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Termination of resuscitation context — DipIMC MCQ

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ModerateResuscitationTermination of resuscitation contextDipIMC

An 89-year-old with metastatic cancer is found in bed by carers. A valid treatment escalation plan declining CPR is present and there are no signs of suspicious circumstances. 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 — Respect the valid plan and do not commence CPR

Respect the valid plan and do not commence CPR is the best answer because valid advance decisions or treatment escalation plans should guide resuscitation decisions when applicable. 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: Resuscitation Council UK Guidelines; JRCALC Guidelines