Pre-hospital patient assessment: DipIMC practice questions
PHEM curriculum unit 2.1 · Theme 2: Providing Pre-hospital Emergency Medical Care
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit 2.1, Assess patients in the pre-hospital phase.
Below are 3 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 21 questions on this unit.
Question 1 · Medical & Resuscitation · Easy
You are asked to design the assessment teaching for a community first responder course, following the first aid chapter introduced in Guidelines 2025. Which structured approach should lay responders be taught to use when assessing a person who needs help?
AAirway and breathing only, then call for help
BAVPU, then a head-to-toe secondary survey
CSBAR, from situation through to recommendation
DLook, listen and feel for 10 seconds, then act
EABCDE, from airway through to full exposure
Show answer
Answer: E
ABCDE, from airway through to full exposure
The RCUK 2025 first aid guideline, new in this edition, describes first aid as a helping behaviour by anyone, for any emergency condition, in any situation. For assessment it recommends a structured ABCDE approach — Airway, Breathing, Circulation, Disability, Exposure — to promptly identify and treat life-threatening conditions, after immediate attention to safety, responsiveness and life-threatening bleeding. Stopping at airway and breathing would miss circulation problems such as life-threatening bleeding, which the guideline asks responders to attend to immediately. AVPU is one part of D, not a framework; SBAR is a handover tool; and look, listen and feel describes one step within B.
Where this comes from
First aid guidelines 2025Resuscitation Council UK·Key points: structured assessment“Utilise an ABCDE approach to promptly identify and treat life-threatening conditions.”Open at this sentence
First aid guidelines 2025Resuscitation Council UK·Structured first aid assessment of a person appearing ill, injured or in shock (ABCDE)“Use the ABCDE framework to structure your assessment of a person in need.”Open at this sentence
First aid guidelines 2025Resuscitation Council UK·Structured first aid assessment: immediate attention to safety, responsiveness and bleeding“Pay immediate attention to safety, the responsiveness of the victim, and life-threatening bleeding.”Open at this sentence
med-013 · Medical & Resuscitation · First Aid · Easy · v2
Question 2 · Medical & Resuscitation · Moderate
NICE NG253, published in November 2025, stratifies the risk of severe illness or death from suspected sepsis in acute hospital, acute mental health and ambulance settings using the NEWS2 score. Which set of NEWS2 bands does it use?
A7 or more high risk; 4 to 6 moderate risk; 1 to 3 low risk; 0 very low risk
B5 or more high risk; 3 to 4 moderate risk; 1 to 2 low risk; 0 very low risk
C7 or more high risk; 5 to 6 moderate risk; 1 to 4 low risk; 0 very low risk
D9 or more high risk; 5 to 8 moderate risk; 1 to 4 low risk; 0 very low risk
E7 or more high risk; 5 to 6 moderate risk; 3 to 4 low risk; 0 to 2 very low risk
Show answer
Answer: C
7 or more high risk; 5 to 6 moderate risk; 1 to 4 low risk; 0 very low risk
NG253 recommendation 1.6.2 bands NEWS2 as follows: a score of 7 or more suggests high risk, a score of 5 or 6 a moderate risk, a score of 1 to 4 a low risk, and a score of 0 a very low risk of severe illness or death from sepsis. Two riders matter as much as the numbers. If a single parameter contributes 3 points to the NEWS2 score, a high-priority review by a clinician is requested whatever the total. And the band is a floor, not a ceiling: recommendations 1.6.3 and 1.6.4 say to consider the risk as higher than the score suggests where there is, for example, mottled or ashen appearance or a non-blanching petechial or purpuric rash. This guideline replaces NG51. The distractors shift the moderate band down, compress all the bands, inflate the thresholds, or move 1 and 2 points into very low risk.
med-070 · Medical & Resuscitation · Medical · Moderate · v2
Question 3 · Medical & Resuscitation · Moderate
A 79-year-old woman is brought to the emergency department by her daughter, who says she has been 'just not herself' since yesterday. She is afebrile and denies pain. Her NEWS2 score is 4. On examination her skin is mottled over the knees and her lips are dusky. What does NICE NG253 recommend?
AManage her as low risk, matching the band for a NEWS2 score of 4
BRepeat the NEWS2 score in 4 hours and act on the second reading
CEscalate her risk level above the band indicated by her NEWS2 score
DManage her as very low risk while she remains afebrile and free of pain
EWithhold a risk category until her lactate result is available
Show answer
Answer: C
Escalate her risk level above the band indicated by her NEWS2 score
NG253 bands a NEWS2 score of 1 to 4 as low risk, but recommendations 1.6.3 and 1.6.4 tell clinicians to consider the risk as higher than the score suggests where there is, among other findings, mottled or ashen appearance, a non-blanching petechial or purpuric rash, or cyanosis of the skin, lips or tongue. This patient is mottled with dusky lips, so a score of 4 does not make her low risk. Recommendation 1.2.1 lists factors that may increase the risk of developing sepsis, including being 75 or over; she is 79 and the history of her being 'not herself' came from her daughter. Absence of fever and pain is no reassurance. Waiting four hours to repeat the score, or waiting for a lactate before assigning a category, inverts a guideline that uses clinical appearance to move risk up immediately.