Major trauma destination — DipIMC MCQ

Correct answer: B — Bypass to the major trauma centre with pre-alert

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

B is correct: Major trauma with haemodynamic compromise should usually go directly to a major trauma centre if immediate life-saving care is not required elsewhere. A 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 it does not address the discriminator in the vignette; E is less suitable because the vignette contains high-risk features that require escalation. 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; NICE Major Trauma NG39; ATACC