Biophysical injury mechanisms associated with lightning injury

Abstract

The passage of damaging quantities of electrical current through the body can produce tissue injury through multiple distinct biophysical energy transduction mechanisms. These mechanisms include the direct action of direct electrical forces on proteins, membranes and other biomolecular structures, as well as the indirect action mediated by the generation of heat. Adding to this complexity are the multiple modes of frequency-dependent tissue-current interactions, the variation in current density along the path through the body, as well as variations in body size, body position and use of protective gear. The dominant mode of injury for any particular trauma victim and how it manifests depends on several different factors. As a result, in no two cases of accidental electrical injury are the injury manifestations identical. The purpose of this chapter is to review the biophysical pathways and mechanisms of electrical trauma injury and their relationship to clinical injury manifestations. The focus will be on frequency-dependent effects because of the relevance to lightning injury. It was written with the hope to provide insight into some of the unusual neurophysiological manifestations.