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Lightning strike injury — RCPSC EM MCQ

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HardCardiovascular emergenciesLightning strike injuryRCPSC EM

A 41-year-old farmer is found after a lightning strike. He is awake with confusion, tympanic membrane rupture and branching skin marks. ECG and troponin are initially normal, but he had a witnessed brief loss of consciousness. What is the most appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Observe with cardiac monitoring and assess for neurologic, ocular and auditory injury

Lightning injury with loss of consciousness warrants monitoring and evaluation for cardiac, neurologic, ocular and auditory complications even if early ECG is normal.

Reference: ACLS/ATLS/PALS principles adapted to Canadian ED practice