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80-657: The Reef Fire was a wildfire that was started by a lightning strike and took place in the Bob Marshall Wilderness in Montana in the United States , near Count Peak. The fire, which was reported on August 13, 2017, burned more than 10,658 acres (43 km) and was contained by October 1, 2017. Instead, it wound up merging with the Rice Ridge Fire . The Reef Fire was reported on August 13, 2017 at 5:45 PM. The fire,

160-440: A condition often mentioned in young people's deaths, occurs in one of every 5000 to 7000 newborns and is estimated to be responsible for 3000 deaths annually compared to the approximately 300,000 cardiac arrests seen by emergency services. These conditions are a fraction of the overall deaths related to cardiac arrest but represent conditions that may be detected prior to arrest and may be treatable. The symptomatic expression of LQTS

240-470: A day that seems devoid of clouds. This occurrence is known as "a bolt from the blue [sky]"; lightning can strike up to 10 miles from a cloud. Lightning interferes with amplitude modulation (AM) radio signals much more than frequency modulation (FM) signals, providing an easy way to gauge local lightning strike intensity. To do so, one should tune a standard AM medium wave receiver to a frequency with no transmitting stations, and listen for crackles among

320-418: A fraction of a second. Lightning strikes can injure humans in several different ways: Warning signs of an impending strike nearby can include a crackling sound, sensations of static electricity in the hair or skin, the pungent smell of ozone , or the appearance of a blue haze around persons or objects ( St. Elmo's fire ). People caught in such extreme situations – without having been able to flee to

400-586: A lifetime probability of about 1 in 60,000. However, due to increased awareness and improved lightning conductors and protection, the number of annual lightning deaths has been decreasing steadily year by year. According to the National Oceanic and Atmospheric Administration in 2012, over the twenty years to 2012 the United States averaged 51 annual lightning strike fatalities, making it the second-most frequent cause of weather-related death after floods . In

480-417: A lightning strike that produced no external injuries. It may also point to the victim not being directly struck at all, but just being very close to the strike termination. Another effect of lightning on bystanders is to their hearing . The resulting shock wave of thunder can damage the ears. Also, electrical interference to telephones or headphones may result in damaging acoustic noise . According to

560-495: A lightning-related injury, let alone particulars, which a medical examiner , police investigator , or on the rare occasion a trained lightning expert may have difficulty identifying to record accurately. As of 2013, direct-strike casualties could be much higher than reported numbers. In 2015 it was reported that between five and ten deaths from lightning occur in Australia every year with over 100 injuries occurring. In 2018, it

640-544: A preferred pathway to ground if lightning terminates on a structure. The class of these products is often called a "finial" or "air terminal". A lightning rod or "Franklin rod" in honor of its famous inventor, Benjamin Franklin , is simply a metal rod, and without being connected to the lightning protection system, as was sometimes the case in the past, will provide no added protection to a structure. Other names include "lightning conductor", "arrester", and "discharger"; however, over

720-428: A risk of progressing to sudden cardiac arrest, albeit this risk remains low. Many of these conduction blocks can be treated with internal cardiac defibrillators for those determined to be at high risk due to severity of fibrosis or severe electrophysiologic disturbances. Structural heart diseases unrelated to coronary artery disease account for 10% of all sudden cardiac deaths. A 1999 review of sudden cardiac deaths in

800-544: A safer, fully enclosed space – are advised to assume the "lightning position", which involves "sitting or crouching with knees and feet close together to create only one point of contact with the ground" (with the feet off the ground if sitting; if a standing position is needed, the feet must be touching). Lightning strikes can produce severe injuries in humans, and are lethal in between 10 and 30% of cases, with up to 80% of survivors sustaining long-term injuries. These severe injuries are not usually caused by thermal burns, since

