Thunderclap headache — DipIMC MCQ

Correct answer: D — Transport urgently to an emergency department with pre-alert for possible subarachnoid haemorrhage

Transport urgently to an emergency department with pre-alert for possible subarachnoid haemorrhage is the best answer because thunderclap headache with meningism is a high-risk presentation needing urgent imaging and specialist care. Transport to the nearest minor injury unit is less appropriate because a minor injury unit cannot provide definitive major trauma care; Allow self-evacuation in a private vehicle is less appropriate because private transport is unsafe for an unstable or potentially unstable casualty. Delay transport for full wound cleaning and Remain on scene until observations normalise 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 Headaches guidance