(Disclaimer: This article is for scientific purposes only, in order to protect the privacy of patients, the relevant information in the following content has been processed) Abstract: Lightning strike injuries are injuries caused by lightning passing through the human body, the patient was struck by lightning and appeared comatose for 4 hours to consult the doctor, at the time of the consultation of blurred consciousness, irritability, cardiac enzymes and cardiac myosin increased, electrocardiogram extensive lead ST-segment downward shift, T-wave inversion, given to the sedation, dehydration, cranial pressure, cerebral protection, nutrition, protection of organs and other related treatment for 1 week, the patient basically recovered. The patient was given sedation, dehydration, cranial pressure reduction, brain protection, myocardial nutrition, protection of multiple organs and other related treatments for 1 week, and was discharged from the hospital with basic recovery. Basic information] Female, 50 years old [Type of disease] Lightning injury [Hospital] The Second Affiliated Hospital of Harbin Medical University [Date of consultation] January 2022 [Treatment plan] Sedation (diazepam injection) + prevention of cerebral edema (mannitol injection) + enhancement of cerebral protection (edaravone injection) + nutrition of the myocardium (vitamin C injection, fructose injection) + nutrition of the nerves (vitamin B1 injection, methylcobalamin injection). injection, methylcobalamin injection) + protection of liver and kidney function (glutathione injection) + oral medication (vitamin B1 tablets + methylcobalamin tablets) 【Treatment cycle】 hospitalization for 7 days 【Treatment effect】 the condition has been significantly controlled, and the abnormal indicators have returned to normal I. Initial consultation The patient was driving his flock of sheep in the rain 4 hours prior to the consultation, when he fainted on the road after a sudden flash of lightning and thunder. When the family found the patient, he was still in a coma, and the family immediately sent the patient to our hospital. At the time of consultation, the patient was unconscious and irritable, and no trauma was found on careful examination of the trunk and limbs, and the muscle strength of the limbs was basically normal. Perfect fingertip blood glucose check 8.1mmol/L, exclude hypoglycemia, given diazepam injection moderate sedation, the patient agitation reduced, perfect head CT examination did not see any abnormality, basically exclude cerebrovascular lesions. According to the description of the family, the scene scene of the discovery of the patient and had been working in thunderstorms, preliminary consideration of the patient may be lightning injury. Rapidly complete the electrocardiogram examination, extensive lead ST-segment downshift, T wave inversion, and at the same time complete the blood routine, cardiac enzymes, liver and kidney function, electrolytes and other indicators of the examination, troponin 2.168ug/L, creatine kinase isoforms 12.9ug / L. II. Treatment According to the patient’s symptoms of blurred consciousness, restlessness and anxiety, the patient was considered to have a brain injury, cerebral edema, in addition to the administration of diazepam injection for sedation. Mannitol injection was also used for dehydration and lowering of cranial pressure, and edaravone injection was administered intravenously to enhance cerebral protection. From the patient’s electrocardiogram changes, combined with the results of cardiac enzymes and myocardial proteins, troponin 2.168ug/L, creatine kinase isoenzyme 12.9ug/L, it was found that the patient had myocardial injury, in order to exclude acute myocardial infarction, dynamic review of the electrocardiogram, cardiac enzymes and myocardial proteins, and then the patient was given intravenous vitamin C injection, fructose injection and other drugs to nourish the cardiac myocytes, and at the same time, continuous monitoring of the electrocardiogram, in order to timely detection of the cardiac myocardial infarction. The electrocardiogram was monitored in order to detect arrhythmogenic lesions in time. Although no obvious abnormality was found in the liver and kidney functions of the patient at the early stage, considering that electric shock can cause multi-organ damage to the nervous system and liver and kidney, the patient was given intramuscular vitamin B1 injection, static methylcobalamin injection to nourish the nerves, and injectable glutamine peptide to protect the liver and kidney and other organs, and the electrocardiogram, cardiac enzymes, cardiac myosin, and liver and kidney functions were dynamically rechecked every 2 days. Third, treatment effect The patient gradually woke up on the 2nd day after admission, could answer questions correctly, and self-reported peripheral pain and weakness, chest tightness, and numbness in both legs. After the above therapeutic measures were given, these uncomfortable symptoms were gradually relieved. Dynamic review of the electrocardiogram and all abnormal indicators also gradually improved. On the 7th day of hospitalization, the electrocardiogram was found to be normal, creatine kinase, creatine kinase isoenzyme and troponin were restored to normal values, liver and kidney functions were normal, and the numbness of both lower limbs was still slight, so the patient was discharged from the hospital to go home for recuperation. Fourth, precautions We are glad that the patient’s symptoms improved after treatment. For this patient, we consider that the patient was electrocuted by lightning, and it is lucky that he can survive in this situation, usually this situation has a big damage to the body, and the patient is left with nerve damage of the lower limbs, so we suggest that the patient should take vitamin B1 tablets and methylcobalamin tablets orally after discharge from the hospital in order to nourish the nerves. In addition, the patient was advised to take more rest and avoid overwork after discharge, and was told that the patient might have symptoms of nerve paralysis or defects, and might also have adverse complications such as cataracts, and that he should go to the hospital for examination and treatment in a timely manner once any uncomfortable symptoms appeared. The patient was instructed not to go out in thunderstorms in the future, not to walk under an umbrella in an open environment, and not to hide under a big tree to avoid the rain, which is more likely to suffer from lightning strikes. V. Personal Insights Most of the common electric shock injuries in life are caused by unsafe use of electricity, and most of them can be avoided as long as we have the common sense of safe use of electricity. Thunderstorm lightning when the electric shock is also a form of electrocution, due to the instantaneous formation of the voltage, current is very high, usually can instantly kill any organism in the circuit, due to the high heat and mechanical violence it produces, it can make the hit person charcoal, tissue tearing, and immediate death. Consider that the reason this patient survived and the organic damage was not very severe may be related to the shunting of the lightning by the sheep or the fact that the patient was electrocuted at the time because of the cross-step voltage caused by the lightning.