Injuries and wounds: lightning triage: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Forensic Medicine · Injuries and wounds: lightning triage

Sample item

Lightning strikes a group of five hikers. Two are conscious with minor burns, one is confused, and two have no pulse and are not breathing. A single rescuer reaches the scene. Whom should the rescuer attend to first?

AThe confused hiker with a head injuryBThe two with no pulse or breathingCThe two conscious hikers with burnsDWhichever has the widest area of burns

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. The two with no pulse or breathing

In mass lightning strikes the usual triage is reversed. Apparently dead victims are in cardiac or respiratory arrest, which is often reversible with early resuscitation, whereas those who are conscious already have a good prognosis. Delay in the arrested victims leads to hypoxic death.

Option by option

A. The confused hiker with a head injury
Confusion is common after a strike and is not the most immediately life-threatening problem here.
B. The two with no pulse or breathing (correct)
Correct. Arrested victims have the best chance of benefit from immediate CPR.
C. The two conscious hikers with burns
Conscious victims with burns can wait, as they are likely to survive without immediate intervention.
D. Whichever has the widest area of burns
The area of skin burn is not the main determinant of survival in lightning injury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, The two with no pulse or breathing. In mass lightning strikes the usual triage is reversed.

Why is "The confused hiker with a head injury" not the answer?

Confusion is common after a strike and is not the most immediately life-threatening problem here.

Why is "The two conscious hikers with burns" not the answer?

Conscious victims with burns can wait, as they are likely to survive without immediate intervention.

Why is "Whichever has the widest area of burns" not the answer?

The area of skin burn is not the main determinant of survival in lightning injury.

What concept does this question test?

It tests Injuries and wounds: lightning triage in Forensic Medicine. Apparently dead victims are in cardiac or respiratory arrest, which is often reversible with early resuscitation, whereas those who are conscious already have a good prognosis. Delay in the arrested victims leads to hypoxic death.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries and wounds: lightning triage?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.