Question

A 60-year-old man is brought to the ED after a high-speed motor vehicle collision in a rural area. He is hypotensive (BP 80/40 mm Hg) with suspected intra-abdominal haemorrhage. The nearest trauma centre is 400 km away and weather prevents air transfer. As the rural physician, what is the MOST appropriate initial approach?

Accepted Answer

Begin damage-control resuscitation with blood products (if available), permissive hypotension and rapid imaging, while coordinating transfer and possible damage-control surgery on site

Answer

Delay resuscitation until transfer is arranged

Answer

Discharge home because definitive care is unavailable

Answer

Attempt complex definitive laparotomy despite lack of surgical support or blood bank

Answer

Only provide crystalloid fluids to normalise BP to 140/90 mm Hg

Practice question