10 free Paramedic practice questions: Multiple Casualty Incidents, Triage, and Incident Command

Load the immediate patient into the ambulance: Loading feels right because immediate patients get first crack at the ambulance once resources exist, but three occupants are still unassessed, and one of them could outrank the tagged patient in severity. Loading is a transport decision that only makes sense after the full sort is done.

Transport the immediate patient to the hospital: Transporting the worst-looking patient is the instinct that triage discipline exists to override; with three occupants still unassessed and only one crew on scene, leaving now abandons patients nobody has laid eyes on yet, and that decision has to wait until the sort is complete.

Begin treating the immediate patient's breathing: Severe difficulty breathing looks like an obvious call to intervene now, and airway and hemorrhage control are the only interventions initial triage allows mid-sort, but this patient is already tagged immediate and stable enough to wait the short time it takes to finish sorting the three remaining occupants, one of whom may need that same intervention sooner.

Begin treating the two patients with severe respiratory distress while waiting for rescue crews: Treating the two patients with respiratory distress while waiting for rescue crews leaves the resource request undone, delaying additional ambulances and mutual aid that every patient on this scene needs.

Focus all efforts on extricating the two trapped patients from the building: Focusing all efforts on extrication without first requesting resources means the crew works alone on a scene that clearly exceeds what one unit can handle.

Triage all eight patients before any treatment or rescue efforts begin: Triaging all eight patients before requesting resources delays getting rescue teams, additional ambulances, and mutual aid moving: the request should go out based on the scene size-up, not wait for triage to finish.

Green (minor injuries): Green tags the ambulatory walking wounded, patients who can get up and move to a treatment area on their own. This patient cannot walk because of crush injuries to both lower extremities, failing the very first START check before respirations or mental status even get assessed.

Yellow (delayed): Yellow fits a non-ambulatory patient with respirations under 30, a present regular radial pulse, and adequate perfusion, exactly what the rate of 22, pulse of 88, and warm dry skin suggest, but the last START check is mental status, and this patient can't state their name or the date, which overrides those normal findings and moves them to Red.

Black (expectant): Black is reserved for patients with no signs of life, apneic even after an airway reposition, or injuries clearly incompatible with survival. This patient is breathing at 22 per minute with a strong, regular pulse, showing clear signs of life that rule out expectant triage.

Red: all burn injuries require immediate assessment and transport: Some burns do warrant Red, large surface area, airway involvement, or circumferential injury with signs of poor perfusion, but that call still comes from the START sequence, not from the presence of a burn alone; this patient's superficial arm burn and independent gait never reach that threshold.

Yellow: all burn patients must be triaged as Yellow until vitals confirm stability: Yellow fits a patient who cannot walk but shows intact respirations, a palpable radial pulse, and a normal mental status on the START checks; this patient already passed the ambulation step by walking to you, so holding them at Yellow skips ahead of a test that has already been answered.

Black: any patient with a burn injury is classified as nonviable: Black is reserved for patients who are apneic after you reposition the airway, not simply anyone with a burn; a patient who is walking, talking, and reporting their own status is clearly viable.

Begin treatment of the most critically injured patient while waiting for additional units: Starting treatment on the most critical patient is right once the scene is safe and triage has sorted the patients. Traffic is still moving at highway speeds and no triage has happened, so you don't know who is actually most critical among the four. Treating one patient first skips scene safety and triage.

Wait for fire department to arrive before treating any patients: Waiting for fire department can be appropriate when extrication is needed, but nothing here calls for that, and the moving highway traffic demands you request units and start triage immediately, not wait idle.

Transport the first patient immediately to reduce the number of patients at the scene: Transporting the first patient immediately looks efficient for clearing the scene, but it abandons the other three untreated and skips the triage and safety steps that must happen before any transport decision.

