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Penetrating neck injury — DipIMC MCQ

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HardPre-Hospital Trauma ManagementPenetrating neck injuryDipIMC

A 50-year-old farm worker has a penetrating neck wound with expanding swelling, hoarseness and increasing respiratory distress. The nearest trauma unit is 8 minutes away; the major trauma centre is 45 minutes away. What is the most appropriate transport decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Transport to the nearest unit capable of immediate airway control with pre-alert

An expanding neck haematoma with airway compromise is a time-critical airway threat. Although major trauma centres are usually optimal, immediate airway control at the nearest capable unit may be necessary when the airway may be lost en route. Circumferential neck pressure risks occluding venous return and worsening airway compromise. The pearl is that destination decisions balance definitive care against imminent physiological deterioration.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025