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Agitated major trauma patient — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementAgitated major trauma patientDipIMC

A 47-year-old lorry driver is ejected from the cab. He is combative, has oxygen saturations of 90%, a systolic blood pressure of 85 mmHg and a large scalp laceration with controlled bleeding. What is the most appropriate management?

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

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Correct answer: A — Treat hypoxia and shock, prevent heat loss and expedite major trauma transfer

Agitation after high-energy trauma may reflect hypoxia, shock or head injury, so oxygenation, haemorrhage control, prevention of hypothermia and rapid transfer are key. Sedation without addressing physiology risks masking deterioration and worsening airway compromise. Prolonged scene assessment adds little before lifesaving priorities are complete. The pearl is that behaviour can be a vital sign in trauma.

Reference: JRCALC Guidelines 2025; NICE Major Trauma NG39