Following a multi-vehicle collision, four clients arrive simultaneously in the emergency department during a mass casualty event with limited staff and resources. Using disaster triage principles, which client should be treated first?
- AA client found in cardiac arrest with no pulse and no respirations
- BA client with a superficial laceration that has stopped bleeding and is alert
- CA client with a closed forearm fracture and stable vital signs
- DA client with stridor, labored breathing, and an oxygen saturation of 84%
Show answer & explanationAnswer & explanation
Correct answer: D. A client with stridor, labored breathing, and an oxygen saturation of 84%
In disaster/mass casualty triage, clients who are salvageable with immediate intervention (airway compromise with stridor and hypoxia) are classified as 'immediate' (red) and treated first. A client in cardiac arrest with no pulse is typically classified as 'expectant' (black) in a mass casualty situation due to the high resource demand and low survival likelihood, unlike standard single-client care where CPR would be the priority.
Why the other options are wrong
- A. In mass casualty triage, cardiac arrest is classified as expectant given limited resources, differing from standard prioritization.
- B. A controlled superficial laceration is classified as 'minor' (green) and treated last.
- C. A stable fracture is classified as 'delayed' (yellow) and can safely wait.
Disaster/Mass Casualty Triage
In mass casualty events, triage prioritizes salvageable clients needing immediate intervention over those in cardiac arrest, reversing normal single-client ABC prioritization due to limited resources.
- Red = immediate, salvageable with rapid intervention
- Yellow = delayed, stable but needing care
- Green = minor, walking wounded
- Black = expectant, unlikely to survive given resource constraints (includes cardiac arrest in mass casualty)
Memory trick: In disasters, save the savable, not the unsalvageable.