Singapore, albeit a small country, has one of the highest lightning activities in the world. However, injuries related to this spectacular weather phenomenon are under-reported and rarely a subject of study. Most reported cases dealt with lightning-caused fatalities but lightning-caused accidents are not always fatal. Actual reported international data showed that about 80% of lightning victims survived, with or without after effects. This study reviewed the cases of lightning-related injuries who presented to Tan Tock Seng Hospital, Emergency department.

This is a case series of 5 patients. All 5 patients presented to Tan Tock Seng Hospital, Emergency Department after a thunderstorm. All were undergoing military training when the incident happened. The circumstances surrounding their injury and their presentation and symptomatology were reviewed.

In our study, three possible mechanisms of injury were identified through a side flash which occurred when the lightning hit the tree and traveled partly down that tree before a portion jumped to the nearby victims; through the concussive effect of the shock waves produced by the lightning; and through step voltage mechanism wherein the lightning after hitting the tree traveled into the ground where victims were standing. Two patients were diagnosed with rhabdomyolysis, one suffered from sensory-neural hearing loss, and one patient had a mild conjunctivitis as a result of tissue inflammation. Other symptoms included retrograde amnesia, parasthesia, tinnitus, and a single episode of seizure which resolved spontaneously. All our patients survived the ordeal and were discharged well back to their premorbid states.

This paper supports existing evidence that lightning-caused accidents are not always fatal and that victims may survive with no or little side effects given proper medical treatment.