Question

You are on the scene of a church bus roll-over collision. There are 30 passengers involved. As triage officer, which one of the following patients should you assign the highest priority?

A. 35-year-old pregnant woman with a cut on her head, neck pain, and numbness and tingling in her arms
B. Unresponsive 9-year-old male with an open skull fracture who is in cardiac arrest
C. 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side
D. 30-year-old man with multiple lower extremity fractures who is awake, has a strong radial pulse, and is complaining of severe pain

Answer 1

The highest priority should be given to the 70-year-old woman with difficulty breathing and absent lung sounds, indicating a possible life-threatening tension pneumothorax.

Step-by-step explanation:

The patient that should be assigned the highest priority in a triage situation following a church bus roll-over collision is the 70-year-old woman who is awake but having difficulty breathing and has absent lung sounds on the right side. This indicates a possible tension pneumothorax, which is a life-threatening condition that requires immediate intervention to prevent cardiovascular collapse. Such a condition has the potential to be quickly fatal if not addressed promptly.

In triage, the goal is to prioritize patients who have life-threatening conditions that are immediately treatable. The unresponsive 9-year-old with an open skull fracture in cardiac arrest, although also in critical condition, would be classified as deceased in a mass casualty triage situation, as the likelihood of successful resuscitation is low and requires significant resources.

The 35-year-old pregnant woman with a cut on her head and neurological symptoms would be of secondary priority compared to the woman with breathing difficulty. The 30-year-old man, although in severe pain, has a stable circulatory status and is not in immediate life-threatening danger.