Postpartum haemorrhage — DipIMC MCQ

Correct answer: B — Massage the uterus and manage as obstetric haemorrhage

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

E is correct: Atonic postpartum haemorrhage needs uterine massage, resuscitation and urgent obstetric transfer. A is less suitable because a detailed survey is inappropriate before correcting an immediate threat; B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it does not address the discriminator in the vignette; D is less suitable because it creates avoidable delay in a time-critical presentation. 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