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Lightning kills about 100 people each year in the United States, more than the average annual number of deaths due to any single type of "natural disaster."

Being struck by lightning happens in certain high-risk groups. The highest death rates occur at ages 10-19 and is six times as high among males as females. About one-fifth of all deaths from lightning occur on farms. The southern and Rocky Mountain states have the highest death rates.Deaths are most common during the summer, when people are likely to be outdoors and thunderstorms are most common. Most involve people who are in open fields or on the water and/or are touching metal equipment such as antennas. Deaths related to recreation are most apt to involve golfers, anglers and campers.

Lightning-caused deaths have dramatically decreased during the past 50 years. This has come probably because of the decrease in the farm population and because of electrical systems improvement.

First aid

Your main concern with a lightning injury is cardiac or respiratory arrest. When the current passes through the victim's body, complete depolarization of the heart can occur, causing ventricular fibrillation or cardiac arrest. Generalized paralysis of the muscles can trigger respiratory arrest.

Many times, lightning won't strike a victim directly. Instead, it bounces off a nearby structure, then hits the victim. When this happens, you're likely to see spidery markings on the skin because the impact of the lightning has been diffused.

In many cases, the victim's clothing will be ignited, so extinguish any flames with water or by rolling the victim on the ground.

Have someone contact the Emergency Medical Services System. Don't move the victim; he or she might have a spinal cord injury, head injury or a fracture.

Assess the victim's ABCs. Is the airway open? Is the victim breathing? Is the heart beating? The victim may be temporarily stunned and resume breathing spontaneously. If necessary, give cardiopulmonary resuscitation (CPR). If CPR is needed, it usually requires an aggressive, prolonged effort by rescuers.

Be aware that the victim's spinal cord may be affected, so if he or she is unconscious, treat the victim as though it were broken. Be very gentle and immobilize the neck, and if necessary, use the jaw thrust method to open the airway.

Victims most likely to die from a lightning strike are those who suffering immediate cardiac arrest. Those not experiencing arrest immediately have an excellent chance of recovery. Therefore, when several victims have been simultaneously struck by lightning, those who appear dead immediately following the strike should be treated before other victims showing signs of life.

A couple of misconceptions persist about lightning-struck victims. One is the belief that all those struck are killed and nothing can be done. Another myth is lightning-struck victims are unsafe to handle and that it's possible to get electrocuted by touching the victim.

- Alton Thygerson is a professor of health sciences at Brigham Young University.