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May 1994

Picture of the Month

Author Affiliations

From the Department of Pediatrics, University of Colorado Health Science Center (Drs Volinsky and Lustig) and Presbyterian–St Luke's Medical Center (Dr Hanson), Denver, Colo.

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