Lightning injury causing prolongation of the Q-T interval.
This case report describes the development of temporary prolongation of the Q-T interval in a patient struck by lightning. A variety of electrocardiographic changes have been documented previously in association with lightning injury; however, the changes in this patient have not previously been reported. (+info)
Lightning injury: two case histories and a review of management.
Two cases of fatal lightning injury are described. Fixed dilated pupils should not be taken as an indicator of death after a lightning strike. Persons who fail to breath spontaneously within one minute of lightning shock should receive external cardiac massage and mouth-to-mouth resuscitation. Paralysis may persist as result of cerebral oedema or prolonged hypoxia-it is therefore suggested that adequate ventilation and metabolic balance should be maintained until recovery or death. (+info)
Asthma and thunderstorms: description of an epidemic in general practice in Britain using data from a doctors' deputising service in the UK.
OBJECTIVE: To describe the areas affected and the scale of an epidemic of thunderstorm associated asthma on the night of 24/25 June 1994 and to explore the spatial and temporal relationship between the thunderstorm and the associated epidemic. SETTING: The 29 offices of a deputising service for general practitioners' (GP) out of hours calls (Healthcall). At the time of the storm the deputising service provided out of hours cover for about 8500 out of about 30000 GPs in England, Scotland, and Wales. METHODS: Patients who phoned the Healthcall offices to request a home visit were categorised as "asthma" or "other causes" based on their presenting complaint. The number of calls on the night of 24/25 June 1994 was compared in areas affected by thunderstorms and areas not affected by thunderstorms and with the night of 17/18 June 1994, when there were no thunderstorms. RESULTS: A large area of the south and east of England was affected by an epidemic of asthma closely related both temporally and spatially with the thunderstorms on 24/25 June 1994. The pooled Mantel-Haenszel estimate for the risk of asthma in thunderstorm affected areas compared with the control night was 6.36 (95% confidence interval 4.97, 8.32) compared with a value of 1.01 (0.80, 1.27) for those not exposed. Extrapolation suggests about 1500 extra patients were likely to have requested a visit from a GP that night because of epidemic asthma. CONCLUSIONS: Under certain circumstances thunderstorms are associated with asthma and can affect many patients. Deputising services are a useful source of data for the investigation of epidemics in primary care. (+info)
Effect of thunderstorms and airborne grass pollen on the incidence of acute asthma in England, 1990-94.
BACKGROUND: Thunderstorms and prior grass pollen counts were investigated as predictors of daily hospital admissions for asthma in England. This study was motivated by reports in the literature of spectacular asthma epidemics associated with thunderstorms, particularly in the grass pollen season. METHODS: Asthma admissions for two age groups (0-14 years and 15 and over) were measured using the Hospital Episodes System (HES) in the 14 regional health authorities (RHAs) in England. Thunderstorms were measured daily in each RHA using densities of sferics (lightning flashes). Relative asthma excesses for moderate positive and exceptionally high sferic densities, with or without previous high grass pollen counts, were measured using log linear autoregression--allowing for weekly, seasonal, and longer term background variation--and pooled over RHAs by calculating geometric means. RESULTS: Relative risks from all RHAs were pooled to form geometric means. Exceptional sferic densities were associated with a relative excess risk of around 25% in both age groups. Moderate sferic densities were associated with a smaller excess, statistically significant in the two age groups taken together. In five RHAs in which grass pollen counts were available, high pollen counts for the previous five days were associated with an amplification of the excess associated with thunderstorms. CONCLUSION: Very large sferic densities are associated with moderate rises in hospital admissions for acute asthma. However, typical thunderstorm days are not associated with spectacular asthma epidemics of the scale previously reported in the literature. Thunderstorm-associated excesses are amplified after a run of high pollen counts. (+info)