Question:
During a mass casualty incident following a building collapse, a patient is brought in with moribund appearance, multiple fractures, tear in the lower abdomen, depressed skull fracture, and is pulseless. What tag is given to this patient during triage?
During a mass casualty incident following a building collapse, a patient is brought in with moribund appearance, multiple fractures, tear in the lower abdomen, depressed skull fracture, and is pulseless. What tag is given to this patient during triage?
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In mass casualty triage, full CPR is generally NEVER performed. Pulseless or apneic patients (who remain apneic after simple airway opening) are tagged Black immediately to conserve resources for those who can be saved.
Updated On: Sep 3, 2026
- Black
- Red
- Yellow
- Green
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The Correct Option is A
Solution and Explanation
Concept:
The question tests the clinician's knowledge of disaster management triage protocols (such as the START system) applied strictly during a mass casualty incident (MCI) to efficiently categorize patients based on survivability and optimal resource allocation.
Explanation:
• In a normal emergency setting, a pulseless patient receives immediate maximal resuscitative efforts. However, in a mass casualty setting, medical resources and personnel are severely overwhelmed by the sheer number of victims. The utilitarian ethical goal abruptly shifts to "doing the greatest good for the greatest number of people."
• Green tag (Minimal): The "walking wounded." These are victims with minor injuries that can safely wait for hours for medical attention.
• Yellow tag (Delayed): Patients with severe but non-life-threatening injuries. They require care but can tolerate a delay without immediate risk to life or limb.
• Red tag (Immediate): Patients with strictly life-threatening injuries that are readily correctable with rapid, straightforward intervention (e.g., tension pneumothorax, massive external hemorrhage). They receive first priority.
• Black tag (Expectant/Deceased): Victims who are either already dead or possess catastrophic, overwhelming injuries that are deemed unsurvivable even with maximal medical care (e.g., massive head trauma with exposed brain matter, pulseless/apneic patients who do not respond to simple airway repositioning).
• The patient described is moribund, has massive multisystem trauma (a depressed skull fracture, severe open abdominal trauma), and crucially, is completely pulseless. Attempting CPR on this patient in a mass casualty scenario would deplete massive amounts of time and resources needed to save multiple salvageable (Red tag) patients.
Final Answer:
Given the catastrophic, incompatible-with-life injuries and the total absence of a pulse, this patient is categorized as expectant and tagged Black.
The question tests the clinician's knowledge of disaster management triage protocols (such as the START system) applied strictly during a mass casualty incident (MCI) to efficiently categorize patients based on survivability and optimal resource allocation.
Explanation:
• In a normal emergency setting, a pulseless patient receives immediate maximal resuscitative efforts. However, in a mass casualty setting, medical resources and personnel are severely overwhelmed by the sheer number of victims. The utilitarian ethical goal abruptly shifts to "doing the greatest good for the greatest number of people."
• Green tag (Minimal): The "walking wounded." These are victims with minor injuries that can safely wait for hours for medical attention.
• Yellow tag (Delayed): Patients with severe but non-life-threatening injuries. They require care but can tolerate a delay without immediate risk to life or limb.
• Red tag (Immediate): Patients with strictly life-threatening injuries that are readily correctable with rapid, straightforward intervention (e.g., tension pneumothorax, massive external hemorrhage). They receive first priority.
• Black tag (Expectant/Deceased): Victims who are either already dead or possess catastrophic, overwhelming injuries that are deemed unsurvivable even with maximal medical care (e.g., massive head trauma with exposed brain matter, pulseless/apneic patients who do not respond to simple airway repositioning).
• The patient described is moribund, has massive multisystem trauma (a depressed skull fracture, severe open abdominal trauma), and crucially, is completely pulseless. Attempting CPR on this patient in a mass casualty scenario would deplete massive amounts of time and resources needed to save multiple salvageable (Red tag) patients.
Final Answer:
Given the catastrophic, incompatible-with-life injuries and the total absence of a pulse, this patient is categorized as expectant and tagged Black.
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