Prevention and treatment of lightning injuries.

Lightning ranks first among natural disasters in terms of fatalities and property damage each year. If fortunate enough to survive, the victim of a lightning or electrical accident often presents with numerous complicated clinical manifestations. The astute nurse practitioner will be challenged to identify the immediate signs and symptoms of possible system disruption, and to institute the follow-up management necessary to prevent further complications. This article explores the nurse practitioner's role in the physical assessment of the client and the protocol for management and follow-up care. Case studies are presented to illustrate the various multisystem findings of clients struck either directly or indirectly by lightning. Environmental precautions to decrease the likelihood of lightning's harmful effects are also discussed. It is easier to prevent a lightning and/or electrical accident than to treat the victim.