How should EMS respond to a lightning strike victim who is unconscious with no pulse?

• A. Begin CPR immediately; use AED as indicated; continue resuscitation per protocol and monitor for return of spontaneous circulation.
• B. Wait for signs of breathing before starting CPR.
• C. Only provide oxygen and avoid chest compressions.
• D. Transport without resuscitation.

Answer: (A)

Lightning strikes can cause immediate cardiac and respiratory arrest. If an unconscious victim has no pulse, treat it as a cardiac arrest. Start CPR right away to provide circulation and oxygen delivery; chest compressions plus rescue breaths per protocol are essential. Apply an AED as soon as it’s available and follow its prompts. Continue resuscitation per protocol and monitor for return of spontaneous circulation. Do not wait to see if the person is breathing before starting CPR, because the absence of a pulse means there is no effective circulation and delays cost lives. Providing only oxygen or delaying chest compressions isn’t appropriate for a cardiac arrest, and transporting without continuing resuscitation deprives the person of ongoing life-saving care.