skip to main content

Haemorrhage with traumatic brain injury — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

HardPre-Hospital Trauma ManagementHaemorrhage with traumatic brain injuryDipIMC

A 45-year-old woman is trapped after a high-speed crash. She has suspected major bleeding and a severe head injury with one dilated pupil; systolic blood pressure is 78 mmHg. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: D — Prioritise haemorrhage control while avoiding prolonged hypotension because traumatic brain injury is present

Major haemorrhage and traumatic brain injury create competing priorities. NICE advises restrictive resuscitation for haemorrhage, but a less restrictive approach is needed when brain injury dominates to preserve cerebral perfusion. Large crystalloid volumes remain harmful, and uncontrolled hyperventilation can reduce cerebral blood flow. The pearl is that permissive hypotension is not a blanket rule in trauma.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025