At a multiple casualty incident, people were struck by lightning. Which patient is the highest priority for treatment?

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In a mass casualty incident, triage focuses on finding patients who have life-threatening conditions that can deteriorate quickly and who will benefit most from immediate care. A patient who cannot move his extremities raises immediate concern for a serious neurologic or spinal injury, which in turn can compromise breathing or circulation or progress rapidly if not stabilized right away. Even if he is awake and currently responsive, the potential for rapid deterioration makes him the top priority for rapid assessment and intervention, including airway protection, spinal precautions, and quick evaluation of breathing and circulation. The other patients described are ambulatory or have only minor injuries, indicating a lower immediate threat. So the one unable to move his extremities is treated first because of the high risk of life-threatening progression without prompt care.