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Hypovolaemic shock from abdominal trauma — DipIMC MCQ

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HardTraumaHypovolaemic shock from abdominal traumaDipIMC

A 45-year-old man has blunt abdominal trauma after a quad-bike rollover. He is pale, pulse 136/min, systolic blood pressure 82 mmHg, FAST is unavailable, and estimated time to the major trauma centre is 18 minutes; blood products are not available. What is the most appropriate drug/dose?

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Correct answer: E — Give small aliquots of crystalloid to maintain a central pulse

Pre-hospital major haemorrhage management uses restrictive volume resuscitation when blood is unavailable, titrating to a central pulse rather than normal blood pressure. Large crystalloid volumes can worsen dilutional coagulopathy and disrupt clot formation. Imaging is not required before treating clinically evident shock.

Reference: NICE NG39 Major trauma; JRCALC Guidelines