Enter the tank with a rope and harness to retrieve the patient quickly: A rope and harness is confined-space gear, making a quick pull-out look like the fix for someone who can't climb out. Yet the patient's inability to climb after 15 minutes points to an oxygen-deficient or toxic atmosphere that drops an unprotected rescuer in seconds. That gear only works with air monitoring, supplied air, and a trained team, not solo entry.

Have a site supervisor enter the tank first to assess the environment before you proceed: A site supervisor knows the tank's contents and shutoff points, which makes them useful for information, not entry. Sending anyone without confined-space training and air monitoring into the same atmosphere that has already trapped this patient only creates a second victim for the rescue team to recover.

Lower a ladder into the tank and direct the patient to climb out while monitoring from above: Lowering a ladder and coaching the patient up fits a shallow space with known-safe air and a patient who can move on their own. Here the patient is unable to climb out, which points to a toxic or oxygen-poor atmosphere; pushing exertion in that air speeds collapse, and leaning over the opening puts you at the hazard's edge unmonitored.

Enter the house to assess the full scene and determine if other patients require assistance: This fits a scene size-up that includes checking for additional patients once the scene is safe. The shouting and breaking glass mean the house is an active hazard, not secured, so entering now puts you inside an unfolding assault with no protection. Confirming other patients is a task police handle once the scene is secured.

Quickly assess and transport the patient to the hospital before the situation inside escalates further: This is the right move once a scene is confirmed safe, load and go rather than linger near a hazard. Here the danger is coming from inside the house, not from the patient, so speeding through patient contact does nothing to remove the threat behind you. You still need police on scene before you're close enough to load anyone.

Provide full assessment and treatment from inside the ambulance while monitoring the house until police arrive: This looks safe because staying in the ambulance keeps you off the lawn while you wait, but full assessment and treatment is still patient care, and nothing here has confirmed the scene is safe yet. Staging means notifying dispatch and requesting police first, not treating from the cab yards from a disturbance you haven't reported.

To the ambulance, where a running count can be kept: The ambulance looks like the obvious rally point and an easy place to keep a running count, but it is parked in the only clear driveway here, so pulling 20 patients toward it blocks the vehicle and the access route the incoming units need in 8 minutes.

To the treatment area once it has been established: This assumes a treatment area already exists, but no other EMS personnel are on scene yet to establish one, so this answers a later stage of the incident rather than the first move the paramedic has to make right now.

To the nearest exit from the collapsed floor section: Holding patients at the exit from the collapsed floor section blocks the same passage that arriving crews and any remaining ambulatory patients need to use, turning a route into a crowded holding point instead of a clear gathering location.

Triage the patients where they stand and tag them for later: Triage feels like the first thing that happens to any patient found at a mass-casualty incident. Triaging patients who are still wet with the chemical exposes the paramedic, contaminates the tag, and defeats the zone control the hazmat team has already set up.

Triage the patients as minimal and send them for transport: Walking out of the plant makes these patients look like the walking wounded, so the minimal category seems automatic. Ambulatory status does not clear a patient for the transportation area, and moving contaminated patients toward the ambulances spreads the contamination into a clean area.

Walk the patients into the treatment area and triage them: This gets patients to care quickly, which is the right instinct on an ordinary call. It carries the chemical into the treatment area, and patients are decontaminated before they are taken to a treatment area, not after.

Tag the patient immediate and move to the next patient: A pulse is present, so the patient is alive and obviously critical, and immediate looks like the safe tag. In JumpSTART the immediate tag belongs to the child who starts breathing after the rescue breaths; the child who does not is expectant.

Give five more rescue breaths and reassess for breathing: Repeating the trial follows the reasoning behind the rescue-breath step and feels safer than stopping. The algorithm allows one trial of five breaths, and repeating it holds primary triage on a single patient while the rest of the scene goes unsorted.

Begin chest compressions and ventilations: Compressions treat cardiac arrest, and a distal pulse is palpable in this patient. Starting a full resuscitation during primary triage also commits the paramedic to one patient while every other patient waits to be assessed.