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CASE SCENARIO:
A 75-year-old female in good general health was struck by lightning as she was standing 3 metres away from a tree. On-site evaluation showed the patient in prone position; her clothes and shoes were partially burned, still-smoking, and were removed immediately. She was hemodynamically stable (BP 138/87 mmHg, HR 87 beats per minute) and conscious. However, she presented transient amnesia for the event. Burn injuries going from the left ear to the left toe were visible. The patient was transferred to the emergency department for further evaluation, where thorough clinical examination by a plastic surgeon confirmed linear first and superficial second degree burns with some blisters on a line going from the left ear to the left toe, corresponding to about 6% of the total body surface area. Total body CT revealed no profound injuries with the exception of an old fracture of the second thoracic vertebra. The ECG depicted a right bundle branch block, with deep and symmetrical T-wave inversion in precordial and lateral leads and a prolonged QT interval.
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