Lightning injuries: A major source of injury and death from the environment, lightning is one of the top three causes of death from environmental origins. Lightning-related injuries are estimated to account for 3000 admissions to burn units each year in the US. Lightning is neither a direct current nor an alternating current. It is a unidirectional, massive, current impulse with several return strokes back to the cloud. Once connection from the cloud is made, a tremendously large current impulsively flows for an incredibly short time. The most important difference between lightning and high-voltage electrical injuries is the duration of exposure to the current. Lightning has only brief contact with the skin. There is not enough time to allow skin burns. Internal burns and renal failure play a small part in the injury pattern from lightning. Respiratory and cardiac arrest, vascular spasm, and neurologic damage are potential serious consequences of lightning injuries.