Shoulder dystocia — DipIMC MCQ

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EasyPaediatric and Obstetric EmergenciesShoulder dystociaDipIMC

A baby’s head delivers in an ambulance but the shoulders do not deliver with the next contraction. The mother is on the trolley. What is the most appropriate immediate action?

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

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Correct answer: C — Call for help and use McRoberts positioning with suprapubic pressure

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

A is correct: Shoulder dystocia requires immediate manoeuvres that increase pelvic outlet and disimpact the anterior shoulder. B is less suitable because it moves the patient before the decisive threat or destination issue is addressed; C is less suitable because a detailed survey is inappropriate before correcting an immediate threat; D is less suitable because analgesia is important but does not replace the first physiological intervention; 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 Paediatric and Newborn Guidelines; NICE NG39