NREMT Paramedic Cognitive ExamOperationsHard
A paramedic is responding to a mass casualty incident (MCI) where multiple patients have crush injuries after a building collapse. During triage using the START method, a patient is found to have absent radial pulses, respirations of 28/min, and is unable to follow commands. What triage category should this patient be assigned?
- ADeceased (Black)
- BImmediate (Red)
- CDelayed (Yellow)
- DMinor (Green)
Show answer & explanationAnswer & explanation
Correct answer: B. Immediate (Red)
According to the START triage method, a patient with absent radial pulses (indicating poor perfusion) is immediately categorized as 'Immediate' (Red), regardless of other findings, as this signifies critical shock. The other findings (respirations 28/min, unable to follow commands) would also independently place the patient in the 'Immediate' category.
Why the other options are wrong
- A. Deceased (Black) patients are those who are apneic after repositioning the airway.
- C. Delayed (Yellow) patients are those who can walk, have normal respirations, and have peripheral pulses, but cannot follow commands.
- D. Minor (Green) patients are ambulatory and have minor injuries.
START Triage (Perfusion)
A component of the START triage method that assesses circulatory status by checking for the presence or absence of a radial pulse.
- Radial pulse present = perfusion likely adequate.
- Radial pulse absent = hypoperfusion/shock, triage as Immediate (Red).
- This is a rapid assessment to identify life-threatening circulatory compromise.
Memory trick: RPM: Respiration, Perfusion, Mental Status.