Mass casualty triage US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Mass casualty triage. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Mass casualty triage US Medical PG Question 1: A 28-year-old research assistant is brought to the emergency department for severe chemical burns 30 minutes after accidentally spilling hydrochloric acid on himself. The burns cover both hands and forearms. His temperature is 37°C (98.6°F), pulse is 112/min, respirations are 20/min, and blood pressure is 108/82 mm Hg. Initial stabilization and resuscitation is begun, including respiratory support, fluid resuscitation, and cardiovascular stabilization. The burned skin is irrigated with saline water to remove the chemical agent. Which of the following is the most appropriate method to verify adequate fluid infusion in this patient?
- A. The Parkland formula
- B. Blood pressure
- C. Pulmonary capillary wedge pressure
- D. Heart rate
- E. Urinary output (Correct Answer)
Mass casualty triage Explanation: ***Urinary output***
- Maintaining a specific **urinary output** (e.g., adult with major burns: 0.5-1.0 mL/kg/hr or 30-50 mL/hr) is the most reliable clinical indicator of adequate fluid resuscitation in burn patients.
- This ensures sufficient end-organ perfusion and avoids both under-resuscitation (leading to shock and organ damage) and over-resuscitation (risk of compartment syndrome and pulmonary edema).
*The Parkland formula*
- The **Parkland formula** is used to *calculate* the initial fluid volume needed, but it does not *verify* the adequacy of the infusion once started.
- This formula provides a starting point for fluid administration, which then needs to be adjusted based on the patient's response.
*Blood pressure*
- **Blood pressure** can be misleading in burn patients; it may remain deceptively normal due to compensatory mechanisms even with significant fluid deficits.
- It is a late indicator of hypovolemic shock, and relying solely on it can lead to under-resuscitation.
*Pulmonary capillary wedge pressure*
- **Pulmonary capillary wedge pressure (PCWP)** requires invasive monitoring via a pulmonary artery catheter, which is rarely indicated for routine fluid management in burn patients due to its invasiveness and associated risks.
- Less invasive and equally effective methods, like urinary output, are preferred for monitoring resuscitation.
*Heart rate*
- **Heart rate** is a sensitive but non-specific indicator of fluid status; it can be elevated due to pain, anxiety, or infection, not solely hypovolemia.
- While a decreasing heart rate can indicate improved fluid status, it is not as reliable or direct an indicator of end-organ perfusion as urinary output.
Mass casualty triage US Medical PG Question 2: A 25-year-old man is brought to the emergency department 3 hours after rescuing babies and puppies from a burning daycare center. He complains of headache and nausea, which he attributes to running. He is breathing comfortably. What is another likely finding in this patient?
- A. Oxygen saturation of 86% on pulse oximetry
- B. Low blood lactate levels
- C. Arterial oxygen partial pressure of 20 mmHg
- D. Oxygen saturation of 99% on pulse oximetry
- E. Cherry red facial appearance (Correct Answer)
Mass casualty triage Explanation: ***Cherry red facial appearance***
- The patient's presentation after being in a burning building strongly suggests **carbon monoxide (CO) poisoning**. CO binds to hemoglobin with higher affinity than oxygen, forming **carboxyhemoglobin**, which gives the skin and mucous membranes a characteristic **cherry-red (plethoric) appearance**, though this is often only seen in severe cases or post-mortem.
- Other symptoms like **headache and nausea** are classic for CO poisoning, often mistaken for other mild ailments or exertion.
*Oxygen saturation of 86% on pulse oximetry*
- While a low oxygen saturation is concerning, **pulse oximetry readings are unreliable in carbon monoxide poisoning** because standard pulse oximeters cannot differentiate between oxyhemoglobin and carboxyhemoglobin.
- A patient with significant CO poisoning can have a high pulse oximetry reading even with severe hypoxemia at the tissue level, making this an unlikely and misleading finding.
*Low blood lactate levels*
- **Carbon monoxide poisoning** leads to **tissue hypoxia**, which switches cellular metabolism from aerobic to anaerobic glycolysis.
- This results in the overproduction of **lactate**, leading to **elevated blood lactate levels**, not low levels.
*Arterial oxygen partial pressure of 20 mmHg*
- A **PaO2 of 20 mmHg** is severely low and would indicate extreme hypoxemia, which would likely present with significant respiratory distress or altered mental status, and a pulse oximetry reading would be reflective of this severe hypoxemia.
