{
  "id": "emergency/lightning-strike-cpr-pulse-check",
  "signature": "AI tells bystanders to check for pulse for 10 seconds before starting CPR on a lightning strike victim, but immediate CPR is required because they may be in cardiac arrest with no pulse",
  "signature_zh": "AI告诉旁观者在雷击受害者开始CPR前检查脉搏10秒，但需要立即CPR，因为他们可能心脏骤停无脉搏",
  "regex": "lightning.*cpr.*pulse.check|lightning.*check.pulse|lightning.*rescue.breathing",
  "domain": "emergency",
  "category": "life_safety",
  "subcategory": null,
  "root_cause": "The AI applies standard CPR sequence (check pulse first) to lightning strike victims, but lightning-induced cardiac arrest often results from simultaneous respiratory and cardiac arrest; delayed CPR reduces survival",
  "root_cause_type": "generic",
  "root_cause_zh": "AI将标准CPR流程（先检查脉搏）应用于雷击受害者，但雷击引起的心脏骤停常由同时的呼吸和心脏骤停导致；延迟CPR会降低生存率",
  "versions": [
    {
      "version": "AHA CPR & ECC Guidelines 2020",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Wilderness Medical Society 2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "CDC Lightning Safety 2024",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Lightning strike often causes asystole or VF; any delay in compressions reduces chance of ROSC. The victim may have a pulse initially but lose it rapidly. Immediate CPR is recommended",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Lightning can cause prolonged respiratory arrest even if pulse is present initially; without rescue breathing, hypoxic cardiac arrest follows. Delayed intervention worsens outcome",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Burns are secondary; cardiac arrest is the immediate life threat. Treat life threats first, then burns",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Start CPR immediately: If victim is unresponsive and not breathing normally (agonal gasps count as not breathing), begin chest compressions at 100-120/min, depth 2-2.4 inches. Do not delay to check pulse for more than 5 seconds. After 30 compressions, give 2 rescue breaths. Continue cycles. Example: 'Victim down, unresponsive, not breathing. Start compressions immediately: push hard and fast at 110/min. No pulse check delay.'",
      "success_rate": 0.92,
      "how": "Start CPR immediately: If victim is unresponsive and not breathing normally (agonal gasps count as not breathing), begin chest compressions at 100-120/min, depth 2-2.4 inches. Do not delay to check pulse for more than 5 seconds. After 30 compressions, give 2 rescue breaths. Continue cycles. Example: 'Victim down, unresponsive, not breathing. Start compressions immediately: push hard and fast at 110/min. No pulse check delay.'",
      "condition": "",
      "sources": []
    },
    {
      "action": "If victim has a pulse but is not breathing (respiratory arrest only): give rescue breathing at 1 breath every 5-6 seconds (10-12 breaths/min). Recheck pulse every 2 minutes. If pulse disappears, start CPR.",
      "success_rate": 0.85,
      "how": "If victim has a pulse but is not breathing (respiratory arrest only): give rescue breathing at 1 breath every 5-6 seconds (10-12 breaths/min). Recheck pulse every 2 minutes. If pulse disappears, start CPR.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use an AED as soon as available. Lightning strikes can cause VF; defibrillation is effective. Apply pads, follow prompts. Ensure victim is not lying in water or on metal.",
      "success_rate": 0.88,
      "how": "Use an AED as soon as available. Lightning strikes can cause VF; defibrillation is effective. Apply pads, follow prompts. Ensure victim is not lying in water or on metal.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "立即开始CPR：如果受害者无反应且呼吸不正常（濒死喘息算作无呼吸），开始胸外按压，频率100-120次/分钟，深度2-2.4英寸。不要延迟检查脉搏超过5秒。30次按压后，给予2次人工呼吸。继续循环。示例：'受害者倒地，无反应，无呼吸。立即开始按压：以110次/分钟快速用力按压。无脉搏检查延迟。'",
    "如果受害者有脉搏但不呼吸（仅呼吸停止）：给予人工呼吸，每5-6秒一次（10-12次/分钟）。每2分钟重新检查脉搏。如果脉搏消失，开始CPR。",
    "尽快使用AED。雷击可导致室颤；除颤有效。贴电极片，遵循提示。确保受害者不在水中或金属上。"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.cdc.gov/disasters/lightning/medical.html",
  "official_doc_section": null,
  "error_code": "LIGHTNING-ERR-007",
  "verification_tier": "ai_generated",
  "confidence": 0.85,
  "fix_success_rate": 0.9,
  "resolvable": "true",
  "first_seen": "2024-07-30",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}