DKA — DipIMC MCQ

Correct answer: A — Give cautious fluids and convey for insulin-based DKA care

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

C is correct: Pre-hospital care for DKA is supportive fluid resuscitation and urgent transfer; insulin infusion is hospital-managed. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it does not address the discriminator in the vignette; D is less suitable because pre-alert is needed when definitive teams must prepare; 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; Resuscitation Council UK; NICE guidance where applicable