4/29/23, 3:03 PM
ATLS Flashcards | Quizlet
ATLS
Science
Study
Medicine
Surgery
ATLS
4.4 (11 reviews)
Textbook solutions for this set
Alexander's Care of the Patient in Surgery
15th Edition • ISBN: 9780323089425
Jane Rothrock
Search for a textbook or question
Terms in this set (175)
Which of the following is the
C. Warm (40 degrees) water
recommended Method for
trestemt frostbite?
A. Vasodilators
B. Anticigulants
C. Warm (40 degrees) water
D. Padding and elevation
E. Application of heat from a
hairdryer
https://quizlet.com/466306232/atls-flash-cards/
1/98
4/29/23, 3:03 PM
ATLS Flashcards | Quizlet
Which of the following physical
ATLS
D. Presence of deep tendon reflexes. Spinal shock
findings suggest a cause of
refers to loss of muscle toe (flaccidty) and loss of
hypotension other than spinal
reflexes.
cord injury?
A. Prispism
B. Bradycardia
C. Diaphragmatic breathing
D. Presence of deep tendon
reflexes
E. Ability to flex forearms but
not extend them
The primary indication for
C. Resource limitations as determined by the
transferring A patient to a higher
transferring doctor (MÅ SJEKKES)
level trauma center is:
A. Unavailibility of surgeon or
operating staff
B. Multiple system injuries,
including severe head injury
C. Resource limitations as
determined by the transferring
doctor
D. Resource limitations as
determined by the hospital
administration
E. Widened mediastinum on
chest x-ray following blunt
trauma
https://quizlet.com/466306232/atls-flash-cards/
2/98
4/29/23, 3:03 PM
A young man sustains a rifle
ATLS
ATLS Flashcards | Quizlet
A. Laparotomy because of hemodynamic abnormality
wound to the mid-abdomen. He
is brought promptly to the ED
by prehospital personnel. His
skin is cool and diaphoretic, and
his systolic blood pressure is
58mmHg. Warmed crystalloid
fluids are initiated without
improvement in his vital signs.
The next, most appropriate,
step is to perform:
A. a laparotomy
B. An abdominal CT-scan
C. Diagnostic laparoscopy
D. Abdominal ultrasonography
E. A diagnostic peritoneal
lavage
https://quizlet.com/466306232/atls-flash-cards/
3/98
4/29/23, 3:03 PM
A 42-year-old man is trapped
ATLS
ATLS Flashcards | Quizlet
MÅ SJEKKES
from the waist down beneath his
overturned tractor for several
hours before medical assistance
arrives. He is awake and alert
until just before arriving in the
ED. He is now unconscious and
responds only to painful stimuli
by moaning. His pupils are 3mm
in diameter and symmetrically
reactive to light. Prehospital
personnel indicate that they
have not seen the patient move
either of his lower extremities.
On examination in the ED, no
movement of his lower
extremities are detected, even
in response to painful stimuli.
The most likely cause for this
finding is:
A. An epidural hematoma
B. A pelvic fracture
C. Central cord syndrome
D. Intracerebral hemorrhage
E. Bilateral compartment
syndrome
https://quizlet.com/466306232/atls-flash-cards/
4/98
4/29/23, 3:03 PM
A 6-year-o boy is struck by an
ATLS
automobile and brought to the
ATLS Flashcards | Quizlet
D. Percutaneous peripheral veins in the upper
extremities
ED. He is lethargic, but
withdraws purposefully from
painful stimuli. His blood
pressure is 90mmHg systolic,
heart rate 140 beats per minute
and his respiratory rate is 36
breaths per minute. The
preferred route of venous
access in this patient is:
A. Percutaneous femoral vein
cannulation
B. Cutdown on the saphenous
vein at the ankle
C. Intraosseous catheter
placement in the proximal tibia
D. Percutaneous peripheral
veins in the upper extremities
E. Central venous access via the
subclavian or internal jugular
vein
https://quizlet.com/466306232/atls-flash-cards/
5/98
4/29/23, 3:03 PM
A young man sustains a gunshot
ATLS
ATLS Flashcards | Quizlet
C. Control internal hemorrhage operatively
wound to the abdomen and is
brought promptly to the ED by
prehospital personnel. His skin
is cool and diaphoretic, and he
is confused. His pulse is thready
and his femoral pulse is only
weakly palpable. The definitive
treatment in managing this
patient is to:
A. Administer O-negative blood
B. Apply external warming
devices
C. Control internal hemorrhage
operatively
D. Apply a pneumatic antishock
garment (PASG)
E. Infuse large volumes of
intravenous crystalloid
solutions.
