Pregnant trauma — DipIMC MCQ

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ModerateTraumaPregnant traumaDipIMC

A 32-week pregnant passenger has abdominal pain after a motorway collision. She is hypotensive, has no external bleeding and complains of reduced fetal movement. What is the most appropriate management?

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Correct answer: A — Apply left uterine displacement and prioritise maternal resuscitation

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

B is correct: Maternal resuscitation is the best fetal resuscitation; left uterine displacement helps relieve aortocaval compression. A is less suitable because it does not address the discriminator in the vignette; C is less suitable because the vignette contains high-risk features that require escalation; D is less suitable because it moves the patient before the decisive threat or destination issue is addressed; E is less suitable because a detailed survey is inappropriate before correcting an immediate threat. 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