880-468: A second event, most often in the first year. Furthermore, of those who experienced recurrence, 35% had a third episode. Additional significant risk factors include cigarette smoking , high blood pressure , high cholesterol , history of arrhythmia , lack of physical exercise , obesity , diabetes , family history , cardiomyopathy , alcohol use, and possibly caffeine intake. Current cigarette smokers with coronary artery disease were found to have

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960-514: A similar protocol to that which the European Resuscitation Council has adopted. In a non-acute setting where the patient is expired, diagnosis of cardiac arrest can be done via molecular autopsy or postmortem molecular testing, which uses a set of molecular techniques to find the ion channels that are cardiac defective. This could help elucidate the cause of death in the patient. Other physical signs or symptoms can help determine

1040-450: A storm being overhead, contrary to popular belief . If thunder can be heard at all, then a risk of lightning exists. The National Lightning Safety Institute also recommends using the F-B (flash to boom) method to gauge distance to a lightning strike. The flash of a lightning strike and resulting thunder occur at roughly the same time. But light travels 300,000 km/sec, almost a million times

1120-503: A strike increases above a set level determined by a risk assessment for the location's conditions and circumstances. One significant improvement has been in the area of detection of flashes through both ground- and satellite-based observation devices. The strikes and atmospheric flashes are not predicted, but the level of detail recorded by these technologies has vastly improved in the past 20 years. Although commonly associated with thunderstorms at close range, lightning strikes can occur on

1200-434: A strike victim wearing an iPod suffered more serious injuries as a result. During a flash, though, the current flowing through the channel and around the body can generate large electromagnetic fields and EMPs, which may induce electrical transients (surges) within the nervous system or pacemaker of the heart, upsetting normal operations . This effect might explain cases where cardiac arrest or seizures followed

1280-475: A two to threefold increase in the risk of sudden death between ages 30 and 59. Furthermore, it was found that former smokers' risk was closer to that of those who had never smoked. A statistical analysis of many of these risk factors determined that approximately 50% of all cardiac arrests occur in 10% of the population perceived to be at greatest risk, due to aggregate harm of multiple risk factors, demonstrating that cumulative risk of multiple comorbidities exceeds

1360-508: A vertical scar. If the damage is severe, the tree may not be able to recover, and decay sets in, eventually killing the tree. In sparsely populated areas such as the Russian Far East and Siberia , lightning strikes are one of the major causes of forest fires . The smoke and mist expelled by a very large forest fire can cause secondary lightning strikes, starting additional fires many kilometers downwind. When water in fractured rock

1440-570: Is a complex, multistage process, some parts of which are not fully understood. Most CG flashes only "strike" one physical location, referred to as a "termination". The primary conducting channel, the bright, coursing light that may be seen and is called a "strike", is only about one inch ( ca. 2.5 cm) in diameter, but because of its extreme brilliance, it often looks much larger to the human eye and in photographs. Lightning discharges are typically miles long, but certain types of horizontal discharges can be tens of miles in length. The entire flash lasts only

1520-457: Is a leading cause of sudden cardiac deaths in the adult population. This is most commonly the result of longstanding high blood pressure , or hypertension, which has led to maladaptive overgrowth of muscular tissue of the left ventricle , the heart's main pumping chamber. This is because elevated blood pressure over the course of several years requires the heart to adapt to the requirement of pumping harder to adequately circulate blood throughout

1600-432: Is a tool that can be used to examine the movement of the heart and its force of contraction at the patient's bedside. POCUS can accurately diagnose cardiac arrest in hospital settings, as well as visualize cardiac wall motion contractions. Using POCUS, clinicians can have limited, two-dimensional views of different parts of the heart during arrest. These images can help clinicians determine whether electrical activity within

1680-780: Is achieved with these interventions, then sudden cardiac arrest has occurred. By contrast, if the person does not survive the event, this is referred to as sudden cardiac death. Among those whose pulses are re-established, the care team may initiate measures to protect the person from brain injury and preserve neurological function. Some methods may include airway management and mechanical ventilation, maintenance of blood pressure and end-organ perfusion via fluid resuscitation and vasopressor support, correction of electrolyte imbalance, EKG monitoring and management of reversible causes, and temperature management. Targeted temperature management may improve outcomes. In post-resuscitation care, an implantable cardiac defibrillator may be considered to reduce

