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Crush injury — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateTraumaCrush injuryDipIMC

A 44-year-old builder has both legs trapped under masonry for 90 minutes. He is conscious, in pain and extrication is expected to take another 30 minutes. What is the most appropriate immediate action?

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

Reveal the answer and explanation

Correct answer: A — Establish access and prepare fluids before limb release

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

A is correct: Prolonged crush entrapment risks hyperkalaemia and shock on release; preparation before extrication is time-critical. B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it delays the immediate life-saving step in the cABCDE sequence; D is less suitable because it does not address the discriminator in the vignette; 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