- In **carbon monoxide poisoning**, the PaO2 is typically normal because oxygen can still dissolve in the plasma, but its transport and offloading are impaired by carboxyhemoglobin.
*Oxygen saturation of 99% on pulse oximetry*
- A pulse oximeter measures the percentage of hemoglobin saturated with oxygen. However, it cannot distinguish between **oxyhemoglobin** and **carboxyhemoglobin**.
- Therefore, in CO poisoning, pulse oximetry may give a **falsely high or normal reading (e.g., 99%)**, even when the patient is severely hypoxic due to CO.
Mass casualty triage US Medical PG Question 3: A 52-year-old obese man is brought to the emergency department 30 minutes after he was involved in a high-speed motor vehicle collision. He was the unrestrained driver. On arrival, he is lethargic. His pulse is 112/min, respirations are 10/min and irregular, and blood pressure is 94/60 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 91%. The pupils are equal and react sluggishly to light. He withdraws his extremities to pain. There are multiple bruises over his face, chest, and abdomen. Breath sounds are decreased over the left lung base. Two large bore peripheral venous catheters are inserted and 0.9% saline infusion is begun. Rapid sequence intubation is initiated and endotracheal intubation is attempted without success. Bag and mask ventilation is continued. Pulse oximetry shows an oxygen saturation of 84%. The patient has no advance directive and family members have not arrived. Which of the following is the most appropriate next step in the management of this patient?
- A. Nasotracheal intubation
- B. Video laryngoscopy
- C. Cricothyrotomy (Correct Answer)
- D. Comfort measures only
- E. Tracheostomy
Mass casualty triage Explanation: ***Cricothyrotomy***
- In a trauma patient with **failed endotracheal intubation** and declining oxygen saturation (from 91% to 84% despite bag-mask ventilation), an emergent cricothyrotomy is indicated for **immediate airway control**.
- This procedure provides a definitive airway in a **can't intubate/can't ventilate** scenario, preventing further hypoxia and potential brain damage.
*Nasotracheal intubation*
- **Nasotracheal intubation** is generally contraindicated in patients with suspected **facial or skull base fractures** due to the risk of intracranial intubation.
- Given the high-speed collision and facial bruises, such fractures are possible, making this a less safe option compared to cricothyrotomy.
*Video laryngoscopy*
- While **video laryngoscopy** can be helpful for difficult airways, it was already implied that intubation was attempted and failed, suggesting the issue might be with visualization or access, not just technique.
- Critically, the patient's oxygen saturation is dropping rapidly, requiring a quicker, more definitive solution than another attempt at orotracheal intubation.
*Comfort measures only*
- The patient has **no advance directive**, and family members have not arrived to make decisions regarding end-of-life care.
- Despite the severity of his injuries, the patient is still alive and does not have clear indications for **comfort measures only** at this stage; resuscitative efforts are warranted.
*Tracheostomy*
- **Tracheostomy** is a surgical procedure for establishing a long-term airway and is not suitable for **emergent airway management** in a rapidly decompensating trauma patient.
- It typically requires specialized surgical expertise and takes longer to perform than a cricothyrotomy, which is a faster, life-saving measure in this acute situation.
Mass casualty triage US Medical PG Question 4: Four days after being hospitalized, intubated, and mechanically ventilated, a 30-year-old man has no cough response during tracheal suctioning. He was involved in a motor vehicle collision and was obtunded on arrival in the emergency department. The ventilator is at a FiO2 of 100%, tidal volume is 920 mL, and positive end-expiratory pressure is 5 cm H2O. He is currently receiving vasopressors. His vital signs are within normal limits. The pupils are dilated and nonreactive to light. Corneal, gag, and oculovestibular reflexes are absent. There is no facial or upper extremity response to painful stimuli; the lower extremities show a triple flexion response to painful stimuli. Serum concentrations of electrolytes, urea, creatinine, and glucose are within the reference range. Arterial blood gas shows:
pH 7.45
pCO2 41 mm Hg
pO2 99 mm Hg
O2 saturation 99%
Two days ago, a CT scan of the head showed a left intracerebral hemorrhage with mass effect. The apnea test is positive. There are no known family members, advanced directives, or individuals with power of attorney. Which of the following is the most appropriate next step in management?
