Stroke remote — DipIMC MCQ

Correct answer: A — Discuss direct transfer to a hyperacute stroke pathway

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

E is correct: Time-critical stroke from remote locations requires early destination and transport coordination. A is less suitable because it does not address the discriminator in the vignette; B is less suitable because it moves the patient before the decisive threat or destination issue is addressed; 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. 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 Service Delivery NG40; ATACC