https://quizlet.com/466306232/atls-flash-cards/
6/98
4/29/23, 3:03 PM
Regarding shock in the child,
ATLS
which of the following is FALSE?
ATLS Flashcards | Quizlet
D. The absolute volume of blood loss required to
produce shock is the same as in adults
A. Vital signs are age-related
B. Children have greater
physiologic reserves than do
adults
C. Tachycardia is the primary
physiologic response to
hypovolemia
D. The absolute volume of
blood loss required to produce
shock is the same as in adults
E. An initial fluid bolus for
resuscitation should
approximate 20ml/kg Ringers
Lactate
https://quizlet.com/466306232/atls-flash-cards/
7/98
4/29/23, 3:03 PM
A 33-year-old man is struck by a
ATLS
ATLS Flashcards | Quizlet
D. Perform diagnostic peritoneal lavage or FAST
car travelling at 56km/h
(35mph). He has obvious
fractures of the left tibia near
the knee, pain in the pelvic area,
and severe dyspnea. His heart
rate is 182 beats per minute, and
his respiratory rate is 48 breaths
per minute with no breath
sounds heard in the left chest. A
tension pneumothorax is
relieved by immediate needle
decompression and tube
thoracostomy. Subsequently, his
heart rate decreases to 144
beats per minute, his
respirartory rate decreases to
36 breaths per minute and his
blood pressure is 81/53 mmHg.
Warmed Ringers lactate is
adminstered intravenously. The
next priority should be to:
A. Perform external fixation of
the pelvis
B. Obtain abdominal and pelvic
CT-scans
C. Perform arterial embolization
of the pelvic vessel
D. Perform diagnostic
peritoneal lavage or FAST
E. Perform a urethrogram and
cystogram
https://quizlet.com/466306232/atls-flash-cards/
8/98
4/29/23, 3:03 PM
A 42-year-old man, injured in a
ATLS
ATLS Flashcards | Quizlet
A. Obtain a chest x-ray (MÅ SJEKKES)
motor vehicle crash, suffers a
closed head injury, multiple
palpable left rib fractures, and
bilateral femur fractures. He is
intubated orotracheally without
difficulty. Initially, his ventilations
are easily assisted with a bagmask device. It becomes more
difficult to ventilate the patient
over the next 5 minutes, and his
hemoglobin oxygen saturation
level decreases from 98% to
89%. The most appropriate next
step is to:
A. Obtain a chest x-ray
B. Decrease the tidal volume
C. Decrease PEEP
D. Increase the rate of assisted
ventilations
E. Perform needle
decompression of the left chest.
https://quizlet.com/466306232/atls-flash-cards/
9/98
4/29/23, 3:03 PM
A 30-year-old man sustains a
ATLS
ATLS Flashcards | Quizlet
B. Tamponade of the wound with a pressure dressing
severely comminuted, open,
distal right femur fracture in a
motorcycle crash. The wound is
actively bleeding. Normal
sensation is present over the
lateral aspect of the foot but
decreased over the medial foot
and great toe. Normal motion of
the foot is observed. Dorsalis
pedis and posterior tibial pulses
are easily palpable on the left,
but heard only by Doppler on
the right. Immediate efforts to
improve circulation to the
injured extremity should involve:
A. Immediate angiography
B. Tamponade of the wound
with a pressure dressing
C. Wound exploration and
removal of bony fragments
D. Realignment of the fracture
segments with a traction splint
E. Fasciotomy of all four
compartments in the lower
extremity
https://quizlet.com/466306232/atls-flash-cards/
10/98
4/29/23, 3:03 PM
An 18-yeard-old, unhelmeted
ATLS
motorcyclist is brought by
ATLS Flashcards | Quizlet
E. The patient probably has an acute epidural
hematoma
ambulance to the ED following
a crash. He had decreased level
of consciousness at the scene,
but then was alert and
conversational during
transportation. Now his GCS is
only 11. Which of the following
statements is TRUE?
