Isolated hip fracture — DipIMC MCQ

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ModerateTraumaIsolated hip fractureDipIMC

An 86-year-old slips at home and has a shortened externally rotated leg. She is normotensive, alert and has no head injury or chest pain. What is the most appropriate transport decision?

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

Reveal the answer and explanation

Correct answer: C — Convey to the nearest appropriate emergency department

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

A is correct: Isolated hip fracture without major trauma physiology usually needs local emergency care rather than major trauma bypass. B is less suitable because it does not address the discriminator in the vignette; 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 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; NICE Major Trauma NG39; ATACC