Upper GI bleed — DipIMC MCQ

Correct answer: A — Transport urgently to hospital with pre-alert and resuscitation en route

Transport urgently to hospital with pre-alert and resuscitation en route is the best answer because massive haematemesis with shock requires urgent hospital resuscitation, endoscopy and blood products. Allow self-evacuation in a private vehicle is less appropriate because private transport is unsafe for an unstable or potentially unstable casualty; Transport to the nearest minor injury unit is less appropriate because a minor injury unit cannot provide definitive major trauma care. Transport to the nearest hospital without pre-alert and Delay transport for full wound cleaning 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 Upper GI bleeding guidance