FRIDAY, June 6 (HealthDay News) -- Imagine you're a coach with a dugout full of Little Leaguers, and a storm strikes. You hear thunder. Many parents dropped off their kids and aren't there, and the school next to the field is locked. How do you get the kids to safety?
That's just the type of situation that Katie Walsh, director of athletic training education at East Carolina University in Greenville, N.C., hopes people will start to prepare for. "Lightning is about 100 percent avoidable, but you have to have a plan," she said.
Each year, dozens of people are killed by lightning strikes in the United States, according to the National Weather Service, part of the U.S. National Oceanic and Atmospheric Administration (NOAA). That risk goes up considerably in the summer, when lightning-laced thunderstorms are more apt to occur and when more people are on the beach, in the mountains or on athletic fields and golf courses.
Walsh's university has a plan and has had to use it. "We have a football stadium that holds 50,000 people, and we had to evacuate it," she said. "As much as people gripe about it, I'd rather have to evacuate the stadium than have one person hurt. I want people to be safe."
Walsh said they were lucky because there's an indoor coliseum next to the football stadium. But that's not always the case, especially for the myriad of youth sporting events that occupy so many fields in warmer-weather months.
"Lightning season is April to November in many areas, and it's common between 4 p.m. and 7 p.m., which is often when people are playing," she said. "So, have a plan. Is there a school bus that could be parked by the field that the coaches could take children to if a storm pops up?"
John Jensenius, a lightning safety specialist with the National Weather Service, also advocates having a plan -- one that always starts with checking the weather. "That way you can postpone or cancel the activity if there's a possibility of thunderstorms," he said. "If you go ahead with your activity, stay in tune to the forecast and keep an eye on the sky. If you hear thunder, the storm is already close enough for lightning to strike. Seek shelter right away."
Safe shelters include any building with plumbing and wiring, cars with hard tops, trucks, RVs and buses. On the not-safe list is anything that's open to the outside, such as dugouts, bus stops, convertibles, and even open garages.
"People think if they're not getting wet, they can't get struck, but if you're outside, you're at risk," said Walsh, who recently chaired a group writing a new position statement on lightning safety for the National Athletic Trainers' Association.
Once you're indoors, stay away from windows and doors, as well as from anything plugged in or anything that has a direct connection to the plumbing, according to Jensenius. "So, no washing dishes or taking showers or baths," he said. Talking on a cordless phone is OK, but stay off corded phones, he advised. If you're in a car, the rubber tires won't protect you, but lightning will travel along the outside metal of the car. To stay safe, don't touch the metal door handles. Also, avoid touching the windshield if your car's antenna is built into it, and leave the radio alone, too, he cautioned.
If you're outside and can't find a safe shelter, look for an area with shorter trees, but keep some distance from the trees. "If you're with a group, spread out," Jensenius said. "This might actually increase the risk of someone getting hit, but if you're all together and that area gets hits, there won't be anyone who can help," he explained.
"Avoid being, or being near, the tallest object in your immediate area," Jensenius added. "But don't be out in the open or near isolated trees, either."
If you're on the water, Walsh said, get to shore as quickly as possible. If you're in a pool, get out and seek shelter. And, don't go outside or in the water again until at least 30 minutes after the lightning flash or the last clap of thunder.
If you haven't been able to find appropriate shelter and suddenly feel your hair standing on end, the Federal Emergency Management Agency recommends that you crouch down as low as you can, placing your weight on the balls of your feet so that as little of you is connected to the ground as possible. Cover your ears with your hands and put your head between your knees to make yourself the smallest target possible.
If the worst happens, and you or someone you're with is struck by lightning, the first concern is sudden cardiac arrest.
"Lightning can immediately stop your heart," Walsh said. "CPR needs to be started right away." If you happen to be where there's a portable automated external defibrillator, Jensenius said, use it if the person's heart has stopped.
"If someone is moving around, or if you know they have a heartbeat, take care of others who don't," Walsh advised.
Other problems that could occur from a lightning strike are fractures, ruptured ear drums and concussions, according to Walsh. "People don't always come back to where they were before the lightning strike," she said. "Some people have problems that last the rest of their lives. They may have trouble sleeping or headaches."
Jensenius added that some people experience burns, and others have trouble concentrating, are more forgetful, get easily distracted or have personality changes after being hit by lightning. Treatment, he said, depends on the particular injury, though it begins with getting immediate medical help for anyone who's been struck.
And, before that, it starts with a plan.
The National Oceanic and Atmospheric Administration has more about lightning safety.
A companion article details the experience of a lightning strike survivor.