In a park lightning strike incident with three patients, what is the correct initial action after calling for backup?

• A. Focus your initial treatment efforts on the patients who are conscious because the unresponsive patient is likely in irreversible cardiac arrest.
• B. Immediately begin CPR on the unresponsive patient, but cease resuscitation efforts if there is no response after 5 minutes of treatment.
• C. Assess the unresponsive patient's pulse, begin CPR starting with chest compressions if he is pulseless, and attach the AED as soon as possible.
• D. Recognize that the patients who are conscious should be treated first, as the unresponsive patient may not be in cardiac arrest.

Answer: (C)

In a lightning strike incident, the priority is the unresponsive patient with potential cardiac arrest and getting life support started without delay. After calling for backup, quickly check for responsiveness and the presence of a pulse. If there’s no pulse, begin CPR immediately with chest compressions to maintain circulation and blood flow to vital organs. At the same time, attach an AED as soon as it’s available so a defibrillation strip can be applied if a shockable rhythm is present. If a pulse is present but the patient isn’t breathing, provide rescue breaths and monitor.

This approach is better than assuming the unresponsive patient isn’t recoverable, or waiting to treat conscious patients first, or stopping resuscitation after a set time. Early CPR and rapid AED use give the best chance of a return of spontaneous circulation, especially in lightning-related injuries where cardiac arrest can occur but is potentially reversible.