Question

A 23-year-old man is brought to a remote nursing station in northern Canada after a quad bike rollover. He has suspected pelvic and long bone fractures, HR 132, BP 86/50 mm Hg and cool extremities. There is no on-site blood bank and transfer time to the nearest trauma centre by air is estimated at 2 hours. Which approach best reflects damage control resuscitation in this rural/remote context?

Accepted Answer

Permissive hypotension with limited crystalloids, early activation of aeromedical transfer and use of available blood products if possible

Answer

Aggressive crystalloid resuscitation to normalise BP before transfer

Answer

Delay transfer until full-body CT scan is obtained

Answer

Immobilise and observe until BP normalises spontaneously

Answer

Start high-dose vasopressors instead of fluids or blood

Practice question