Lightning injury (reverse triage) — DIPIMC MCQ

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HardEnvironmental MedicineLightning injury (reverse triage)DIPIMC DipIMC

Several people are struck by lightning. Some are in cardiac or respiratory arrest while others are walking wounded.

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Correct answer: C — Use reverse triage and prioritise those in respiratory or cardiac arrest, who may respond to prompt resuscitation

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

Lightning and electrocution are exceptions to conventional triage: those who appear dead are treated first ('reverse triage'), because the primary problem is often a respiratory arrest that responds well to prompt ventilation and CPR. Applying standard triage and labelling the arrested casualties expectant (A) would withhold treatment from patients with a genuine chance of recovery. In a lightning mass-casualty, resuscitate the apparently dead first.

Reference: Resuscitation Council UK 2025 (electrocution); wilderness medicine