A. Cerebral perfusion is intact
B. Intravascular volume status is
normal
C. The patient is in a postictal
state
D. Intra-abdominal visceral
injury is unlikely
E. The patient probably has an
acute epidural hematoma
https://quizlet.com/466306232/atls-flash-cards/
11/98
4/29/23, 3:03 PM
A previously healthy, 70kg (175
ATLS
pound) man suffers an
ATLS Flashcards | Quizlet
E. His systolic blood pressure will be maintained with
an elevated diastolic pressure.
estimated acute blood loss of
two liters. Which one of the
following statements apply to
this patient?
A. His pulse pressure will be
widened
B. His urinary output will be at
the lower limits of normal
C. He will have tachycardia, but
no change in systolic blood
pressure
D. His systolic blood pressure
will be decreased with a
narrowed, pulse pressure
E. His systolic blood pressure
will be maintained with an
elevated diastolic pressure.
https://quizlet.com/466306232/atls-flash-cards/
12/98
4/29/23, 3:03 PM
The physioclogic hypervolemia
ATLS
of pregnancy has clinical
ATLS Flashcards | Quizlet
D. Increasing the volume of blood loss to produce
shock
significance in the management
of the severely injured gravid
woman by
A. Reducing the need for blood
transfusion
B. Increasing the risk of
pulmonary edema
C. Complicating the
management of closed head
injury
D. Increasing the volume of
blood loss to produce
shock/maternal hypotension
E. Reducing the volume of
crystalloid required for
resuscitation
https://quizlet.com/466306232/atls-flash-cards/
13/98
4/29/23, 3:03 PM
A 17-year-old helmeted
ATLS
ATLS Flashcards | Quizlet
B. A long spine board
motorcyclist loses
consciousness when he is struck
broad side by an automobile at
an intersection. He arrives in the
ED with a blood pressure of
140/92, pulse rate 88 beats per
minute, a respiratory rate of 18
breaths per minue, and a GCS of
7. Appropriate initial
immobilization of this patient
should include a semi-rigid
cervical collar and:
A. A scoop stretcher
B. A long spine board
C. A short spine board
D. Cervical traction tongs
E. Pneumatic antishock garment
https://quizlet.com/466306232/atls-flash-cards/
14/98
4/29/23, 3:03 PM
During an altercation, a 36ATLS
ATLS Flashcards | Quizlet
E. Chest X-ray to confirm tube placement
year-old man sustains a gunshot
wound above the nipple line on
the right, with an exit wound
posteriorly above the scapula
on the right. He is transported
by ambulance to a community
hospital. He is endotracheally
intubated, close tube
thoracostomy is performed, and
2 liters Ringers lactate solution
are infused via 2 large-caliber
IV´s. His blood pressure now is
60/0mmHg, heart rate is 160
beats per minute, and
respiratory rate is 14 breaths per
minute (ventilated with 100%
O2). The most appropriate next
step in managin this patient is:
A. Laparotomy
B. Diagnostic peritoneal lavage
C. Arterial blood gas
determination
D. Administer packed red blood
cells
E. Chest X-ray to confirm tube
placement
https://quizlet.com/466306232/atls-flash-cards/
15/98
4/29/23, 3:03 PM
Abscence of breath sounds and
ATLS
ATLS Flashcards | Quizlet
A. Left hemothorax
dullness to percussion over the
left hemithorax are findings best
explained by:
A. Left hemothorax
B. Cardiac contusion
C. Left simple pneumothorax
D. Left diaphragmatic rupture
E. Right tension pneumothorax
A 23-year-old man is brought
D. Transfer the patient to the operating room, while
immediately to the ED from the
initiating fluid therapy
hospitals parking lot where he
was shot in the lower abdomen.
Examination reveals a single
bullet wound. He is breathing
and has a thready pulse.