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1760-418: Is also identified by a lack of central pulses and abnormal or absent breathing. Cardiac arrest and resultant hemodynamic collapse often occur due to arrhythmias (irregular heart rhythms). Ventricular fibrillation and ventricular tachycardia are most commonly recorded. However, as many incidents of cardiac arrest occur out-of-hospital or when a person is not having their cardiac activity monitored, it

1840-475: Is an arrhythmia (an irregular rhythm). Without organized electrical activity in the heart muscle , there is inconsistent contraction of the ventricles , which prevents the heart from generating adequate cardiac output (forward pumping of blood from the heart to the rest of the body). This hemodynamic collapse results in poor blood flow to the brain and other organs, which if prolonged causes persistent damage. There are many different types of arrhythmias, but

1920-421: Is diagnosed by the inability to find a pulse in an unresponsive patient. The goal of treatment for cardiac arrest is to rapidly achieve return of spontaneous circulation using a variety of interventions including CPR , defibrillation , and/or cardiac pacing. Two protocols have been established for CPR: basic life support (BLS) and advanced cardiac life support (ACLS). If return of spontaneous circulation

2000-595: Is difficult to identify the specific mechanism in each case. Structural heart disease , such as coronary artery disease , is a common underlying condition in people who experience cardiac arrest. The most common risk factors include age and cardiovascular disease. Additional underlying cardiac conditions include heart failure and inherited arrhythmias . Additional factors that may contribute to cardiac arrest include major blood loss , lack of oxygen , electrolyte disturbance (such as very low potassium ), electrical injury , and intense physical exercise . Cardiac arrest

2080-748: Is in the morning hours and the second is in the afternoon. Moreover, survival rates following cardiac arrest were lowest when occurring between midnight and 6am. Many of these non-cardiac causes of cardiac arrest are reversible. A common mnemonic used to recall the reversible causes of cardiac arrest is referred to as the Hs and Ts . The Hs are hypovolemia , hypoxia , hydrogen cation excess ( acidosis ), hyperkalemia , hypokalemia , hypothermia , and hypoglycemia . The Ts are toxins , (cardiac) tamponade , tension pneumothorax , thrombosis ( myocardial infarction ), thromboembolism , and trauma. The definitive electrical mechanisms of cardiac arrest, which may arise from any of

2160-464: Is not preceded by any warning symptoms in approximately 50 percent of people. For individuals who do experience symptoms, the symptoms are usually nonspecific to the cardiac arrest. For example, new or worsening chest pain , fatigue , blackouts , dizziness , shortness of breath , weakness , or vomiting . When cardiac arrest is suspected by a layperson (due to signs of unconsciousness, abnormal breathing, and/or no pulse) it should be assumed that

2240-404: Is prolonged cardiac arrest, progression of ventricular fibrillation, or efforts like defibrillation executed to resuscitate the person. Coronary artery disease (CAD), also known as atherosclerotic cardiovascular disease, involves the deposition of cholesterol and subsequent inflammation-driven formation of atherosclerotic plaques in the arteries. CAD involves the accumulation and remodeling of

2320-535: Is quite broad and more often presents with syncope rather than cardiac arrest. The risk of cardiac arrest is still present, and people with family histories of sudden cardiac arrests should be screened for LQTS and other treatable causes of lethal arrhythmia. Higher levels of risk for cardiac arrest are associated with female sex, more significant QT prolongation, history of unexplained syncope (fainting spells), or premature sudden cardiac death. Additionally, individuals with LQTS should avoid certain medications that carry

2400-443: Is rapidly heated by a lightning strike, the resulting steam explosion can cause rock disintegration and shift boulders. It may be a significant factor in erosion of tropical and subtropical mountains that have never been glaciated. Evidence of lightning strikes includes erratic magnetic fields. Telephones , modems , computers , and other electronic devices can be damaged by lightning, as harmful overcurrent can reach them through

