Lightning strike causes IED-like injuries

Eight-year-old twin boys, camping in a backyard tent, received penetrating blast injuries when a bolt of lightning struck a transformer near their tent, sending them to the emergency department for treatment. The extremely rare case study was published online yesterday in Annals of Emergency Medicine. ("'Thunderstruck' -- Penetrating Thoracic Injury from Lightning Strike")

"One of the boys had a missile trajectory through the lung -- very much like injuries caused by improvised explosive devices (IEDs) -- which we could have missed because on the outside he had only a tiny puncture wound to the chest," said lead study author Lt. Col. O.J.F. van Waes, of the department of trauma surgery at Erasmus University Medical Center in Rotterdam, The Netherlands. "His brother was also injured. What is remarkable is that they were not struck by lightning themselves, but were hit by shrapnel that went flying when lightning struck a transformer near them."

The less seriously injured brother had second-degree burns to the face and copper wires protruding from his shoulder blade which were visible in the physical exam. The other brother had a collapsed lung due to a two-centimeter length of copper wire buried in his chest. Both boys were admitted to the hospital, treated successfully for their injuries and released.

The most typical types of lightning injuries are burns caused by direct lightning strikes to the body.

"We were familiar with IED-type injuries from our deployment in the recent military conflict in Afghanistan," said Dr. van Waes. "Our experience in the military setting helped us deliver prompt treatment to a very seriously injured boy. Remember: If there is lightning anywhere near you, go indoors."