About 90% of people struck by lightning survive, according to the CDC. Your odds depend on the type of strike, how quickly you receive medical attention, and what you do in the minutes and hours before a storm hits. Around 40 million lightning bolts strike the ground in the United States each year, and from 2006 through 2021, 444 people died from them. Most lightning deaths happen because no one was nearby to perform CPR.
How Lightning Actually Hits You
A direct strike, where you become part of the main discharge channel, is the least common way to be hit but the most dangerous. When it happens, some of the current travels along the surface of your skin (called flashover) while the rest passes through your body, primarily through the cardiovascular and nervous systems. The surface current can cause burns, but it’s the internal current that poses the greatest threat to your heart and brain.
Ground current is actually the leading cause of lightning deaths and injuries. When a bolt hits a tree, pole, or open ground, the energy spreads outward along the surface. Anyone standing nearby can have that current enter through one foot, travel through their body, and exit through the other. The farther apart your contact points with the ground, the more dangerous this becomes, which is why livestock with wide stances are killed so frequently by nearby strikes.
Side flash occurs when lightning hits a tall object near you and part of the current jumps to your body. This typically happens when you’re within a foot or two of the struck object. Most side flash victims were sheltering under a tree. Conduction, the fourth type, happens when lightning travels through wires, plumbing, or metal surfaces. This is the primary cause of indoor lightning injuries.
What a Lightning Strike Does to Your Body
The primary cause of death from a lightning strike is cardiac arrest. The massive electrical surge can stop your heart instantly, either causing it to quiver uselessly or flatline entirely. However, the heart has a natural ability to restart itself. If it does regain a rhythm on its own, the bigger problem becomes breathing: the part of the brain that controls respiration may not recover as quickly. Without breathing support, the survivor can go into a second cardiac arrest from oxygen deprivation.
Up to 80% of lightning strike survivors experience a temporary condition called keraunoparalysis, a sudden paralysis of the limbs. The affected limbs go cold, pale, numb, and completely limp. It looks terrifying, but it resolves on its own, typically within two to four hours. One case report described a woman who lost all strength and sensation on one side of her body after a strike and recovered near-complete function within hours.
Some survivors develop distinctive fern-like patterns on their skin called Lichtenberg figures. These branching red marks appear within an hour of the strike on areas of moist skin and fade within about 48 hours. They aren’t burns. They’re thought to result from damage to tiny blood vessels near the skin’s surface, and they’re the only skin marking that definitively confirms a lightning strike.
What to Do If Someone Near You Is Struck
Lightning victims carry no residual electrical charge. You will not be shocked by touching them. This is one of the most important things to know, because hesitation costs lives.
If the person isn’t breathing or has no pulse, start CPR immediately and call emergency services. Use an automated external defibrillator (AED) if one is available. Resuscitation attempts on lightning victims have a higher success rate than cardiac arrest from most other causes, and they can work even when there’s been a significant delay. The American Heart Association recommends “vigorous resuscitative measures even for those who appear dead on initial evaluation.”
If multiple people are struck at once, use what’s called reverse triage. In most mass casualty events, responders focus on people who are still breathing and conscious. Lightning strikes flip this logic. Because the heart can restart on its own but breathing often doesn’t follow, the people who look dead are actually the ones most likely to be saved with immediate help. Prioritize anyone who isn’t breathing. Those who are conscious and breathing, while possibly injured, are far less likely to die.
How to Avoid Getting Struck
The simplest rule comes from NOAA: when thunder roars, go indoors. If you can hear thunder, you’re within striking distance. Move to a substantial building or a fully enclosed, hard-topped vehicle. Do not resume outdoor activities until 30 minutes after the last clap of thunder. That 30-minute buffer matters because lightning can strike from a storm cell more than 10 miles away from any rainfall.
If you’re caught outside with no shelter available, avoid being the tallest object in an open area. Stay away from isolated trees, metal fences, and bodies of water. Get off elevated terrain. Crouch low with your feet together to minimize the distance between your contact points with the ground, reducing the danger from ground current. Do not lie flat, as that increases your surface contact.
Indoor Hazards Most People Miss
Being inside doesn’t make you immune. Lightning can travel through a building’s plumbing and electrical wiring. During a thunderstorm, don’t shower, bathe, or wash dishes. Don’t use anything plugged into an outlet: computers, gaming systems, washers, dryers, or stoves. Corded phones are particularly dangerous because they provide a direct path for electrical current. Cordless and cell phones are safe.
Lightning can also travel through metal wires or rebar embedded in concrete walls and floors. If you’re in a structure with a concrete floor, like a garage, be aware that the floor itself can conduct ground current from a nearby strike. Whole-house surge protectors can shield your appliances but won’t protect you from direct contact with a conducting path.
Long-Term Effects Survivors Face
Surviving the initial strike is only part of the story. Many lightning survivors deal with chronic neurological and psychological problems that can persist for months or years. In one review, 71% of survivors reported memory problems, 63% had difficulty concentrating, and 50% experienced a general decline in mental sharpness.
Depression, anxiety, irritability, chronic fatigue, and PTSD are all common after a strike. Some survivors describe personality changes noticeable enough that family members comment on them. Emotional instability, where mood swings seem to come from nowhere, is frequently reported. These psychiatric symptoms can appear weeks or even months after the event, catching survivors off guard after they assumed the worst was over.
The mechanism behind these delayed symptoms isn’t fully understood, but lightning passes through the nervous system and can cause subtle damage to brain tissue and nerve pathways that doesn’t show up on standard imaging. Survivors who experience any cognitive or emotional changes should seek a neuropsychological evaluation, as many of these issues respond to rehabilitation and treatment once properly identified.