Traumatic brain injury with shock — DipIMC MCQ

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HardPre-Hospital Trauma ManagementTraumatic brain injury with shockDipIMC

A woman after a high-speed crash has GCS 8, systolic blood pressure 78 mmHg and suspected pelvic injury. There is no visible external haemorrhage. What is the most appropriate management?

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Correct answer: A — Control suspected pelvic bleeding and maintain central circulation

Option A is correct because Combined haemorrhage and TBI requires haemorrhage control while avoiding profound hypotension that worsens secondary brain injury. Option C is less appropriate because watchful waiting risks deterioration or delays definitive care; option E is less appropriate because the clinical risk exceeds that destination or timeframe. Option D is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option B is less appropriate because analgesia is important but not sufficient as the primary intervention. 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