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Haemorrhagic shock — DipIMC MCQ

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HardPre-Hospital Trauma ManagementHaemorrhagic shockDipIMC

A 60-year-old man is trapped after a rollover crash. His airway is patent, respiratory rate is 28, radial pulse is absent and he has a deformed pelvis already bound correctly. What is the most appropriate management?

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

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Correct answer: D — Use permissive hypotension with blood products if available and rapid extrication

In active traumatic haemorrhage, resuscitation should be restrictive until definitive haemorrhage control, using blood products where available. Normalising blood pressure with crystalloid may worsen bleeding and coagulopathy. Removing a correctly placed binder risks clot disruption. The pearl is that pre-hospital resuscitation aims for central perfusion, not normal numbers, unless traumatic brain injury dominates.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025