- A. Ethics committee consultation (Correct Answer)
- B. Remove the ventilator
- C. Court order for further management
- D. Repeat CT scan of the head
- E. Cerebral angiography
Mass casualty triage Explanation: ***Ethics committee consultation***
- The patient meets criteria for **brain death**, but there are no family members or advance directives to guide end-of-life decisions. An **ethics committee consultation** is essential to navigate the complex legal and ethical implications of withdrawing life support in such a situation.
- The committee can provide guidance on hospital policies, relevant laws, and ethical principles to ensure a decision that respects the patient's presumed wishes and societal values, especially given the absence of surrogates.
*Remove the ventilator*
- While the patient appears to meet the criteria for **brain death**, premature withdrawal of the ventilator without proper legal and ethical guidance is inappropriate, especially given the lack of identified next of kin or advance directives.
- A formal process, including definitive declaration of brain death by two separate physicians and addressing legal and ethical considerations, must precede such an action.
*Court order for further management*
- A court order might be necessary if there are intractable disagreements among stakeholders or if brain death cannot be definitively declared. However, an **ethics committee consult** is typically the initial step to resolve complex cases lacking surrogate decision-makers before escalating to legal action.
- Seeking a court order is a more extreme measure usually reserved when internal hospital mechanisms and ethical consultations fail to provide a clear path forward.
*Repeat CT scan of the head*
- A repeat CT scan would typically be performed to assess changes in the intracerebral hemorrhage or mass effect if there were signs of ongoing neurological deterioration that might be reversible, or to guide surgical intervention.
- However, in this patient, the clinical picture, including absent brainstem reflexes and a positive apnea test indicating **brain death**, suggests that further imaging for diagnostic purposes related to hemorrhage progression is unlikely to alter the prognosis or management related to end-of-life decisions.
*Cerebral angiography*
- **Cerebral angiography** is used to assess cerebral blood flow and can be a confirmatory test for brain death if clinical examination and apnea testing are inconclusive, especially in cases where sedative medications might confound the clinical picture.
- In this case, the comprehensive clinical examination and positive apnea test strongly suggest brain death, making angiography unnecessary at this stage, particularly without surrogate decision-makers.
Mass casualty triage US Medical PG Question 5: A 3-month-old boy is brought to the emergency department by his mom for breathing difficulty after a recent fall. His parents say that he rolled off of the mattress and landed on the hard wood floor earlier today. After an extensive physical exam, he is found to have many purplish bruises and retinal hemorrhages. A non-contrast head CT scan shows a subdural hemorrhage. He was treated in the hospital with full recovery from his symptoms. Which of the following is the most important follow up plan?
- A. Provide parents with anticipatory guidance
- B. Referral to genetics for further testing
- C. Reassurance that accidents are common
- D. Inform child protective services (Correct Answer)
- E. Provide home nursing visits
Mass casualty triage Explanation: ***Inform child protective services***
- The combination of **multiple purplish bruises**, **retinal hemorrhages**, and **subdural hemorrhage** in a 3-month-old infant after a minor fall (rolling off a mattress) is highly suggestive of **abusive head trauma** (shaken baby syndrome).
- Healthcare professionals have a **legal and ethical obligation** to report suspected child abuse to Child Protective Services (CPS) to ensure the child's safety and initiate an investigation.
*Provide parents with anticipatory guidance*
- While anticipatory guidance on child safety and development is generally important, it is **insufficient and inappropriate** as the primary follow-up in a case of suspected child abuse.
- Focusing solely on guidance would **neglect the immediate safety concerns** and the need for investigation into the injuries.
*Referral to genetics for further testing*
- While some genetic conditions can predispose to easy bruising or bleeding, the specific pattern of injuries (**retinal hemorrhages, subdural hemorrhage, multiple bruises, and a history inconsistent with the severity of injuries**) overwhelmingly points to trauma, not a genetic disorder.
- Genetic testing would be a secondary consideration, if at all, after abuse has been ruled out or addressed.
*Reassurance that accidents are common*
- Reassuring parents that "accidents are common" would be **medically negligent and dangerous** in this scenario, as the injuries sustained are typically not caused by a simple fall from a mattress in an infant of this age.
- This response would dismiss critical signs of potential abuse and leave the child at risk.
*Provide home nursing visits*
- Home nursing visits might be beneficial for monitoring general health and development, but they do **not address the immediate and grave concern** of potential child abuse.
