Lightning is a massive electrical discharge generated by imbalances in electrical potential within storm clouds or between clouds and the ground. A typical lightning bolt can carry tens of thousands of amperes and hundreds of millions of volts, releasing immense energy in milliseconds. The lifetime risk of being struck in the United States is about 1 in 10,000. Although a significant weather hazard, approximately 90% of individuals struck by lightning survive.
The Immediate Impact on the Body
The immediate effects on a person struck by lightning are severe. The most direct and life-threatening consequences involve the cardiovascular and respiratory systems. Lightning’s electrical current can disrupt the heart’s rhythm, causing immediate cardiac arrest or dangerous arrhythmias. Simultaneously, the electrical discharge can paralyze respiratory muscles, leading to respiratory arrest. While the heart may spontaneously restart, respiratory paralysis can be prolonged, potentially leading to a second cardiac arrest if breathing is not supported.
Burns frequently occur due to the extreme heat generated by a lightning strike, which can reach temperatures hotter than the surface of the sun. These burns often manifest as linear streaks where sweat or rainwater on the skin instantly vaporizes, or as distinctive fern-like patterns known as Lichtenberg figures. These figures, formed by ruptured capillaries beneath the skin, typically appear within hours and fade within days. Despite the intense heat, the brief duration of the strike often results in superficial burns rather than deep tissue damage.
Beyond electrical and thermal injuries, the mechanical force of a lightning strike can inflict blunt force trauma. The superheated air around the bolt rapidly expands, creating a powerful shockwave similar to an explosion. This force can throw a person several yards, leading to injuries such as fractures, dislocations, or internal organ contusions. The explosive pressure wave can cause concussive injuries, including ruptured eardrums, lung damage, and pneumothorax. Loss of consciousness is a common immediate neurological effect.
Understanding How Lightning Injures
Lightning injures the human body through several distinct mechanisms. These include the direct effect of electrical current on tissues, intense heat, and mechanical forces from pressure waves. Injuries are not always from a direct hit, which accounts for only about 5% of cases.
More commonly, lightning injuries result from indirect pathways:
Side flash: Lightning strikes a nearby object, and a portion of the electrical energy jumps to a person.
Ground current: Electrical discharge spreads across the ground after a strike, entering the body through the feet.
Contact injury: A person touches an object that is then struck by lightning, allowing the current to pass through them.
Upward leader: An electrical discharge rises from the ground but does not connect with the downward lightning strike.
The rapid expansion of superheated air generates a shockwave, causing concussive injuries and propelling an individual. Thunder is a direct result of this explosive effect. The electrical current can cause violent muscle contractions, contributing to falls and other traumatic injuries. The combined effects of electricity, heat, and pressure waves interact with the body’s systems to produce the range of immediate and lasting injuries observed in lightning strike survivors.
Recovery and Lingering Effects
For those who survive a lightning strike, recovery can be extensive, often involving persistent health challenges. Approximately 75% of survivors experience ongoing health problems, with many living with some form of permanent disability. These lingering effects are distinct from immediate acute injuries and can significantly impact a person’s quality of life.
Neurological problems are common, as lightning primarily injures the nervous system. Survivors may experience difficulties with memory, concentration, information processing, slower reaction times, and multitasking. Chronic pain, often stemming from nerve damage, and headaches are frequently reported. Seizures and keraunoparalysis, a temporary limb paralysis caused by vascular spasm, can also occur.
Psychological effects are prevalent among survivors. The traumatic nature of the event can lead to post-traumatic stress disorder (PTSD), anxiety, and depression. Some individuals may experience personality changes, increased irritability, or social isolation. These impacts can affect their ability to return to work or maintain relationships.
Sensory impairments are another group of long-term consequences. Ocular injuries, such as cataracts and various vision problems, are common. Hearing issues, including ruptured eardrums, sensorineural deafness, tinnitus, and vertigo, are frequently observed due to the blast effect or electrical injury. Musculoskeletal problems, such as chronic muscle stiffness and joint pain, often result from intense muscle contractions and blunt force trauma during the strike.
Immediate Care After a Strike
Providing immediate care to someone struck by lightning can significantly improve their outcome. The first step is to call emergency services immediately. A rapid response is vital, as cardiac arrest is a common cause of death.
Before approaching the individual, assess the scene to ensure it is safe and there is no ongoing threat of lightning. A person struck by lightning does not retain an electrical charge and is safe to touch, dispelling a common misconception.
If the person is unconscious, not breathing, or has no pulse, begin cardiopulmonary resuscitation (CPR) without delay. Prompt CPR is highly effective in increasing survival rates for lightning strike victims. Even if the heart’s rhythm spontaneously returns, respiratory paralysis may persist, so continued breathing support is important until medical help arrives. If multiple victims are present, prioritize those in cardiac or respiratory arrest, as they have the highest potential for successful resuscitation. While waiting for emergency personnel, treat for shock by laying the person flat and elevating their legs, and check for burns, providing preliminary care as needed.