Head injury with herniation signs — DipIMC MCQ

Correct answer: D — Pre-alert and transport directly to a major trauma centre with neurosurgical capability

Pre-alert and transport directly to a major trauma centre with neurosurgical capability is the best answer because severe traumatic brain injury with herniation signs needs rapid definitive trauma and neurosurgical care. Perform a full secondary survey before treating the abnormality is less appropriate because secondary survey follows correction of immediate life threats; Wait for imaging before intervening is less appropriate because imaging is not available or appropriate before treating a clinical life threat. Delay intervention until arrival at hospital and Give a large crystalloid bolus before controlling the injury 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: NICE Major Trauma NG39; JRCALC Guidelines