An explosion occurs at a local factory, and the hospital is notified about the surge in admissions. Based on triage protocol, which patient would the nurse immediately transfer to the hospital?

A 65-year-old man with lacerations to the upper arm who can walk unassisted.

A 46-year-old client with an open fracture of the femur and a scalp laceration.

A 23-year-old unconscious client with a large metal pole through the head and no vital signs.

An 18-year-old with maxillofacial wounds ambulating in the area.