Mangled extremity with shock — DipIMC MCQ

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ModerateTraumaMangled extremity with shockDipIMC

A 37-year-old railway worker has a crushed contaminated lower leg with uncontrolled bleeding and absent distal pulses. He is pale and confused. What is the most appropriate transport decision?

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Correct answer: D — Control bleeding, splint, give TXA and transport to major trauma care with limb salvage capability

Control bleeding, splint, give TXA and transport to major trauma care with limb salvage capability is the best answer because a mangled limb with shock needs haemorrhage control and specialist trauma services. Delay transport for full wound cleaning is less appropriate because wound toilet should not delay urgent haemorrhage or surgical care; Allow self-evacuation in a private vehicle is less appropriate because private transport is unsafe for an unstable or potentially unstable casualty. Remain on scene until observations normalise and Transport to the nearest hospital without pre-alert 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