Pelvic fracture haemorrhage — DipIMC MCQ

Correct answer: B — Apply a pelvic binder centred over the greater trochanters

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

D is correct: A suspected unstable pelvic fracture with shock requires early circumferential pelvic binding at the greater trochanters to reduce pelvic volume and bleeding. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it creates avoidable delay in a time-critical presentation; C is less suitable because it moves the patient before the decisive threat or destination issue is addressed; E is less suitable because it delays the immediate life-saving step in the cABCDE sequence. 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