Which victim of a train crash should be prioritized for transport to the Emergency Department?

In this scenario, the client with full-thickness burns over 30% of body surface area should be prioritized for transport to the Emergency Department. This is because extensive full-thickness burns pose a significant threat to the individual’s life due to factors such as fluid loss, risk of infection, and potential for hypovolemic shock. The percentage of body surface area affected is critical; burns covering over 20% in adults or 10% in children are considered major and require immediate medical intervention.

These patients also face complications related to their airway, breathing, and circulation due to the impact of severe burns, which necessitates prompt evaluation and treatment in an emergency setting. The urgency is further compounded by the possibility of inhalation injuries, which can occur in the context of a train crash.

While other injuries and conditions are serious, particularly those involving respiratory distress or fractures, the severity of the burns and the extensive body area involved place the client at a higher risk of life-threatening complications, thereby requiring immediate medical attention.