Post-ROSC shock — DipIMC MCQ

Correct answer: B — Optimise oxygenation, treat hypotension and pre-alert for post-arrest care

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

E is correct: After ROSC, management focuses on controlled oxygenation, haemodynamic support and rapid transfer to a centre able to manage post-cardiac arrest syndrome. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because analgesia is important but does not replace the first physiological intervention; C is less suitable because a detailed survey is inappropriate before correcting an immediate threat; D 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: Resuscitation Council UK Guidelines 2025; JRCALC Guidelines