A 45 year old male playing tennis is struck by lightning and witnessed by bystanders.  He is thrown several feet.  He appears to be in cardiac arrest and CPR is started.  After 5 minutes EMS arrives.  His initial rhythm is asystole.  His pupils are fixed and dilated.  What is the next step in management?


B. Defibrillation

C. Lidocaine

D.Stop resusitation

E. Continue CPR


Answer – Continue with CPR.  The patient has transient paralysis of autonomic dysfunction.  The patient should be continued to be treated with ACLS algorithms.  Patient such as this can benefit from prolonged resuscitation.