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Haemorrhagic shock — MCCQE Part 1 MCQ

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EasyTraumaHaemorrhagic shockMCCQE Part 1

29-year-old man presents with penetrating abdominal trauma. He is pale, tachycardic and hypotensive with a distended abdomen. Which of the following is the most appropriate next step?

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Correct answer: C — Activate trauma team and massive transfusion with surgical control of bleeding

Activate trauma team and massive transfusion with surgical control of bleeding is best because shock after penetrating abdominal trauma is haemorrhage until proven otherwise. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Definitive haemorrhage control is required.

Reference: ATLS Canada principles