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Older adult blunt trauma — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementOlder adult blunt traumaDipIMC

A 70-year-old woman is struck by a vehicle at 30 mph. She is alert, has chest wall tenderness, a respiratory rate of 24 and takes apixaban for atrial fibrillation. What is the most appropriate transport decision?

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Correct answer: A — Transport to an emergency department within the regional major trauma pathway

Older patients have high morbidity after blunt thoracic trauma, and anticoagulation increases risk from occult bleeding. Normal consciousness does not exclude serious injury, and ED assessment within a trauma network is appropriate. A walk-in centre is unlikely to manage deterioration or anticoagulant-related complications. The pearl is that frailty and anticoagulation alter trauma thresholds.

Reference: NICE Major Trauma NG39; JRCALC Guidelines 2025