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Exsanguinating junctional haemorrhage — DipIMC MCQ

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ModerateTraumaExsanguinating junctional haemorrhageDipIMC

A 32-year-old motorcyclist has a deep groin wound after striking a barrier. Direct pressure is failing, he is pale and confused, and the wound is too proximal for a limb tourniquet. What is the most appropriate immediate action?

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Correct answer: E — Pack the wound with haemostatic gauze and maintain firm pressure

Pack the wound with haemostatic gauze and maintain firm pressure is the best answer because junctional haemorrhage requires wound packing and sustained pressure when a tourniquet cannot be placed. Give a large crystalloid bolus before controlling the injury is less appropriate because fluid cannot replace early control of bleeding or ventilation problems; Wait for imaging before intervening is less appropriate because imaging is not available or appropriate before treating a clinical life threat. Transport without treating the identified time-critical problem and Perform a full secondary survey before treating the abnormality are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Major Trauma NG39; ATACC Manual