In a mass casualty incident triage, how should you manage an apneic patient with a pulse?

• A. Move patient to triage area and await care.
• B. Check for a pulse and begin chest compressions.
• C. Reposition airway and provide 5 rescue breaths. If the patient remains apneic, they are to be tagged as DECEASED. If they begin breathing again, tag them as IMMEDIATE.
• D. Reposition airway and provide 2 rescue breaths. If breaths return, tag IMMEDIATE; if not, DECEASED.

Answer: (C)

In mass casualty triage, the priority for an apneic patient who still has a pulse is to reopen the airway and attempt ventilation because the patient has circulation but is not breathing, which is a reversible problem you can address quickly with basic airway management. Reposition the airway (perform a head-tilt–chin-lift or jaw-thrust if needed) and deliver a brief trial of rescue breaths. The usual approach in this scenario is to administer five rescue breaths to assess whether ventilation can be restored. If the patient begins to breathe after these breaths, they are reclassified as IMMEDIATE, since they now show a life-threatening condition that can be rapidly addressed. If there is no return of spontaneous breathing after the ventilatory attempt, they are considered DECEASED for triage purposes, since resources are limited and the patient is unlikely to survive with the current situation.

This avoids unnecessary chest compressions, which are reserved for patients without a pulse, and provides a quick, repeatable test to decide whether the patient can be saved with immediate ventilation efforts.