However, he is unconsious and
has no detectable blood
pressure. Optimale immediate
management is to:
A. Perform a diagnostic
peritoneal lavage
B. Initiate infusion of packed red
blood cells
C. Insert a nasogastric tube and
urinary catheter
D. Transfer the patient to the
operating room, while initiating
fluid therapy
E. Initiate fluid therapy to return
his blood pressure to
normotensive
https://quizlet.com/466306232/atls-flash-cards/
16/98
4/29/23, 3:03 PM
A teen-aged bicycle rider is hit
ATLS
ATLS Flashcards | Quizlet
D. Perform endotracheal intubation and ventilation
by a truck traveling at high
speed. In the ED, she is actively
bleeding from open fractures of
her legs, and has abrasions on
her chest and abdominal wall.
Her blood pressure is 80/50
mmHg, heart rate is 140 beats
per minute, respiratory rate is 8
breaths per minute, and GCS
score is 6. The first step in
managing this patient is to:
A. Obtain a lateral cervical spine
x-ray
B. Insert av central venous
pressure line
C. Adminster 2 liters of
crystalloid solution
D. Perform endotracheal
intubation and ventilation
E. Apply a pneumatic antishock
garment (PASG) and inflate the
leg compartments.
https://quizlet.com/466306232/atls-flash-cards/
17/98
4/29/23, 3:03 PM
An 8-year-old boy falls 4,5
ATLS
ATLS Flashcards | Quizlet
D. Admit the patient to the intensive care unit
meters (15 feet) from a tree and
is brought to the ED by his
family. His vital signs are normal,
but he complains of left upper
quadrant pain. An abdominal
CT-scan reveals a moderately
severe laceration of the spleen.
The receiving institution does
not have 24-hour-a-day
operating room capabilities. The
most appropriate management
of this patient would be to
A. Type and crossmatch for
blood
B. Request consultation of a
pediatrician
C. Transfer the patient to a
trauma center
D. Admit the patient to the
intensive care unit
E. Prepare the patient for
surgery the next day
https://quizlet.com/466306232/atls-flash-cards/
18/98
4/29/23, 3:03 PM
Which of the following
ATLS
statements regarding injury to
ATLS Flashcards | Quizlet
A. Children suffer spinal cord injury without x-ray
abnormality more commonly than adults.
the central nervous system in
children is TRUE?
A. Children suffer spinal cord
injury without x-ray abnormality
more commonly than adults.
B. An infant with a traumatic
brain injury may become
hypotensive from cerebral
edema
C. Initial therapy for the child
with traumatic brain injury
includes the administration of
methylprednisolone
intravenously
D. Children have more focal
mass lesions as a result for
traumatic brain injury when
compared to adults.
E. Young children are less
tolerant of expanding
intracranial mass lesions than
adults
https://quizlet.com/466306232/atls-flash-cards/
19/98
4/29/23, 3:03 PM
A 17-year-old helmeted
ATLS
ATLS Flashcards | Quizlet
A. Air splints
motorcyclist is struck broadside
by an automobile at an
intersection. He is unconscious
at the scene with a blood
pressure of 140/90mmHg, heart
rate of 90 beats per minute, and
respiratory rate of 22 breaths
per minute. His respirations are
sonorous and deep. His GCS
score is 6. Immobilization of the
entire patient may include the
use of all the following EXCEPT:
A. Air splints
B. Bolstering devices
C. A long spine board
D. A scoop-style stretcher
E. A semi-rigid cervical collar
https://quizlet.com/466306232/atls-flash-cards/
20/98
4/29/23, 3:03 PM
Twenty-seven patients are
ATLS
seriously injured in an aircraft
ATLS Flashcards | Quizlet
E. Produce the greatest number of survivors based
on available resources
accident at a local airport. The
basic principle of triage should
be to:
A. Treat the most severely
injured patients first
B. Establish a field triage area
directed by a doctor
C. Rapidly transport all patients
to the nearest appropriate
hospital
D. Treat the greatest number of
patients in the shortest period
of time
E. Produce the greatest number
of survivors based on available
resources
https://quizlet.com/466306232/atls-flash-cards/
21/98
4/29/23, 3:03 PM
An electrician is eletrocuted by
ATLS
a downed power line after a
ATLS Flashcards | Quizlet
B. Aggressive fluid infusion - suspected
rhabdomyolyse
thunderstorm. He apparently
made contact with the wire at
the level of the right mid thigh.
