A: Lightning strikes have killed more than 2,500 people in the United States during the past 20 years. In Arizona, where lightning strikes are common during the summer monsoon season, physicians must be able to correctly identify lightning-strike victims, and people must know what to do if they find themselves in a lightning situation.

Generally, 20 million volts of electricity pass through a person directly struck by lightning. A person hit by lightning often is found unconscious, disoriented and/or suffering from paralysis in the extremities. Lightning-strike victims sometimes are misidentified as assault victims because of these symptoms and clothing that is in disarray or blown off. Other signs of lightning strike are unusual- looking burns caused by a high electrical charge. Flash burns that appear to be deep sunburn and feathering, wispy, tentacle-like patterns on the skin, are the most common type of burns. To avoid being struck by lightning when outside, never stand directly under a tree. Instead, assume a crouching position in a dry depression in the ground with some type of insulation -- like a rain poncho -- between your body and the ground. A few facts about lightning: most lightning strikes occur in the summer in the daytime; lightning strikes men (80 percent) more often than women (20 percent); people 20-29 years old are the most likely to be struck; lightning strikes take place outdoors 95 percent of the time. Michael Esser, M.D., Department of Surgery, The University of Arizona College of Medicine in Tucson

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