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Time-critical neurosurgical retrieval — DipIMC MCQ

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HardRetrieval MedicineTime-critical neurosurgical retrievalDipIMC

A 49-year-old on a small island has GCS 7 after a fall, unequal pupils and vomiting. Weather permits helicopter transfer to a neurosurgical major trauma centre in 45 minutes or boat transfer to a district hospital in 70 minutes. What is the most appropriate transport decision?

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Correct answer: E — Helicopter transfer directly to neurosurgical major trauma care with pre-alert

Severe traumatic brain injury with signs of herniation needs rapid definitive neurotrauma care. Helicopter retrieval is appropriate when it materially shortens time to the right facility and safety is acceptable. Waiting for unavailable imaging or a slower lower-capability destination worsens secondary brain injury risk.

Reference: NICE NG40 Major trauma service delivery; retrieval medicine principles