Skin vasoconstriction in a reticular pattern is thought to be characteristic of a lightning injury. Electrocution is an injury caused by the passage of electric current through the body. It is usually caused by inadvertent electrocution or lightning strikes. When a person is struck by lightning, the heartbeat and respiration often stop immediately, accompanied by myocardial damage, followed by myosinuria, and skin vasoconstriction in a reticular pattern, which is thought to be characteristic of lightning injury. This is followed by myosinuria. In mild cases, only painful muscle contractions, panic, pallor, headache, dizziness, and palpitations occur after electrocution. Severe cases can lead to loss of consciousness, shock, cardiac and respiratory arrest, and severe ventricular arrhythmia, pulmonary edema, gastrointestinal hemorrhage, coagulation dysfunction, and acute renal insufficiency often occur after electric shock. Special clinical attention should be paid to the possibility that the injured person has multiple injuries, including mandatory muscle injury, visceral organ injury, and external and internal burns. Survivors may have cardiac and neurologic sequelae. Severe burns from high-voltage electrocution are common at the site of current entry and exit, and the most striking feature of electrocution wounds is the small trauma to the skin and the extensive deep tissue damage beneath the skin. History of lightning injury, when a person is struck by lightning, heartbeat and respiration often stop immediately, accompanied by myocardial damage. Skin vasoconstriction in a reticular pattern is thought to be characteristic of lightning injury. This is followed by myosinuria. Other clinical manifestations are similar to those of high-voltage electrical injury. The general examination includes ECG examination, blood pressure monitoring, respiratory examination and so on. The simpler the examination, the better, in order to better compete to save the patient. ECG shows various arrhythmias, acute myocardial injury, non-specific ST-T changes. x-ray shows fractures may be present. Myocardial biochemical markers are elevated, blood amylase is elevated, blood creatinine and urea are elevated, hyperkalemia, myoglobin and hemoglobinuria are present. Arterial blood gas analysis showed acidosis and hypoxemia. The diagnosis can be made based on the patient’s history of electrocution and the scene. The presence or absence of episodes of falling from a height or being thrown away by an electric shock should be understood. Note the possibility of cervical cord injury, fractures, and visceral injuries. Measurement of blood LDH, CK, and amylase, and detection of urinary myoglobin and hemoglobin can assist in determining the extent of tissue damage.