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Severe TBI Initial Resuscitation Ethics — FRCA Final MCQ

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HardTrauma & Emergency AnaesthesiaSevere TBI Initial Resuscitation EthicsFRCA Final

A 22-year-old man falls 10 metres onto concrete. He is unresponsive with bilateral fixed dilated pupils. CT shows massive cerebral contusions with midline shift. SpO2 is 82% on arrival. He has no advance directive. What is the correct initial approach?

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Correct answer: A — Full resuscitation including intubation, ventilation, and ICP management

In the acute phase of trauma, full resuscitation should be initiated while the extent of injuries is being assessed. Decisions about withdrawal of treatment should be made after thorough assessment, senior neurosurgical input, and family discussion — not at the point of arrival. The primary survey follows ATLS principles regardless of apparent severity.

Reference: ATLS – 2018 – Initial assessment; NICE – 2023 – NG232 Major trauma