A patient has been in cardiac arrest for seven minutes after being struck by lightning. What is the immediate step you should take?

In a scenario where a patient is in cardiac arrest, the immediate priority is to ensure that high-quality chest compressions are initiated as quickly as possible. In this case, the correct course of action is to start chest compressions, as they are critical for maintaining blood flow to vital organs during cardiac arrest. The concept of ABC (Airway, Breathing, Circulation) is important, but the emphasis in life-threatening situations such as cardiac arrest shifts to CAB (Circulation, Airway, Breathing).

Chest compressions enhance the likelihood of returning spontaneous circulation and can significantly improve chances of survival when performed promptly. In the context of a patient struck by lightning, they may experience a sudden cardiac arrest due to various factors, including trauma or electrical effects on heart rhythm. Therefore, chest compressions should begin without delay to maximize the chances of survival.

Performing rescue breaths or advanced airway management might be considered later, but the primary and urgent action in this situation is to restore circulation through effective chest compressions. Checking ABCs is important in assessing the patient but should occur after initiating compressions, aligning with the shift to CAB in CPR guidelines.