Lightning Strikes: What to Know, What to Do

By Kathleen Doheny. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Every year in the U.S., about 50 people are killed by lightning. Hundreds more are injured but survive.

As of the publish date, in 2014, seven people in the U.S. have died after being struck. One was closing car windows at a construction site, two were near a tree,  one was fishing, another was riding his motorcycle on a highway, one man was working on a new roof at a car dealership, and another was caught out while picking blueberries.

All probably thought they were safe, but obviously they weren’t. Here, what you need to know, and why.

Lightning Strikes: What Happens Inside Your Body

When lightning strikes a person, an extremely powerful, direct current is conducted throughout the body, says Arthur Sanford, MD, associate professor of surgery at Loyola University Chicago's Stritch School of Medicine. He has researched lightning injuries and cared for patients struck by lightning.

The lightning strike usually enters the body through the head or your sides, he says. "Lightning strikes are not always fatal," he says.

When a lightning strike is fatal, the usual problem — and cause of death — is heart stoppage or cardiac arrest. "When you put a big current [from the lightning] across the body or the heart, it overrides the conduction system of the heart," resulting in cardiac arrest, he says.

Contrary to belief, skin burns are not common in lightning strike victims.

However, those who don't suffer cardiac arrest and survive may suffer trauma from being thrown against an object or falling from height; may have burns and muscle damage, and often report neurologic symptoms, including:

  • Nausea,
  • Headache,
  • Mild confusion,
  • Memory problems (a mental fog), and/or 
  • Balance problems.

First Aid for Lightning Strikes

If someone is struck by lightning, immediate first aid is crucial, Sanford says.

A lightning victim is not electrified, despite what people think, he says. The body doesn't store electricity. After the strike, he says, ''You may safely go to them. The current is gone."

What to do?

  • Get the victim to a safe place.
  • Call 9-1-1.
  • Check for pulse and breathing.
  • Administer CPR if needed and if you are trained in it.
  • If an automated external defibrillator (AED) is available, use it. This device restores normal heart rhythms. AEDs are available in many public buildings. They are user-friendly, with instructions.

Lightning Strikes: Long-Term Health Effects

Once a lightning strike victim reaches medical help, doctors will check out the patient for tissue damage and other problems. Care is supportive, tending to symptoms such as nausea and headache. The path the lightning takes varies, and one person might just have skin injuries while another has damage to muscle and even bone.

"One thing we do see is, they can have some personality changes that resolve over about six months," Sanford says. People struck by lightning may find it difficult to carry on a conversation, be depressed or irritable, and report chronic pain or headaches.

Other problems reported by survivors:

  • Slower time reacting
  • Forgetfulness
  • Ringing in the ears
  • Sleeping difficulty
  • Multitasking problems

Next Steps

For Patients

  • If you're outside during a thunderstorm, seek shelter. Cars are safe but convertibles, motorcycles, and bicycles are not. Don't lie flat on the ground. Keep moving to shelter, but don’t go under a tree. Inside, stay away from anything that conducts electricity: corded phones, computers, appliances, TV cables, metal doors or windows.
  • Brain scans in lightning victims may look normal because the brain may be structurally fine but still not be working properly; functional tests done by your doctor may be better at evaluating memory, reasoning and language.
  • U.S. fatalities from lightning, including locations and activities, can help everyone stay mindful of the risks. 

For Family Caregivers

  • If a loved one has been struck by lightning, your support is valuable in helping him overcome the associated problems. Encourage getting help for any chronic pain, or difficulties with concentration or other thinking skills. Check out this international support group for more survivor help.
  • Lightning can, indeed, strike twice. Most vulnerable, says the National Weather Service, are ''tall, pointy, isolated objects" like the Empire State Building in New York City. It gets about 100 hits a year.

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