SPORTS MEDICINE: Mitigating lightning casualties in sports
Sporting activity as any event entails a considerable amount of planning prior to the actual match or main event. What happens behind the scenes where a naked eye of a spectator isn't exposed to, is at times difficult to comprehend when an event cannot be called off for whatever reason. As we are in the rainy season, such meticulous planning and the amount of resources and labor involved (e.g. avoiding disruptions in season proceedings) many times at all costs, forces the event to carry on given the underlying circumstances; if they allow. Heavy rainfall brings with it some challenges such as a slippery surface, poor vision and as a result, collisions and contact injuries are common in this account.
A need for proper footwear is necessary to maintain balance while executing the skillset for each respective team player/individual athlete. A common incident when a sporting activity is halted is as a result of a waterlogged pitch, rendering the playing surface not conducive. Heavy rainfall with thunderstorms also exposes the athletes to dangers associated with lightning and a careful consideration needs to be made in such a setting with regards to whether or not a sporting activity needs to go on. Lightning flashes approximately 50 times per second worldwide, of which roughly 20% strikes the ground. This results in 24,000 deaths per year and ten times as many injuries. Being in an outdoor environment exposes one to a lightning strike. In October of 1998, a bolt of lightning killed an entire 11-man football team from the Democratic Republic of Congo. The opposing team was completely unharmed: however, 30 spectators sustained burn injuries.
A similar incident occurred on 25th October 1998 in Johannesburg, South Africa, in a Premier League soccer match between Jomo Cosmos and Moroka Swallows, without casualties although some players were hospitalised after the incident. Because lightning has the ability to travel large distances, always accompanied by thunder, these two factors have been incorporated into the 30-30 lightning prevention rule. Mitigation measures/Prevention 1. During lightning, cease activity and go indoors. Safety may only be guaranteed in a fully enclosed structure (such as a car, bus or concrete building). 2. All football stadiums should have a predetermined lightning plan in the event of a thunderstorm with lightning.
This is important as the most dangerous times for lightning strikes are the time intervals at the beginning and end of a thunderstorm. 3. 30-30 rule: The 30-30 lightning prevention rule states that there is a danger of someone being struck by lightning when the interval between seeing a lightning flash and hearing the subsequent thunder is less than 30 seconds, see-to-sound time. In this situation, the lightning is within a ten-kilometre distance. The second 30 in the 30-30 lightning prevention rule states that outdoor activities should not resume until 30 minutes have elapsed after the last lightning flash or thunder.
The rule is the simplest, safest and easiest strategy which can be used to prevent injuries due to lightning strikes. It mandates that as part of the stadium pre-determined lightning plan (PLP), someone be designated, within the football stadium management, to monitor the weather, the presence of lightning and the 30-30 lightning prevention rule when there is a forecast, visible threat or presence of a thunderstorm within the vicinity of the football match. Less populated stadiums (crowd control) is quite handy when developing PLPs, because stadiums that are relatively empty allow spectators to move quite easily in their attempts to escape the storm, whereas a stadium that is filled to capacity inhibits crowd movement and may therefore increase the danger of panic and/or a stampede. Lightning Injury Following a lightning strike, safety is the main concern for all. A direct strike is not common (less than 5% of cases).
When this occurs, it most commonly affects the head. As a result, eye and ear injuries (e.g. rupture of the tympanic membrane) are common in lightning strike victims. Blunt injuries are also relatively common as victims can be thrown many meters from the strike point. The main concern, however, is cardiac arrest which is usually a cause of death on the spot in lightning strike victims. Basic CPR, with rescue breathing and external chest compressions, is generally all that is required for lightening related cardiac arrest resuscitation. Advanced life support and the use of AED is rarely required. Safety prior to intervention is priority and the victim has to be safely transferred from an area of danger (i.e. during ongoing lightning and thunderstorms) on a spine board to avoid exacerbating any spinal injuries. In any event, the victim must be taken to a hospital for further assessment and management. As in injury management, prevention is KEY hence observing the 30-30 rule and crowd control in the form of PLPs is helpful in avoiding lightning related incidents and where they occur, prompt recognition, intervention and transfer are essential.