínez G. Enfermedades y muerte por fulguración. MedInt Méx. 2025; 41(7): 439-445.

12. Gruhn KM, Knossalla F, Schwenkreis P, Hamsen U, SchildhauerTA, Tegenthoff M, Sczesny-Kaiser M. Neurologische Erkrankungennach Blitzschlag : Lightning strikes twice [Neurological diseasesafter lightning strike : Lightning strikes twice]. Nervenarzt.2016 Jun; 87(6): 623-8. German. doi: 10.1007/s00115-015-0062-0. PMID: 26873252.

13. Van Ruler R, Eikendal T, Kooij FO, Tan ECTH. A shocking injury: Aclinical review of lightning injuries highlighting pitfalls and a treatmentprotocol. Injury. 2022 Oct; 53(10): 3070-3077. doi: 10.1016/j.injury.2022.08.024. Epub 2022 Aug 17. PMID: 36038387.

14. Hawkins E, Gostigian G, Diurba S. Lightning Strike Injuries. EmergMed Clin North Am. 2024 Aug; 42(3): 667-678. doi: 10.1016/j.emc.2024.02.021. Epub 2024 Mar 21. PMID: 38925781.

15. Blumenthal R. Injuries and deaths from lightning. J Clin Pathol.2021 May; 74(5): 279-284. doi: 10.1136/jclinpath-2020-206492.Epub 2020 Aug 12. PMID: 32796053.

16. Cherington M. Neurologic manifestations of lightning strikes.Neurology. 2003 Jan 28; 60(2): 182-5. doi: 10.1212/01.wnl.0000033801.15204.b5. PMID: 12557851.

17. Samia AM, Thanikachalam S, Dermer H, Maddy AJ. CutaneousManifestations of Lightning Injury: A Review of the Literature. Cutis.2023; 112(3): 157-163.

18. Mahajan AL, Rajan R, Regan PJ. Lichtenberg figures: cutaneous manifestation of phone electrocution from lightning. JPlast Reconstr Aesthet Surg. 2008; 61(1): 111-3. doi: 10.1016/j.bjps.2007.06.020. Epub 2007 Jul 30. PMID: 17664090.

19. Legros V, Floch T, Leclercq-Rouget M, Brochet B. Lightning strikeand Lichtenberg’s figures. Intensive Care Med. 2023 Oct; 49(10):1245-1246. doi: 10.1007/s00134-023-07160-2. Epub 2023 Jul 19.PMID: 37466670.

20. Cherington M, McDonough G, Olson S, Russon R, Yarnell PR.Lichtenberg figures and lightning: case reports and review of theliterature. Cutis. 2007 Aug; 80(2): 141-3. PMID: 17944174.

21. Cohen MA. Clinical pearls: struck by lightning. Cutaneous manifestationof lightning strike (“splash”). Acad Emerg Med. 2001 Sep;8(9): 893, 929-31.

22. Blumenthal R.Lightning and the Forensic Pathologist. Acad ForensicPathol. 2018; 8(1): 98-111.

23. American College of Surgeons. Advanced Trauma Life Support(ATLS): Standardized Trauma Care When Seconds Count. CourseManual. 11th ed. Chicago, IL: American College of Surgeons;2024.

24. American Burn Association. Advanced Burn Life Support Course:Provider Manual. 2018 Update. Chicago, IL: American Burn Association;2018.

25. Waldmann V, Narayanan K, Combes N, Jost D, Jouven X, MarijonE. Electrical cardiac injuries: current concepts and management.Eur Heart J. 2018 Apr 21; 39(16): 1459-1465. doi: 10.1093/eurheartj/ehx142. PMID: 28444167.