Capacity refusal head injury — DipIMC MCQ

Correct answer: C — Treat him as lacking capacity for this decision and arrange safe conveyance

Treat him as lacking capacity for this decision and arrange safe conveyance is the best answer because capacity requires understanding, retaining and weighing information, which is impaired here. Immobilise every joint and delay departure for a detailed examination is less appropriate because prolonged packaging can delay definitive care; Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled. Provide reassurance and reassess after transport and Defer treatment until a senior hospital doctor reviews the patient 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; Mental Capacity Act Code of Practice