In the ED, his vital signs are
normal and no dysrythmia is
noted on ECG. On examination,
there is an exit wound on the
bottom of the right foot. His
urine is positive for blood by
dipstick but not RBCs are seen
microscopically. Initial
management should include:
A. Immediate angiography
B. Aggressive fluid infusion
C. Intravenous pyelography
D. Debridement of necrotic
muscle
E. Admission to the ICU for
observation
https://quizlet.com/466306232/atls-flash-cards/
22/98
4/29/23, 3:03 PM
A young woman sustains a
ATLS
ATLS Flashcards | Quizlet
B. Prevent secondary brain injury
severe head injury as the result
of a motor vehicular crash. In
the ED, her GCS is 6. Her blood
pressure is 140/90 mmHg and
her heart rate 80 beats per
minute. She is intubated and is
being mechanically ventilated.
Her pupils are 3mm in size and
equally reactive to light. There is
no other apparent injury. The
most important principle to
follow in early management of
her head injury is to:
A. Administer an osmotic
diuretic
B. Prevent secondary brain
injury
C. Agressively treat systemic
hypertension
D. Reduce meatbolic
requirements of the brain
E. Distinguish between
intracranial hematoma and
cerebral edema.
https://quizlet.com/466306232/atls-flash-cards/
23/98
4/29/23, 3:03 PM
To establish a diagnosis of
ATLS
shock,
ATLS Flashcards | Quizlet
E. Clinical evidence of inadequate organ perfusion
must be present.
A. Systolic blood pressure must
be below 90mmHg
B. The presence of a closed
head injury should be excluded
C. Acidosis should be present
by arterial blood gas analysis
D. The patient must fail to
respond to intravenous fluid
infusion
E. Clinical evidence of
inadequate organ perfusion
must be present.
https://quizlet.com/466306232/atls-flash-cards/
24/98
4/29/23, 3:03 PM
A 32-year-old is brought to the
ATLS
ATLS Flashcards | Quizlet
A. Inserting an oropharyngeal airway
hospital unconscious with
severe facial injuries and noisy
respirations after an automobile
collision. In the ED, he has no
apparent injury to the anterior
aspect of his neck. He suddenly
becomes apneic, and attempted
ventilation with a face mask is
unsuccessful. Examination of his
mouth reveals a large
hematoma of the pharynx with
loss of normal anatomic
landmarks. Initial management
of his airways should be consist
of:
A. Inserting an oropharyngeal
airway
B. Inserting a nasopharyngeal
airway
C. Performing a surgical
cricothyroidotomy
D. Performing fiberoptic-guided
nasotracheal intubation
E. Performin orotracheal
intubation after obtaining a
lateral c-spine x-ray
https://quizlet.com/466306232/atls-flash-cards/
25/98
4/29/23, 3:03 PM
A 25-year-old woman is
ATLS
ATLS Flashcards | Quizlet
C. Perform endotracheal intubation
brought to the ED after a motor
vehicle crash. She was initially
lucid at the scene and then
developed a dilated pupil and
contralateral extremity
weakness. In the ED, she is
unconscious and has a GCS
score of 6. The initial
management step for this
patient should be to:
A. Obtain a CT-scan of the head
B. Administer decadron 20mg IV
C. Perform endotracheal
intubation
D. Administer mannitol 1g/kg IV
E. Perform an emergency bone
flap craniotomy on the side of
the dilated pupil.
A contraindication to
E. Fracture of the cribiform plate
nasogastric intubation is the
presence of a:
A. Gastric perforation
B. Diaphragmatic rupture
C. Open depressed skull
fracture
D. Fracture of the cervical spine
E. Fracture of the cribiform plate
https://quizlet.com/466306232/atls-flash-cards/
26/98
4/29/23, 3:03 PM
An 8-year-old girl is an
ATLS
unrestrained passenger in a
ATLS Flashcards | Quizlet
D. May exist in the abscence of objective findings on
x-ray studies
vehicle struck from behind. In
the ED, her blood pressure is
80/60mmHg, heart rate is 80
beats per minute, and
respiratory rate is 16 breaths per
minute. Her GCS score is 14. She
complains that her legs feel
"funny and wont move right".