2480-423: Is synonymous with clinical death . The physical examination to diagnose cardiac arrest focuses on the absence of a pulse. In many cases, lack of a central pulse ( carotid arteries or subclavian arteries ) is the gold standard . Lack of a pulse in the periphery (radial/pedal) may also result from other conditions (e.g. shock ) or be the rescuer's misinterpretation. Obtaining a thorough history can help inform

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2560-425: Is treatable using defibrillation . The two "shockable" rhythms are ventricular fibrillation and pulseless ventricular tachycardia , while the two "non-shockable" rhythms are asystole and pulseless electrical activity . Moreover, in the post-resuscitation patient, a 12-lead EKG can help identify some causes of cardiac arrest, such as STEMI which may require specific treatments. Point-of-care ultrasound (POCUS)

2640-440: Is when the heart suddenly and unexpectedly stops beating. When the heart stops beating, blood cannot properly circulate around the body and the blood flow to the brain and other organs is decreased. When the brain does not receive enough blood, this can cause a person to lose consciousness and brain cells can start to die due to lack of oxygen. Coma and persistent vegetative state may result from cardiac arrest. Cardiac arrest

2720-434: The cell membrane , and this group of conditions is therefore often referred to as channelopathies . Examples of these inherited arrhythmia syndromes include Long QT syndrome (LQTS), Brugada Syndrome , Catecholaminergic polymorphic ventricular tachycardia , and Short QT syndrome . Many are also associated with environmental or neurogenic triggers such as response to loud sounds that can initiate lethal arrhythmias. LQTS,

2800-476: The coronary vessels along with other systemic blood vessels. When an atherosclerotic plaque dislodges, it can block the flow of blood and oxygen through small arteries, such as the coronary arteries, resulting in ischemic injury. In the heart, this results in myocardial tissue damage which can lead to structural and functional changes that disrupt normal conduction patterns and alter heart rate and contraction. CAD underlies 68 percent of sudden cardiac deaths in

2880-411: The phone jack , Ethernet cable , or electricity outlet . Close strikes can also generate EMPs, especially during "positive" lightning discharges. Lightning currents have a very fast rise time , on the order of 40 kA per microsecond. Hence, although lightning is a form of direct current , conductors of such currents exhibit marked skin effect as with an alternating current , causing most of

2960-605: The static . Stronger or nearby lightning strikes will also cause cracking if the receiver is tuned to a station. As lower frequencies propagate further along the ground than higher ones, the lower medium wave (MW) band frequencies (in the 500–600 kHz range) can detect lightning strikes at longer distances; if the longwave band (153–279 kHz) is available, using it can increase this range even further. Lightning-detection systems have been developed and may be deployed in locations where lightning strikes present special risks, such as public parks. Such systems are designed to detect

3040-470: The 2000 International Liaison Committee on Resuscitation recommendations were for rescuers to look for "signs of circulation" but not specifically the pulse. These signs included coughing, gasping, color, twitching, and movement. Per evidence that these guidelines were ineffective, the current International Liaison Committee on Resuscitation recommendation is that cardiac arrest should be diagnosed in all casualties who are unconscious and not breathing normally,

3120-485: The American Heart Association. They have suggested that the technique to check carotid pulses should be used only by healthcare professionals with specific training and expertise, and even then that it should be viewed in conjunction with other indicators like agonal respiration . Various other methods for detecting circulation and therefore diagnosing cardiac arrest have been proposed. Guidelines following

3200-459: The CDC there are about 6,000 lightning strikes per minute, or more than 8 million strikes every day. As of 2008 there were about 240,000 "lightning strikes incidents" around the world each year. According to National Geographic in 2009, about 2,000 people were killed annually worldwide by lightning. If all eight billion humans have an equal chance of being killed over a 70-year lifespan, this gives

