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Catastrophic haemorrhage in triage — DipIMC MCQ

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EasyMajor Incident ManagementCatastrophic haemorrhage in triageDipIMC

At a marauding attack, a 33-year-old is screaming and has spurting thigh bleeding. He is unable to walk and several casualties are nearby. What is the most appropriate immediate action?

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

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Correct answer: CApply a tourniquet as a lifesaving intervention before continuing triage

Apply a tourniquet as a lifesaving intervention before continuing triage is the best answer because catastrophic haemorrhage control is performed immediately during triage because it is rapidly fatal and reversible. 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 Delay intervention until arrival at hospital 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: MIMMS Major Incident Medical Management and Support; NHS England Major Incident Triage Tool; JRCALC Guidelines