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Catastrophic femoral haemorrhage — DipIMC MCQ

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EasyPre-Hospital Trauma ManagementCatastrophic femoral haemorrhageDipIMC

A 34-year-old man has a chainsaw wound to the mid-thigh on a farm. Blood is spurting through a towel, he is pale and confused, and direct pressure is failing. What is the most appropriate immediate action?

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

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Correct answer: A — Apply a proximal limb tourniquet and tighten until bleeding stops

Option A is correct because Life-threatening extremity haemorrhage takes priority over access, analgesia or transport, and a tourniquet is indicated when direct pressure is inadequate. Option D is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option C is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option B is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option E is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: NICE Major Trauma NG39; JRCALC Guidelines