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Unstable penetrating chest trauma — DipIMC MCQ

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ModeratePre-Hospital Trauma ManagementUnstable penetrating chest traumaDipIMC

A man with a chest stab wound improves after decompression but remains tachycardic. The major trauma centre is 15 minutes away. What is the most appropriate transport decision?

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

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Correct answer: E — Rapid transfer to the major trauma centre with ATMIST pre-alert

Option E is correct because After life-saving intervention, penetrating chest trauma requires rapid surgical-capable definitive care. Option B is less appropriate because the clinical risk exceeds that destination or timeframe; option C is less appropriate because pre-alert is needed to mobilise the correct receiving team. Option D is less appropriate because watchful waiting risks deterioration or delays definitive care; option A is less appropriate because unmonitored private transport is unsafe for this risk profile. 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