Hypotensive penetrating trauma — DipIMC MCQ

Correct answer: E — Use permissive hypotension and rapid transfer to definitive haemorrhage control

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

B is correct: In bleeding trauma without isolated severe head injury, permissive hypotension and rapid surgery are preferable to large-volume crystalloid resuscitation. A is less suitable because it does not address the discriminator in the vignette; C is less suitable because a detailed survey is inappropriate before correcting an immediate threat; D is less suitable because pre-alert is needed when definitive teams must prepare; E 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 NG39; ATACC