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Cardiac tamponade — DipIMC MCQ

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HardPre-Hospital Trauma ManagementCardiac tamponadeDipIMC

A 22-year-old man is found after a knife assault with a small anterior chest wound. He is pale, confused, has muffled heart sounds, distended neck veins and equal breath sounds. What is the most appropriate transport decision?

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Correct answer: C — Rapid transfer to a major trauma centre with pre-alert for suspected cardiac tamponade

Penetrating chest trauma with shock, raised venous pressure and muffled heart sounds suggests cardiac tamponade, requiring urgent surgical capability. Needle decompression treats tension pneumothorax and is not indicated when breath sounds are equal and tamponade is more likely. Crystalloid may provide transient support but must not delay definitive care. The pearl is that penetrating cardiac injury is a transport decision as much as a diagnosis.

Reference: JRCALC Guidelines 2025; ATACC