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Time-critical pre-alert and destination — DIPIMC MCQ

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ModerateRetrieval and TransportTime-critical pre-alert and destinationDIPIMCDipIMC

You are managing a hypotensive patient with a stab wound to the abdomen and bowel evisceration, and the patient is deteriorating. Which action regarding communication and destination is most appropriate?

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

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Correct answer: A — Give a structured pre-alert and transport without delay

A deteriorating patient with penetrating abdominal trauma and evisceration is time-critical and needs rapid transfer to a major trauma centre with surgical and transfusion capability; a structured pre-alert such as ATMIST lets the receiving team mobilise theatres, blood and senior staff before arrival. Notifying a minor injuries unit is inappropriate for this severity, and transporting without warning wastes the preparation time a pre-alert would buy. On-scene time should be limited to essential life-saving interventions. Pearl: cover eviscerated bowel with a saline-soaked dressing and do not attempt to reduce it in the field.

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