For the non direct hits, obviously the voltage is much reduced and the chances of survival are far better although this is the scenario through which you wind up with the mass casualty scenario that Melclin seems to have such a problem with.
I think you got the wrong idea about my thoughts, although I read my post back and it does come across a bit stronger than I meant it.
Can you point me to a case where a person has produced carbonaceous sputum after a lightning strike? Your inclusion of that in your scenario is yet another example of how little you understand about keraunopathology. Carbonaceous sputum is a sign of the inhalation of the solid products of combustion and not internal burns or any of the other myths you may believe and repeat about lightning. Actually you might be well served to read up on the mechanisms of inhalation injury while you are at it. I'll forward you a couple of review articles if you're interested.
Haha. Yeah my bad, I was just thinking oh airway burns and knocked out a symptom, ignoring the actual cause, quickly looking for a pt who would otherwise die without intervention for the purposes of the scenario. "Carbonaceous sputum is a sign of ...etc" - I realise that, and that it was a stupid example, but a thread is a conversation, not a peer reviewed journal - people trip over their thoughts. Silly mistake.
Do you understand no why "reverse triage" is recommended?
No I didn't. I don't know anything about it, I'd never heard of it until this thread. I wasn't making any other assertions other than that it seemed like a bad idea, followed by why I it seemed that way - the intention being that someone would say yay or nay to my idea and explain why. I'm not sure why you replied like a lecturer arguing that my essay was poorly referenced.
Pain is a secondary concern and the "about to lose their airway" scenario is very uncommon in lightning pathology.
The pain pts existed to flesh out the multicasualty scenario. I don't expect people to treat them first, obviously. I was not aware of the incidence of airway burns in lightning pathology, but it was a (now obviously) flawed attempt to suggest a situation in which you would be effectively killing someone by treating the cardiac arrest victim.
The vast majority of mass casualties cases- rare as they are (hence why it's "expert opinion" guiding care, like so many other things in EMS including general cardiac arrest resuscitation itself for the most part)- have two distinct groups: Walking wounded and the apparently dead. The "dead" are simply the red tags in this scenario and the walking wounded like any other triage situation have to wait.
But yet, I suppose we are supposed to broadly apply the rationalizations of a paramedic student over those of MDs and other health professionals who have looked at the survival rates of persons suffering cardiac arrest after lightning strike and found them to be very high and the mortality of those who initially survive to be complaining of pain, etc to be very low?
Of course not, and the sarcasm, as stupid as my original suggested scenario may have been, is not appreciated.
Actually I only know of one case where someone "talked and died" after a lightning strike and that person died of a closed head injury (including a skull fracture) after falling off a roof secondary to being struck.
Please do not spout off things that are going to hinder the delivery of appropriate and timely medical care to the only critical patients on the scene of a lightning strike.
If you only realized how much of what we do in EMS has far less science underpinning it than what you're badmouthing here, you'd probably be quite surprised.
How does my comment hinder the delivery of care to pt? As I said earlier I think you may have misunderstood my tone (but this may have been my fault), you talk as if I was asserting that I was coming from a position of authority on the matter. I think if I had put a big question mark at the end of my post it would have been clearer.
