Electrical currents cause varying injury patterns, largely determined by the voltage, current, duration of contact, and the pathway of the current. Low voltage, which has been defined as less than 1,000 V, tends not to cause significant deep tissue damage but still can cause fatalities. High-voltage injuries are associated with greater mortality. Because arrhythmias and cardiac arrest are the most common causes of death in electrocution, cardiopulmonary resuscitation should be initiated as soon as safely possible for electric shock-induced cardiac arrest. Victims of lightning strikes, a special form of high-voltage electrical current, generally have significant resuscitation potential. Therefore, “reverse triage” should be implemented for patients in cardiac arrest due to lightning-related mass casualty incidents. Once cardiac arrhythmias and respiratory arrest are addressed, patients with electrical injuries should be evaluated as trauma patients, treating any blunt injuries, and caring for burns.