3280-613: The F-B time is 25 seconds or less, that is, if the lightning is closer than 8 km or 5 miles. A 2014 report suggested that whether a person was standing up, squatting , or lying down when outside during a thunderstorm does not matter, because lightning can travel along the ground; this report suggested being inside a solid structure or vehicle was safest. The riskiest activities include fishing, boating, camping, and golf. A person injured by lightning does not carry an electrical charge, and can be safely handled to apply first aid before emergency services arrive. Lightning can affect

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3360-622: The US, as of 1999, between 9 and 10% of those struck died, with an annual average of 25 deaths in the 2010s decade (16 in 2017). In the United States in the period 2009 to 2018 an average of 27 lightning fatalities occurred per year. In the United States an average of 23 people died from lightning per year from 2012 to 2021. Some people suffer from lifelong brain injuries. As of 2005, in Kisii, Kenya , some 30 people die each year from lightning strikes. Kisii's high rate of lightning fatalities occurs because of

3440-501: The USAF placed protective lightning strike-diversion tower arrays at all of the Italian and Turkish Jupiter MRBM nuclear armed missiles sites after two strikes partially arming the missiles. The exact location of a lightning strike and when it will occur are still impossible to predict. However, products and systems have been designed of varying complexities to alert people as the probability of

3520-420: The United States found that structural heart diseases accounted for over 30% of sudden cardiac arrests for those under 30 years. Arrhythmias not due to structural heart disease account for 5 to 10% of sudden cardiac arrests. These are frequently caused by genetic disorders . The genetic mutations often affect specialized proteins known as ion channels that conduct electrically charged particles across

3600-402: The United States. Indeed, postmortem examinations have shown that the most common finding in cases of sudden cardiac death is chronic, high-grade stenosis of at least one segment of a major coronary artery . While CAD is a leading contributing factor, this is an age-dependent factor, with CAD being a less common cause of sudden cardiac death in people under the age of 40. Abnormalities of

3680-418: The body's needs. The mechanism responsible for the majority of sudden cardiac deaths is ventricular fibrillation. Ventricular fibrillation is a tachyarrhythmia characterized by turbulent electrical activity in the ventricular myocardium leading to a heart rate too disorganized and rapid to produce any meaningful cardiac output, thus resulting in insufficient perfusion of the brain and essential organs. Some of

3760-505: The body. If the heart does this for a prolonged period of time, the left ventricle can experience hypertrophy (grow larger) in a way that decreases the heart's effectiveness. Left ventricular hypertrophy can be demonstrated on an echocardiogram and electrocardiogram (EKG). Abnormalities of the cardiac conduction system (notably the Atrioventricular Node and His-Purkinje system) may predispose an individual to arrhythmias with

3840-652: The brainstem, which controls breathing. Several studies conducted in South Asia and Africa suggest that the dangers of lightning are not taken sufficiently seriously there. A research team from the University of Colombo found that even in neighborhoods that had experienced deaths from lightning, no precautions were taken against future storms. An expert forum convened in 2007 to address how to raise awareness of lightning and improve lightning-protection standards, and expressed concern that many countries had no official standards for

3920-599: The chance of death from recurrence. Per the 2015 American Heart Association Guidelines, there were approximately 535,000 incidents of cardiac arrest annually in the United States (about 13 per 10,000 people). Of these, 326,000 (61%) experience cardiac arrest outside of a hospital setting, while 209,000 (39%) occur within a hospital. Cardiac arrest becomes more common with age and affects males more often than females. Black people are twice as likely to die from cardiac arrest as white people. Asian and Hispanic people are not as frequently affected as white people. Cardiac arrest

4000-420: The chest). Additional non-cardiac causes include hemorrhage , aortic rupture , hypovolemic shock , pulmonary embolism , poisoning such as from the stings of certain jellyfish , and electrical injury . Circadian patterns are also recognized as triggering factors in cardiac arrest. Per a 2021 systematic review, throughout the day there are two main peak times in which cardiac arrest occurs. The first

