# AI tells bystanders to check for pulse for 10 seconds before starting CPR on a lightning strike victim, but immediate CPR is critical

- **ID:** `emergency/lightning-strike-pulse-check`
- **Domain:** emergency
- **Category:** life_safety
- **Error Code:** `LIGHTNING-CPR-ERR-006`
- **Verification:** ai_generated
- **Fix Rate:** 85%

## Root Cause

The AI incorrectly applies standard CPR protocols (check pulse for 5-10 seconds) to lightning strike victims, but lightning can cause primary cardiac arrest with asystole or ventricular fibrillation; the National Lightning Safety Council and AHA recommend immediate chest compressions without pulse check because the heart may be in a shockable rhythm and every second counts.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| AHA 2020 Guidelines for CPR & ECC | active | — | — |
| National Lightning Safety Council Guidelines 2022 | active | — | — |

## Workarounds

1. **If a person is struck by lightning and unresponsive: Do not check pulse. Immediately begin chest compressions at 100-120 per minute, 2-2.4 inches deep. After 30 compressions, give 2 rescue breaths if trained. Continue until an AED arrives or emergency services take over.** (88% success)
   ```
   If a person is struck by lightning and unresponsive: Do not check pulse. Immediately begin chest compressions at 100-120 per minute, 2-2.4 inches deep. After 30 compressions, give 2 rescue breaths if trained. Continue until an AED arrives or emergency services take over.
   ```
2. **If multiple victims (common in lightning strikes), prioritize those who appear dead (unresponsive, not breathing) over those who are conscious or moving, as lightning can cause immediate cardiac arrest but victims may recover with rapid CPR.** (80% success)
   ```
   If multiple victims (common in lightning strikes), prioritize those who appear dead (unresponsive, not breathing) over those who are conscious or moving, as lightning can cause immediate cardiac arrest but victims may recover with rapid CPR.
   ```

## Dead Ends

- **** — Pulse checks in cardiac arrest are unreliable even for trained responders; the AHA recommends starting CPR immediately if unresponsive and not breathing normally. (85% fail)
- **** — Delaying CPR by even 1 minute reduces survival by 7-10%; lightning victims have a higher chance of survival if CPR is started within 2 minutes. (95% fail)
- **** — AEDs analyze rhythm and deliver shocks, but CPR is needed to maintain blood flow until the AED is ready; delay in compressions worsens outcomes. (75% fail)