Sepsis triage — DipIMC MCQ

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At a temporary shelter, a 70-year-old with fever is confused, respiratory rate 32 and radial pulse weak. Several minor injuries are waiting. What is the triage category?

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Correct answer: D — P1 / immediate

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D

B is correct: Sepsis with altered mental status and shock physiology is an immediate threat requiring urgent evacuation. A is less suitable because the patient has clinically significant illness or injury; C is less suitable because the stem does not describe persistent apnoea or injuries incompatible with life; D is less suitable because P3 is for delayed casualties, usually walking or physiologically stable; E is less suitable because P2 is urgent but not the best category for the physiology described. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK; NICE guidance where applicable