4080-493: The complete destruction of a facility or process or simply cause the failure of a remote electronic sensor; it can result in outdoor activities being halted for safety concerns to employees as a thunderstorm nears an area and until it has sufficiently passed; it can ignite volatile commodities stored in large quantities or interfere with the normal operation of a piece of equipment at critical periods of time. Most lightning-protection devices and systems protect physical structures on

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4160-434: The conditions which are believed to favor lightning strikes and provide a warning to those in the vicinity to allow them to take appropriate cover. The U.S. National Lightning Safety Institute advises American citizens to have a plan for their safety when a thunderstorm occurs and to commence it as soon as the first lightning is seen or thunder heard. This is important, as lightning can strike without rain actually falling and

4240-646: The coronary arteries not related to atherosclerosis include inflammation (known as coronary arteritis ), embolism , vasospasm , mechanical abnormalities related to connective tissue diseases or trauma, and congenital coronary artery anomalies (most commonly anomalous origin of the left coronary artery from the pulmonary artery). These conditions account for 10-15% of cardiac arrest and sudden cardiac death. Examples of structural heart diseases include: cardiomyopathies ( hypertrophic , dilated , or arrhythmogenic ), cardiac rhythm disturbances , myocarditis , and congestive heart failure . Left ventricular hypertrophy

4320-408: The current is too brief to greatly heat up tissues; instead, nerves and muscles may be directly damaged by the high voltage producing holes in their cell membranes , a process called electroporation . In a direct strike, the electrical currents in the flash channel pass directly through the victim. The relatively high voltage drop around poorer electrical conductors (such as a human being), causes

4400-508: The currents to flow through the outer surface of the conductor. In addition to electrical wiring damage, the other types of possible damage to consider include structural, fire, and property damage. The field of lightning-protection systems is an enormous industry worldwide due to the impacts lightning can have on the constructs and activities of humankind. Lightning, as varied in properties measured across orders of magnitude as it is, can cause direct effects or have secondary impacts; lead to

4480-431: The earth, aircraft in flight being the notable exception. While some attention has been paid to attempting to control lightning in the atmosphere, all attempts proved extremely limited in success. Chaff and silver iodide crystal concepts were devised to deal directly with the cloud cells, and were dispensed directly into the clouds from an overflying aircraft. The chaff was devised to deal with the electrical manifestations of

4560-486: The electrical activity of the cardiac cycle and use this information to guide the management efforts. EKG readings will help to identify the arrhythmia present and allow the team to monitor any changes that occur with the administration of CPR and defibrillation. Clinicians classify cardiac arrest into "shockable" versus "non-shockable", as determined by the EKG rhythm. This refers to whether a particular class of cardiac dysrhythmia

4640-414: The electrophysiologic mechanisms underpinning ventricular fibrillations include ectopic automaticity, re-entry, and triggered activity. However, structural changes in the diseased heart as a result of inherited factors (mutations in ion-channel coding genes, for example) cannot explain the sudden onset of cardiac arrest. In ventricular tachycardia, the heart also beats faster than normal, which may prevent

4720-457: The frequency of thunderstorms and because many of the area's structures have metal roofs. These statistics do not reflect the difference between direct strikes, where the victim was part of the lightning pathway, indirect effects of being close to the termination point, such as ground currents, and resultant, where the casualty arose from subsequent events, such as fires or explosions. Even the most knowledgeable first responders may not recognize

4800-408: The functional, structural, or physiologic abnormalities mentioned above, are characterized by arrhythmias. Ventricular fibrillation and pulseless or sustained ventricular tachycardia are the most commonly recorded arrhythmias preceding cardiac arrest. These are rapid and erratic arrhythmias that alter the circulatory pathway such that adequate blood flow cannot be sustained and is inadequate to meet

