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Remote axillary haemorrhage — DipIMC MCQ

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ModerateTraumaRemote axillary haemorrhageDipIMC

A 29-year-old hill walker has a deep axillary wound from a fall onto metal. Standard gauze pressure has not stopped bleeding and evacuation will take 50 minutes. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — 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 axillary bleeding is a junctional haemorrhage problem suited to packing and sustained pressure. Give a large crystalloid bolus before controlling the injury is less appropriate because fluid cannot replace early control of bleeding or ventilation problems; Transport without treating the identified time-critical problem is less appropriate because movement alone may not reverse the immediate physiology. Perform a full secondary survey before treating the abnormality and Wait for imaging before intervening 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; ATACC Manual