Stroke destination — DipIMC MCQ

Correct answer: C — Convey directly to the nearest hyperacute stroke unit

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

A is correct: Potential reperfusion candidates should be taken rapidly to hyperacute stroke care rather than the closest non-stroke facility. B is less suitable because it moves the patient before the decisive threat or destination issue is addressed; C is less suitable because it does not address the discriminator in the vignette; D is less suitable because the vignette contains high-risk features that require escalation; 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; Resuscitation Council UK; NICE guidance where applicable