Gebelik ve yıldırım çarpması (Olgu sunumu)
Yıldırım çarpmasına bağlı yaralanmalarda dünyada her yıl yaklaşık olarak 1000 kişinin öldüğü tahmin edilmektedir. Ancak yaralanmaların ortalama %70`i öldürücü değildir. Yıldırım çarpması üç mekanizma ile etki gösterir. Bunlar; en öldürücü ve ciddi yaralanmalara sebep olanı direkt etkilenme, ağaç ya da uzun bir nesneden yansıma ve etkilenmiş zeminde duran kişiye alt ekstremiteden geçiş yoluyla olmaktadır. Bu olgu sunumunda, 29 yaşında 28 haftalık gebeliği olan kadın hastanın açık alanda çalışırken yıldırım çarpmasına maruz kalması, klinik bulguları ve tedavisi anlatıldı.
Pregnancy and lightning strike (Case report)
It is estimated that lightning strikes kill nearly 1000 people per year worldwide, but 70% of these injuries have good survival rates and are not fatal. There are three mechanisms in lightning strikes: a direct strike, (most often fatal or causing severe injuries), current deflection from a tree or other tall object, or current transfer from the ground to the lower extremity of the body. In this case report , the clinical diagnosis and subsequent management of a 29 year-old 28 week pregnant woman who had been exposed a lightning strike while working in the open field are described.
___
- 1. Fontanarosa PB. Electrical shock and lightning strike. Ann Emerg Med 1993; 22:378-87.
- 2 Lichtenberg R, Dries D, Ward K, Marshall W, Scanlon P. Cardiovascular effects of lightning strikes. J Am Coll Cardiol 1993; 21:531-6.
- 3. Elsom DM. Death and injuries caused by lightning in the United Kingdom: analyses of two databases. Atmosph Res 2001; 56:325-34.
- 4. Cooper MA, Andrews CJ, Holle RL, Lopez RE. Lightning injuries. In: Auerbach PS (ed). Wilderness medicine. 4 th ed. St. Louis, Mosby, 2001; 73-110.
- 5. Fahmy FS, Brinsden MD, Smith J, Frame JD. Lightning: the multisystem group injuries. J Trauma 1999; 46:937-40.
- 6. Gutierrez JJG, Melendez J, Torrero JV, Obregon O, Uceda M, Gabilondo FJ. Lightning injuries in a pregnant woman: a case report and review of the literature. Burns 2005; 31:1045-9.
- 7. Lewis AM. Understanding the principles of lightning injuries. J Emerg Nursing 1997; 23:535-41.
- 8. Strasser EJ, Davis RM, Menchey MJ. Lightning injuries. J Trauma 1977; 17:315-9.
- 9. Cankaya H, Egeli E, Evliyaoglu Z. Hearing loss caused by lightning strike: case report and review of the literature. J Otolaryngol 2002; 31:181-3.
- 10. Youngs R, Deck J, Kwok P, Hawke M. Severe sensorineural hearing loss caused by lightning. A temporal bone case report. Arch Otolaryngol Head Neck Surg 1988; 114: 1184-7.
- 11. Akhtar MA, Mulawkar PM, Kulkarni HR. Burns in pregnancy: effect in maternal and fetal outcomes. Burns 1994; 20:351-5.
- 12. Unsur V, Voztopcu C, Atalay C, Alpay E, Turhanoglu B. A retrospective study of 11 pregnant women with termal injuries. Eur J Obstet Gynecol Reprod Biol 1996; 64:55-8.
- 13. Zehender M. Images in clinical medicine : struck by lightning. N Engl J Med 1994; 330:1492
- 14. Polko LE, McMahon MJ. Burns in pregnancy. Obstet Gynecol Surv 1999; 54:131-7.
- 15. Einarson A, Bailey B, Inocencion G, Ormond K, Koren G. Accidental electric shock in pregnancy: A prospective cohort study. Am J Obstet Gynecol 1997; 176:678-81.
- 16. Fish RM. Electric Injury, part III: cardiac monitoring indications, the pregnant patient, and lightning. J Emerg Med 2000; 18:181-7.
- 17. Leiberman JR, Mazor M, Molcho J, Haiam E, Maor E, Insler V. Electrical accidents during pregnancy. Obstet Gynecol 1986; 6:861-3.
- 18. Krasemann T, Hoovey S, Uekoetter J, Bosse H, Kurlemann G, Debus OM. Early infantile epileptic encephalopathy (Ohtahara Syndrome) after maternal electric injury during pregnancy: etiological considerations. Brain Dev 2001; 23:359-62.