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Deterioration during transfer — DipIMC MCQ

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HardRetrieval MedicineDeterioration during transferDipIMC

During a 25-minute ambulance transfer, a chest trauma patient becomes hypotensive with rising airway pressures and absent right breath sounds. The vehicle is five minutes from a safe stopping point. What is the most appropriate immediate action?

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

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Correct answer: A — Stop safely and decompress the right chest

Stop safely and decompress the right chest is the best answer because new tension physiology during transfer is a reversible life threat and should be treated when safe to stop. Give a large crystalloid bolus before controlling the injury is less appropriate because fluid cannot replace early control of bleeding or ventilation problems; Delay intervention until arrival at hospital is less appropriate because delay is unsafe when a reversible pre-hospital threat is present. Wait for imaging before intervening 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: JRCALC Guidelines; ATACC Manual