Obstetric haemorrhage transport — DipIMC MCQ

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ModeratePaediatric and Obstetric EmergenciesObstetric haemorrhage transportDipIMC

A woman has ongoing postpartum haemorrhage after home birth despite uterine massage. She is pale and tachycardic. What is the most appropriate transport decision?

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Correct answer: E — Convey urgently to consultant-led obstetric care with pre-alert

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

A is correct: Ongoing obstetric haemorrhage needs rapid transfer to definitive obstetric and transfusion capability. B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it moves the patient before the decisive threat or destination issue is addressed; 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; Resuscitation Council UK Paediatric and Newborn Guidelines; NICE NG39