Lightning injury — DipIMC MCQ
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Correct answer: D — Prioritise ventilation and resuscitation despite multiple casualties
Explanation lettering: E = shown as A · A = shown as E
D is correct: Lightning incidents may require reverse triage because apparently lifeless patients can respond to prompt respiratory support. A is less suitable because it moves the patient before the decisive threat or destination issue is addressed; B is less suitable because it creates avoidable delay in a time-critical presentation; C is less suitable because a detailed survey is inappropriate before correcting an immediate threat; E is less suitable because it delays the immediate life-saving step in the cABCDE sequence. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.
Reference: JRCALC Guidelines; Resuscitation Council UK Special Circumstances; ATACC