What should a nurse do first after observing a patient struck by lightning?

After observing a patient struck by lightning, the priority action for the nurse is to check breathing and circulation. This approach aligns with the principles of trauma assessment and resuscitation, as maintaining an open airway, ensuring adequate breathing, and assessing circulation are critical life-saving measures.

Patients struck by lightning can experience a variety of severe effects, including cardiac arrest, respiratory failure, or neurological impairment. Immediate evaluation of the patient's vital signs, particularly assessing if the patient is breathing and has a pulse, is essential to determine if cardiopulmonary resuscitation (CPR) is necessary.

Once breathing and circulation are confirmed or addressed, further assessments, such as checking for entrance and exit wounds and assessing for other injuries, can be performed. However, these are secondary to the immediate need for airway management and circulation support.

Moving the patient indoors or getting them up off the ground may also seem important, but these actions could delay critical assessment and interventions needed to support the patient's life. Safety is crucial, but the focus must first be on stabilizing the patient's physiological status.