Injuries often involve multiple organ systems
Both cardiac and respiratory arrest may be present without evidence of external injury
Ventricular dysrhythmias, asystole, and QT prolongation most common
Although cardiac automaticity may spontaneously return, apnea may persist
Duration of apnea rather than cardiac arrest is the critical prognostic factor
Myocardial infarction after<unk>  injury is unusual
Duration of apnea rather than cardiac arrest is the critical prognostic factor
Symptoms are usually immediate and transient or delayed and permanent
Seizure, LOC, confusion, amnesia, extremity paralysis
Pupillary dilation or anisocoria may occur that is unrelated to brain injury
Neuroprognostication should not be based on dilated pupils alone in setting of<unk>  strike
Keraunoparalysis - neuromuscular "stunning" that usually resolves spontaneously within hours
Thought of as a neurologic phenomenon but actually result of arterial vasospasm from catecholamine release
Neuroprognostication should not be based on dilated pupils alone in setting of<unk>  strike
Thought of as a neurologic phenomenon but actually result of arterial vasospasm from catecholamine release
Vasomotor spasm may cause loss of distal pulses, coolness of extremities, loss of sensation
Keraunoparalysis - see above
Cataracts may occur weeks to years after injury (must document careful eye exam in all patients)
Other injuries include vitreous hemorrhage, corneal abrasion, retinal detachment
Blast effect producing Tympanic Membrane Rupture is relatively common
Lichtenberg figures (ferning pattern) - pathognomonic for<unk>  strike
Occur due to electron showering over the skin leading to extravasation of RBC's, not a true burn; disappear within 24hr
Flash burns
Similar to those found in arc welders; appear as mild erythema, may involve cornea
Punctate burns
Look similar to cigarette burns; are full-thickness
Contact burns
Occur when metal close to the skin is heated from the<unk>  current
Occur due to electron showering over the skin leading to extravasation of RBC's, not a true burn; disappear within 24hr
Similar to those found in arc welders; appear as mild erythema, may involve cornea
Look similar to cigarette burns; are full-thickness
Occur when metal close to the skin is heated from the<unk>  current
Compartment Syndrome and rhabdomyolysis are unlikely due to short duration of<unk>  current
Associated with posterior shoulder dislocation
50% of pregnancies have fetal demise, though literature is sparse
Third trimester appears to carry the greatest risk of adverse outcomes
Most surviving fetuses have no long term morbidity when carried to term
Any<unk>  strikes in pregnancy requires fetal monitoring, comprehensive testing in-hospital performed by Ob/Gyn
Third trimester appears to carry the greatest risk of adverse outcomes
Most surviving fetuses have no long term morbidity when carried to term
Any<unk>  strikes in pregnancy requires fetal monitoring, comprehensive testing in-hospital performed by Ob/Gyn
Lightning injuries
Blast injury
Heat stroke
Smoke inhalation injury 
Cold injuries
Chemical injury
Acrolein
Head trauma 