Expectant devastating head injury — DipIMC MCQ

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HardMajor Incident ManagementExpectant devastating head injuryDipIMC

A mass shooting overwhelms resources. One adult has devastating head injury, agonal breathing after airway opening and no radial pulse, while several salvageable P1 casualties need haemorrhage control. What is the triage category?

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Correct answer: B — Priority 4 (expectant)

Option B is correct because Expectant triage is reserved for exceptional resource-limited incidents where survival is unlikely despite maximal care. Option A is less appropriate because Priority 1 is reserved for immediate life-saving needs or severe physiological compromise; option C is less appropriate because Priority 2 is for serious injury without immediate life-saving criteria. Option E is less appropriate because Priority 3 is for walking wounded or minor casualties with stable physiology; option D is less appropriate because the stem does not meet criteria for death assignment. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: MIMMS; NHS Major Incident Triage Tool