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Lightning strike screening — RCPSC EM MCQ

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HardEnvironmental emergenciesLightning strike screeningRCPSC EM

A 31-year-old is found after overnight cold exposure. Core temperature is 29°C, he is drowsy but has a pulse of 48/min and shivering has stopped. There is no major trauma. What is the appropriate immediate management?

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Correct answer: A — Begin active external rewarming with continuous core and cardiac monitoring

The best answer is “Begin active external rewarming with continuous core and cardiac monitoring”. This is moderate hypothermia with impaired consciousness and bradycardia. Canadian guidance calls for careful handling, active external or minimally invasive rewarming, and cardiac and core-temperature monitoring. A hot bath, alcohol and unsupported discharge can worsen hypotension, dysrhythmia or injury; room-temperature fluid does not rewarm the patient effectively.

Reference: Emergency Care BC: Accidental Hypothermia: https://emergencycarebc.ca/clinical_resource/clinical-summary/accidental-hypothermia/