- The primary need is for an investigation into the cause of the injuries and protection for the child, which falls under the purview of CPS.
Mass casualty triage US Medical PG Question 6: A 78-year-old woman is brought to the emergency ward by her son for lethargy and generalized weakness. The patient speaks in short utterances and does not make eye contact with the provider or her son throughout the interview and examination. You elicit that the patient lives with her son and daughter-in-law, and she reports vague weakness for the last couple days. The emergency room provider notices 3-4 healing bruises on the patient's upper extremities; otherwise, examination is not revealing. Routine chemistries and blood counts are unremarkable; non-contrast head CT demonstrates normal age-related changes. Which of the following is the most appropriate next step in management?
- A. Ask the patient's son to leave the room (Correct Answer)
- B. Question the patient's son regarding the home situation
- C. Call Adult Protective Services to report the patient's son
- D. Perform lumbar puncture
- E. Question the patient regarding abuse or neglect
Mass casualty triage Explanation: ***Ask the patient's son to leave the room***
- The patient's **lethargy**, **non-engagement**, and **healing bruises** raise strong suspicions for elder abuse or neglect. Removing the son allows for a private interview, which is crucial for her to feel safe enough to disclose information.
- In situations of suspected abuse, it is paramount to prioritize the **patient's safety and ability to speak freely** without the presence of the suspected abuser.
*Question the patient's son regarding the home situation*
- Questioning the son directly at this point may escalate the situation or make the patient even less likely to disclose abuse, as she is likely **frightened or coerced**.
- This step is premature and should only occur after a private interview with the patient, and potentially with the involvement of Protective Services.
*Call Adult Protective Services to report the patient's son*
- While reporting to **Adult Protective Services** is a critical step if abuse is confirmed, it is not the immediate first action until a private interview with the patient has been conducted to gather more information.
- Making a report without attempting to speak with the patient alone first can hinder the investigation and potentially jeopardize her safety if the abuser is alerted prematurely.
*Perform lumbar puncture*
- A lumbar puncture is an invasive procedure generally performed to diagnose **central nervous system infections** or **inflammatory conditions**.
- There are no clinical indications (e.g., fever, meningeal signs, focal neurological deficits) to suggest a need for a lumbar puncture, especially given the history and physical findings that point towards abuse.
*Question the patient regarding abuse or neglect*
- While it's important to question the patient about abuse, it must be done in a **safe and private environment** where she feels comfortable speaking freely.
- Questioning her while the suspected abuser (her son) is present would likely yield unhelpful responses due to fear or intimidation, as seen by her lack of eye contact and short utterances.
Mass casualty triage US Medical PG Question 7: A mother brings her 6-month-old boy to the emergency department. She reports that her son has been breathing faster than usual for the past 2 days, and she has noted occasional wheezing. She states that prior to the difficulty breathing, she noticed some clear nasal discharge for several days. The infant was born full-term, with no complications, and no significant medical history. His temperature is 100°F (37.8°C), blood pressure is 60/30 mmHg, pulse is 120/min, respirations are 40/min, and oxygen saturation is 95% on room air. Physical exam reveals expiratory wheezing, crackles diffusely, and intercostal retractions. The child is currently playing with toys. Which of the following is the most appropriate next step in management?
