Traumatic arrest near MTC — DipIMC MCQ

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ModerateTraumaTraumatic arrest near MTCDipIMC

A 19-year-old is pulseless after penetrating chest trauma. Bilateral thoracostomies and haemorrhage control have been attempted; the MTC is 4 minutes away. What is the most appropriate transport decision?

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

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Correct answer: E — Convey rapidly to the major trauma centre during ongoing resuscitation

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

C is correct: Selected traumatic arrest close to definitive surgical capability may benefit from very rapid transfer after reversible causes are addressed. A is less suitable because the vignette contains high-risk features that require escalation; B is less suitable because it does not address the discriminator in the vignette; D is less suitable because it does not address the discriminator in the vignette; E 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