High altitude cerebral oedema — DipIMC MCQ

Correct answer: E — Start descent and give oxygen or dexamethasone if available

Option E is correct because Ataxia and confusion at altitude suggest HACE, where descent is the definitive immediate treatment. Option B is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option A is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option C is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option D 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: Wilderness Medical Society altitude guidance; JRCALC principles