Severe head injury — DipIMC MCQ

Correct answer: E — Optimise oxygenation, ventilation and urgent critical care transfer

Explanation lettering: B = shown as A · C = shown as B · D = shown as C · E = shown as D · A = shown as E

A is correct: Severe traumatic brain injury needs prevention of secondary brain injury through oxygenation, ventilation and rapid transfer to neurosurgical trauma care. B is less suitable because it moves the patient before the decisive threat or destination issue is addressed; C is less suitable because it creates avoidable delay in a time-critical presentation; D is less suitable because it delays the immediate life-saving step in the cABCDE sequence; E is less suitable because it does not address the discriminator in the vignette. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; NICE Major Trauma NG39; ATACC