Remote consultation — DipIMC MCQ

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ModerateScene Safety and MedicolegalRemote consultationDipIMC

A paramedic crew asks by phone whether to leave a frail patient at home after a fall. The patient has new confusion and takes warfarin. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: C — Advise conveyance and document the clinical reasoning

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

A is correct: Remote advice must account for risk features and be documented; anticoagulation with confusion after a fall is high risk. B is less suitable because it does not address the discriminator in the vignette; C is less suitable because analgesia is important but does not replace the first physiological intervention; 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; GMC Good Medical Practice; JESIP Joint Doctrine