Penetrating chest trauma — DipIMC MCQ

Correct answer: E — Convey to the major trauma centre with ATMIST pre-alert

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

E is correct: Stable penetrating chest trauma should be transported to the centre able to provide thoracic trauma capability. A is less suitable because it moves the patient before the decisive threat or destination issue is addressed; B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it does not address the discriminator in the vignette; D is less suitable because it moves the patient before the decisive threat or destination issue is addressed. 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