Crisis in Indonesia

This case presents a disaster medical scenario where healthcare professionals respond to injuries following a volcanic eruption and a subsequent lightning strike in Indonesia. The scenario begins with a medical team deployed to a field hospital one week after the volcanic eruptions, only to face a mass casualty incident caused by a lightning strike. The narrative focuses on key elements of mass casualty triage, particularly the unique considerations for lightning injuries, such as reverse triage, where typically nonsurvivable patients may be prioritized for immediate resuscitation. Critical medical management decisions are outlined, including the resuscitation of a pulseless, apneic patient who ultimately regains spontaneous circulation after Advanced Cardiovascular Life Support (ACLS) is applied. The case emphasizes scene safety, reverse triage during lightning events, and teamwork in evacuation procedures. The scenario also highlights the complications of head and neck trauma, rhabdomyolysis, and the need for a higher level of care.