- A. Monitoring (Correct Answer)
- B. Intubation
- C. Albuterol
- D. Chest radiograph
- E. Azithromycin and ceftriaxone
Mass casualty triage Explanation: ***Monitoring (Supportive Care)***
- This infant presents with classic **viral bronchiolitis** (tachypnea, wheezing, crackles, retractions following upper respiratory symptoms)
- The child is **clinically stable**: O2 saturation 95% on room air, alert and playing with toys
- **Current AAP guidelines** recommend **supportive care only** for bronchiolitis, which includes monitoring vital signs, assessing work of breathing, ensuring adequate hydration, and oxygen supplementation if saturation drops below 90%
- This patient requires close observation but no immediate intervention given stable vital signs and reassuring clinical appearance
*Albuterol*
- **Bronchodilators are NOT recommended** for routine use in bronchiolitis per current AAP clinical practice guidelines
- Multiple randomized controlled trials have shown **no significant benefit** from albuterol in bronchiolitis
- While a trial may be considered in select cases with strong family history of asthma, routine use is discouraged
- Bronchiolitis is caused by **small airway inflammation and mucus plugging**, not bronchospasm
*Intubation*
- **Intubation** is reserved for severe respiratory failure with impending respiratory arrest, persistent hypoxemia despite high-flow oxygen, apnea, or altered mental status
- This child has adequate oxygenation (95%), is alert, and playing—**no indication for intubation**
- Signs that would warrant intubation include lethargy, severe retractions with fatigue, O2 sat <90% despite supplementation
*Chest radiograph*
- **Not routinely indicated** in typical bronchiolitis
- Consider only if there's diagnostic uncertainty, concern for complications (pneumothorax, lobar consolidation suggesting bacterial pneumonia), or failure to improve with supportive care
- The clinical presentation is clearly consistent with bronchiolitis, and imaging would not change initial management
*Azithromycin and ceftriaxone*
- Bronchiolitis is a **viral infection** (most commonly RSV), and **antibiotics provide no benefit**
- Antibiotics should only be used if there is clear evidence of **bacterial superinfection** (high fever, focal consolidation, elevated inflammatory markers)
- Routine antibiotic use contributes to antimicrobial resistance and adverse effects
Mass casualty triage US Medical PG Question 8: A 28-year-old soldier is brought back to a military treatment facility 45 minutes after sustaining injuries in a building fire from a mortar attack. He was trapped inside the building for around 20 minutes. On arrival, he is confused and appears uncomfortable. He has a Glasgow Coma Score of 13. His pulse is 113/min, respirations are 18/min, and blood pressure is 108/70 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 96%. Examination shows multiple second-degree burns over the chest and bilateral upper extremities and third-degree burns over the face. There are black sediments seen within the nose and mouth. The lungs are clear to auscultation. Cardiac examination shows no abnormalities. The abdomen is soft and nontender. Intravenous fluid resuscitation is begun. Which of the following is the most appropriate next step in management?
- A. Insertion of nasogastric tube and enteral nutrition
- B. Intravenous antibiotic therapy
- C. Intubation and mechanical ventilation (Correct Answer)
- D. Immediate bronchoscopy
- E. Intravenous corticosteroid therapy
Mass casualty triage Explanation: ***Intubation and mechanical ventilation***
- The patient exhibits several signs of impending **airway compromise** due to **inhalation injury**, including perioral burns, black sediments in the nose and mouth, and being trapped in a fire.
- While current oxygen saturation is 96%, **airway edema** can rapidly worsen, leading to respiratory failure. **Early intubation** is crucial to secure the airway before it becomes obstructed.
*Insertion of nasogastric tube and enteral nutrition*
- A nasogastric tube is often placed in burn patients to decompress the stomach and provide nutritional support, but it is **not the immediate priority** when there is a risk of airway obstruction.
- **Enteral nutrition** is important but should be initiated only after airway control is established and the patient is stable for feeding.
*Intravenous antibiotic therapy*
- **Prophylactic antibiotics** are generally **not recommended** in the immediate management of burn patients unless there is clear evidence of infection, which is not present here.
- Unnecessary antibiotic use can lead to **antibiotic resistance** and fungal infections.
*Immediate bronchoscopy*
- While **bronchoscopy** can confirm the extent of inhalation injury, it is not the primary immediate step. **Securing the airway** through intubation takes precedence over diagnostic procedures when airway compromise is imminent.
- Bronchoscopy can be considered *after* intubation to assess the lower airway for damage and guide further management.
*Intravenous corticosteroid therapy*
- **Corticosteroids** are typically **contraindicated** in the management of inhalation injury because they can **impair immune function** and increase the risk of infection in burn patients.
- Evidence does not support the routine use of corticosteroids to reduce inflammation in inhalation injury, and they may worsen outcomes.
Mass casualty triage US Medical PG Question 9: A 35-year-old man is brought to the emergency department 40 minutes after spilling hot oil over himself in a kitchen accident. Examination shows multiple tense blisters over the abdomen, anterior chest, and right upper extremity. On deroofing the blisters, the skin over the right upper extremity is tender, pink, and blanches with pressure. The skin over the abdomen and anterior chest is tender, mottled, and does not blanch with pressure. The left thigh shows erythema only, is tender, and shows quick capillary refill after blanching with pressure. Which of the following most closely approximates the body surface area affected by 2nd-degree burns in this patient?
