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May 1994

Picture of the Month

Arch Pediatr Adolesc Med. 1994;148(5):529-530. doi:10.1001/archpedi.1994.02170050087019

WHILE PARTICIPATING in a soccer practice, the 10-year-old boy pictured below suddenly collapsed and was found to have suffered a cardiopulmonary arrest. Cardiopulmonary resuscitation was performed immediately. His trachea was intubated and the lungs were ventilated by paramedics on the field, with spontaneous return of a sinus cardiac rhythm. In the emergency department, the child was combative and had occasional purposeful movements. The findings on cutaneous examination are pictured in Figure 1 through Figure 3. The electrocardiogram, chest roentgenogram, and computed tomogram of the head showed no abnormalities. Before the child collapsed, his teammates reported having heard a loud noise.

Lightning strikes kill up to 300 people each year in the United States, with the highest death rate in adolescents.1,2 Approximately 75% of those who are struck by lightning survive.1,3 Lightning bolts have charges of 10 to 30 million V and a current of 20 to 200 000