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Paediatric anaphylaxis — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesPaediatric anaphylaxisDipIMC

A young man with a penetrating chest wound is pulseless with organised electrical activity. A trauma-capable pre-hospital team is present. Which management principle has priority over routine ALS drug sequencing?

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Correct answer: A — Use the HOTT sequence to treat reversible traumatic-arrest causes

The best answer is “Use the HOTT sequence to treat reversible traumatic-arrest causes”. Traumatic cardiac arrest requires immediate treatment of reversible causes using HOTT: hypovolaemia, oxygenation, tension pneumothorax and tamponade. Control catastrophic haemorrhage, ensure oxygenation, perform bilateral thoracostomies when indicated and address tamponade under appropriate governance. A non-shockable organised rhythm does not justify defibrillation, and medical-ALS medications cannot reverse mechanical obstruction or exsanguination.

Reference: Resuscitation Council UK, Special circumstances guidelines: https://www.resus.org.uk/professional-library/2025-resuscitation-guidelines/special-circumstances-guidelines