Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Guy's Hospital, London, United Kingdom.
Prehosp Disaster Med. 2022 Aug;37(4):547-549. doi: 10.1017/S1049023X22000899. Epub 2022 Jun 27.
Most injuries observed in victims of lightning strikes can be explained by electrothermal phenomena. Blast penetrating injuries caused by a lightning-strike-induced explosion of a nearby structure are rarely reported.
Here reported is the case of a patient with numerous mixed injuries caused by a lightning strike, including deep lacerations of both hips and thighs with rock fragments embedded in the wounds. Surgical removal of rock fragments from deep areas of the right hip and right lower leg was necessary. The cause of the formation of rock missiles was the lightning-strike-induced explosion of rock. Rapid evaporation of water enclosed in rock crevices was presumably the main force underlying the explosion.
Blast penetrating injuries should be considered and excluded in all patients struck by lightning, particularly when occurring in rocky terrain. The diagnosis and treatment of such injuries can be difficult and require special preparation.
大多数在雷击受害者身上观察到的损伤都可以用电热现象来解释。由附近结构雷击引发的爆炸导致的穿透性冲击伤很少见。
本文报告了一例患者因雷击造成的多处混合性损伤，包括双侧臀部和大腿的深部撕裂伤，伤口中有岩石碎片嵌入。需要从右臀部和右小腿深部取出岩石碎片。岩石弹丸形成的原因是雷击引发的岩石爆炸。推测岩石裂缝中封闭水的快速蒸发是爆炸的主要力量。
应考虑并排除所有被雷击的患者出现的冲击伤，特别是在多岩石地形中。此类损伤的诊断和治疗可能较为困难，需要特殊准备。