4880-416: The heart chambers from properly filling with blood. Ventricular tachycardia is characterized by an altered QRS complex and a heart rate greater than 100 beats per minute. When V-tach is sustained (lasts for at least 30 seconds), inadequate blood flow to heart tissue can lead to cardiac arrest. Bradyarrhythmias occur following dissociation of spontaneous electrical conduction and the mechanical function of

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4960-529: The heart is pulseless or pseudo-pulseless, as well as help them diagnose the potentially reversible causes of an arrest . Published guidelines from the American Society of Echocardiography , American College of Emergency Physicians , European Resuscitation Council , and the American Heart Association , as well as the 2018 preoperative Advanced Cardiac Life Support guidelines, have recognized

5040-438: The heart resulting in pulseless electrical activity (PEA) or through complete absence of electrical activity of the heart resulting in asystole . Similar to the result of tachyarrhythmias, these conditions lead to an inability to sustain adequate blood flow as well, though in the case of bradyarrhythmias, the underlying cause is an absence of mechanical activity rather than rapid beats leading to disorganization. Cardiac arrest

5120-515: The inaccuracy diagnosis solely based on central pulse detection, some bodies like the European Resuscitation Council have de-emphasized its importance. Instead, the current guidelines prompt individuals to begin CPR on any unconscious person with absent or abnormal breathing. The Resuscitation Council in the United Kingdom stands in line with the European Resuscitation Council's recommendations and those of

5200-400: The installation of lightning rods . Safety measures All events associated or suspected of causing damage are called "lightning incidents" due to four important factors. As such it is often inconclusive, albeit highly probable a lightning flash was involved, hence categorizing it as a "lightning incident" covers all bases. Airplanes are commonly struck by lightning without damage, with

5280-481: The ones most frequently recorded in sudden cardiac arrest are ventricular tachycardia and ventricular fibrillation . Both ventricular tachycardia and ventricular fibrillation can prevent the heart from generating coordinated ventricular contractions, thereby failing to sustain adequate blood circulation. Less common types of arrhythmias occurring in cardiac arrest include pulseless electrical activity , bradycardia , and asystole . These rhythms are seen when there

5360-434: The potential benefits of using POCUS in diagnosing and managing cardiac arrest. POCUS can help predict outcomes in resuscitation efforts. Specifically, use of transthoracic ultrasound can be a helpful tool in predicting mortality in cases of cardiac arrest, with a systematic review from 2020 finding that there is a significant positive correlation between presence of cardiac motion and short term survival with CPR. Owing to

5440-427: The potential cause and prognosis. The provider taking the person's clinical history should try to learn whether the episode was observed by anyone else, when it happened, what the patient was doing (in particular whether there was any trauma), and whether drugs were involved. During resuscitation efforts, continuous monitoring equipment including EKG leads should be attached to the patient so that providers can analyze

5520-629: The risk of increasing the severity of this conduction abnormality, such as certain anti-arrhythmics, anti-depressants, and quinolone or macrolide antibiotics. Another condition that promotes arrhythmias is Wolff-Parkinson-White syndrome , in which an accessory conduction pathway bypassing the atrioventricular node is present and can cause abnormal conduction patterns leading to supraventricular tachycardia and cardiac arrest. Non-cardiac causes account for 15 to 25% of cardiac arrests. Common non-cardiac causes include respiratory arrest , diabetes , certain medications , and blunt trauma (especially to

5600-511: The rural location of the fire. Numerous trails and trailheads were closed due to the Reef Fire, specifically: Cardinal Peak Divide # 136, Cabin Creek #205, Pilot Peak #128, Cardinal Creek #506, Young's Creek #141, Hahn Creek #125, Hahn Creek Cut-across #124, Otter Creek #279 and Blackfoot Divide #278 are closed due to fire behavior. Lightning strike A single lightning event is a "flash", which

