During a lightning storm, you find an unresponsive 33-year-old female with a weak carotid pulse and a fern-like burn pattern. What is your suspicion?

The presence of a fern-like burn pattern on the skin is a classic indicator of a lightning strike. These burns, also known as Lichtenberg figures, are caused by the electrical discharge of the lightning that travels across the surface of the skin. This pattern forms as the high voltage from the lightning creates a path of ionization in the moisture on the skin, which then results in a distinctive branching burn pattern.

In this scenario, the patient is unresponsive and has a weak carotid pulse, which suggests severe compromise of the cardiovascular system potentially as a result of the electrical shock from the lightning. Lightning strikes can cause not only cardiac arrest but also respiratory arrest due to the significant electrical current passing through the body.

Other options, such as being thrown by a pressure wave or struck by flying debris, would not typically result in this type of burn pattern. Exposure to ozone could lead to a different set of health issues, but it wouldn't produce the distinctive signs associated with being struck by lightning. Therefore, the suspicion of being struck by lightning is strongly supported by the observed fern-like burn pattern in conjunction with the patient's unresponsiveness and compromised vital signs.