TY - CHAP M1 - Book, Section TI - Lightning and Electrical Injuries A1 - Navarrete, Norberto A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert PY - 2019 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - Even low-voltage electrical injuries can be fatal and often show no external burns.Higher-energy electrical injury can cause massive muscle damage and release of myoglobin. Without adequate early fluid resuscitation, myoglobinuric acute kidney injury can occur.Sufficient fluid should be administered to maintain a urine flow of 1 to 1.5 mL/kg/h, 2 mL/kg/h until the urine is myoglobin-free.Lip and oral commissure burns are initially bloodless and nearly painless, but as the eschar separates in 1 to 2 weeks, severe bleeding can occur as the labial artery is uncovered.Resuscitation of the apparently dead is the rule with lightning injuries.When Thunder Roars, Go Indoors. Every person should learn and teach this preventive action. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/12 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1155749833 ER -