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Haemorrhagic shock pelvic — DIPIMC MCQ

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HardPre-Hospital TraumaHaemorrhagic shock pelvicDIPIMCDipIMC

A 40-year-old crushed between two vehicles has an unstable pelvis, a heart rate of 130 and a radial pulse that is just palpable. A pelvic binder is in place and you have blood products available. The nearest major trauma centre is 25 minutes away by road. Which combination best reflects appropriate management?

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

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Correct answer: D — Blood products titrated to a palpable radial pulse, tranexamic acid, and rapid transfer to the major trauma centre

Haemorrhagic shock from an unstable pelvis is best managed with early blood products titrated to a permissive target (a palpable radial pulse or systolic around 80-90 mmHg), tranexamic acid given as soon as possible, and rapid transfer to definitive care. Large-volume crystalloid dilutes clotting factors and worsens outcomes, and targeting a normal or high pressure promotes clot disruption. Repeated springing of the pelvis is harmful. Pearl: in pelvic trauma, bypass to a major trauma centre rather than the nearest unit when feasible.

Reference: NICE NG39 (Major Trauma); JRCALC Clinical Guidelines