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Traumatic cardiac arrest — DIPIMC MCQ

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HardPre-Hospital TraumaTraumatic cardiac arrestDIPIMCDipIMC

After blunt trauma, a patient has traumatic cardiac arrest with gross pelvic instability, no chest-wall injury and no signs suggesting thoracic obstruction. Which intervention should be prioritised first while oxygenation is established?

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

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Correct answer: E — Apply pelvic binding and control haemorrhage during HOTT resuscitation

The best answer is “Apply pelvic binding and control haemorrhage during HOTT resuscitation”. In traumatic arrest, treatment is directed by the likely reversible mechanism. Gross pelvic instability makes catastrophic haemorrhage a dominant immediate concern, so pelvic binding and haemorrhage control are prioritised while oxygenation is established. Bilateral thoracostomies are indicated for traumatic arrest when thoracic obstruction is plausible, but should not displace immediate control of an obvious pelvic bleeding source in this specified presentation.

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