5680-458: The speed of sound. Sound travels at the slower speed of about 340 m/sec (depending on the temperature), so the flash of lightning is seen before thunder is heard. A method to determine the distance between lightning strike and viewer involves counting the seconds between the lightning flash and thunder. Then, dividing by three to determine the distance in kilometers, or by five for miles. Immediate precautions against lightning should be taken if

5760-434: The storm from within, while the silver iodide salting technique was devised to deal with the mechanical forces of the storm. Hundreds of devices, including lightning rods and charge transfer systems, are used to mitigate lightning damage and influence the path of a lightning flash. A lightning rod (or lightning protector) is a metal strip or rod connected to earth through conductors and a grounding system, used to provide

5840-527: The sum of each risk individually. The underlying causes of sudden cardiac arrest can result from cardiac and non-cardiac etiologies. The most common underlying causes are different, depending on the patient's age. Common cardiac causes include coronary artery disease , non-atherosclerotic coronary artery abnormalities, structural heart damage, and inherited arrhythmias. Common non-cardiac causes include respiratory arrest, diabetes, medications, and trauma. The most common mechanism underlying sudden cardiac arrest

5920-450: The surrounding air to ionize and break down, and the external flashover diverts most of the main discharge current so that it passes "around" the body, reducing injury. Metallic objects in contact with the skin may "concentrate" the lightning's energy, given it is a better natural conductor and the preferred pathway, resulting in more serious injuries, such as burns from molten or evaporating metal. At least two cases have been reported where

6000-624: The typical commercial aircraft hit at least once a year. Sometimes, though, the effects of a strike are serious. A 2020 lightning bolt across the southern United States set the record for the longest lightning bolt ever detected. The bolt stretched for 477 miles (768 kilometers) over Mississippi, Louisiana, and Texas, although it was between clouds and did not strike the ground. The World Meteorological Organization confirmed its record-breaking status in January 2022. Cardiac arrest Cardiac arrest , also known as sudden cardiac arrest ( SCA ),

6080-458: The victim is in cardiac arrest. Bystanders should call emergency medical services (such as 911 or 112) and initiate CPR . Major risk factors for cardiac arrest include age and underlying cardiovascular disease . A prior episode of sudden cardiac arrest increases the likelihood of future episodes. A 2021 meta-analysis assessing the recurrence of cardiac arrest in out-of-hospital cardiac arrest survivors identified that 15% of survivors experienced

6160-606: The years these names have been incorporated into other products or industries with a stake in lightning protection. Lightning arrester, for example, often refers to fused links that explode when a strike occurs to a high-voltage overhead power line to protect the more expensive transformers down the line by opening the circuit. In reality, it was an early form of a heavy duty surge-protection device. Modern arresters, constructed with metal oxides, are capable of safely shunting abnormally high voltage surges to ground while preventing normal system voltages from being shorted to ground. In 1962,

6240-429: Was estimated that "...one in four people struck by lightning were sheltering under trees." Trees are frequent conductors of lightning to the ground. Since sap is a relatively poor conductor, its electrical resistance causes it to be heated explosively into steam, which blows off the bark outside the lightning's path. In following seasons, trees overgrow the damaged area and may cover it completely, leaving only

6320-572: Was located near Count Peak in the Bob Marshall Wilderness in the Flathead National Forest . The fire was being fueled by timber and sub-alpine fir. On September 3, the fire had crossed and moved downstream Babcock Creek, Youngs Creek and settled in Otter Creek. Before merging with the Rice Ridge Fire on September 5, the fire was being monitored in its burn and was allowed to take its natural course due to concerns for firefighter safety given

6400-625: Was reported that "a direct strike accounts for only 3 to 5 per cent of all injuries and death, while ground currents, which spread out over the ground after lightning strikes, account for up to 50 per cent... ...Where the lightning strikes the ground, the ground becomes highly electrified and if you're within that area of ground electrification..." you can receive an electrical shock from the lightning. As of 2021, it has been reported that "30-60 people are struck by lightning each year in Britain, and on average, 3 (5-10%) of these strikes are fatal." In 2021, it

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