- A. 45%
- B. 18%
- C. 54%
- D. 9% (Correct Answer)
- E. 36%
Mass casualty triage Explanation: ***9%***
- **2nd-degree (partial-thickness) burns** are characterized by blistering with an intact dermis that remains **painful and blanches with pressure**.
- In this patient, the **right upper extremity** shows tense blisters that, when deroofed, reveal tender, pink skin that **blanches with pressure** - this is consistent with **superficial to mid-partial-thickness (2nd-degree) burns**.
- Using the **Rule of Nines**: the entire upper extremity (arm) = **9%**.
- The abdomen and anterior chest show **mottled, non-blanching skin**, which indicates **full-thickness (3rd-degree) burns**, NOT 2nd-degree.
- The left thigh shows only **erythema with blanching**, consistent with **1st-degree (superficial) burns**.
*18%*
- This would represent two full segments using the Rule of Nines (e.g., both upper extremities or anterior trunk).
- The described 2nd-degree burns affect only the right upper extremity (9%), not two segments.
*36%*
- This would represent the anterior chest (9%) + abdomen (9%) + both upper extremities (18%).
- However, the abdomen and anterior chest show **non-blanching, mottled skin**, indicating **3rd-degree burns**, not 2nd-degree.
*45%*
- This represents approximately half the body surface area.
- Far exceeds the single upper extremity affected by 2nd-degree burns in this patient.
*54%*
- This represents more than half the total body surface area.
- Significantly overestimates the 2nd-degree burn involvement, which is limited to one upper extremity.
Mass casualty triage US Medical PG Question 10: A mass casualty incident occurs with 25 casualties arriving simultaneously at a community hospital emergency department. The trauma team has limited resources with 2 operating rooms available and 4 surgeons present. Among the arriving patients: Patient A has traumatic amputation of forearm with tourniquet in place and stable vitals; Patient B has flail chest, respiratory distress, and unstable vitals; Patient C is in cardiac arrest with penetrating chest wound; Patient D has a femur fracture with stable vitals; Patient E has GCS 4 with bilateral blown pupils. Evaluate the triage priority according to ATLS mass casualty protocols.
- A. Priority order: C, E, B, A, D - treat most severely injured first
- B. Priority order: B, A, D, with E and C designated expectant (Correct Answer)
- C. Priority order: A, D, B, E, C - treat all patients equally regardless of prognosis
- D. Priority order: B, A, E, D, C - based on severity alone
- E. Immediate evacuation of all patients to a higher level trauma center
Mass casualty triage Explanation: ***Priority order: B, A, D, with E and C designated expectant***
- In a **mass casualty incident (MCI)** with limited resources, the goal is to provide the **greatest good for the greatest number**; Patient B has life-threatening but **salvageable** injuries (respiratory distress) making them the top priority.
- Patients C (cardiac arrest) and E (GCS 4, blown pupils) are classified as **expectant (black tag)** because their survival probability is minimal and resuscitating them would exhaust resources needed for salvageable patients.
*Priority order: C, E, B, A, D - treat most severely injured first*
- This approach is used in standard trauma situations where resources are ample, but it is incorrect in an **MCI** where resource-heavy, low-prognosis patients are de-prioritized.
- Assigning highest priority to **cardiac arrest (C)** and **severe brain injury (E)** would likely result in the deaths of more salvageable patients like Patient B.
*Priority order: A, D, B, E, C - treat all patients equally regardless of prognosis*
- Treating all patients equally ignores the **ATLS triage categories** (Immediate, Delayed, Minimal, Expectant) and fails to address life-threatening priorities first.
- While A and D have stable vitals and are **Delayed (Yellow tag)**, waiting to treat Patient B's airway/breathing emergency would lead to a preventable death.
*Priority order: B, A, E, D, C - based on severity alone*
- Severity alone does not dictate priority in an MCI; the **likelihood of survival** with the available resources must be considered.
- Patient E, despite being "severe," has a **devastating neurological prognosis** (blown pupils, GCS 4) and should not be prioritized over stable patients with better outcomes like A and D.
*Immediate evacuation of all patients to a higher level trauma center*
- Evacuation is a secondary step; the primary task according to **ATLS protocols** is to perform triage and stabilization at the current facility during the initial influx.
- Attempting to evacuate all 25 casualties simultaneously without triage would overwhelm transport systems and delay life-saving **initial stabilization** for patients like B.
More Mass casualty triage US Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