However, her spine x-rays do
not show a fracture or
dislocation. A spinal cord injury
in this child:
A. Is most likely a central cord
syndrome
B. Must be diagnosed by
magnetic resonance imaging
C. Can be excluded by
obtaining a CT-scan of the
entire spine
D. May exist in the abscence of
objective findings on x-ray
studies
E. Is unlikely because of the
incomplete calcification of the
vertebral bodies.
Immediate chest tube insertion
C. Massive hemothorax
is indicated for which of the
following conditions?
A. Pneumothorax
B. Pneumomediastinum
C. Massive hemothorax
D. Diaphragmatic rupture
E. Subcutaneous emphysema
https://quizlet.com/466306232/atls-flash-cards/
27/98
4/29/23, 3:03 PM
Cardiac tamponade after
ATLS
ATLS Flashcards | Quizlet
C. Can be confused with a tension pneumthorax
trauma:
A. Is seldom life-threating
B. Can be excluded by an
upright, AP chest x-ray
C. Can be confused with a
tension pneumthorax
D. Causes a fall in systolic
pressure of > 15mmHg with
expiration
E. Most commonly occurs after
blunt injury to the anterior chest
wall
A 22-year-old man is brought to
E. Hemorrhage into the chest or abdomen
the hospital after crashing his
motorcycle into a telephone
pole. He is unconscious and in
profound shock. He has no
open wounds or obvious
fractures. The cause of his shock
is MOST LIKELY caused by:
A. A subdural hematoma
B. An epidural hematoma
C. A transected lumbar spinal
cord
D. A basilar skull fracture
E. Hemorrhage into the chest or
abdomen
https://quizlet.com/466306232/atls-flash-cards/
28/98
4/29/23, 3:03 PM
Which of the following
ATLS
statements is FALSE concerning
ATLS Flashcards | Quizlet
C. A negative Kleihauer-Betke test excludes RhIsoimmunzation
Rh-isoimmunization in the
pregnant trauma patient?
A. It occurs in blunt or
penetrating abdominal trauma
B. Minor degrees of
fetomaternal hemorrhage
produce it
C. A negative Kleihauer-Betke
test excludes RhIsoimmunzation
D. This is not a problem in the
traumatized Rh-positive
pregnant patient
E. Initiation of Rhimmunoglobulin therapy does
not require proof of
fetomaternal hemorrhage
All of the following signs on the
A. Mediastinal emphysema
chest x-ray of a blunt injury
victim may suggest aortic
rupture EXCEPT:
A. Mediastinal emphysema
B. Presence of a "pleural cap"
C. Obliteration of the aortic
knob
D. Deviation of the trachea to
the right
E. Depression of the left
mainstem bronchus
https://quizlet.com/466306232/atls-flash-cards/
29/98
4/29/23, 3:03 PM
Early central venous pressure
ATLS
ATLS Flashcards | Quizlet
D. Patient with a severe cardiac contusion
monitoring during fluid
resusciation in the ED has the
greatest utility in a:
A. Patient with a splenic
laceration
B. Patient with a inhalation injury
C. 6 year-old child with a pelvic
fracture
D. Patient with a severe cardiac
contusion
E. 24-year-old man with a
massive hemothorax
A cross-table lateral x-ray of the
E. Is unacceptable unless 7 cervical vertebrae and the
cervical spine:
C-7 to T-1 relationship are visualized.
A. must precede endotracheal
intubation
B. excludes serious cervical
spine injury
C. Is an essential part of the
primary survey
D. Is not necessary for
unconscious patients with
penetrating cervical injuries
E. Is unacceptable unless 7
cervical vertebrae and the C-7
to T-1 relationship are visualized.
https://quizlet.com/466306232/atls-flash-cards/
30/98
4/29/23, 3:03 PM
A 24-year old man sustains
ATLS
ATLS Flashcards | Quizlet
E. Endotracheal intubation and mechanical ventilation
multiple fractured ribs bilaterally
as a result of being crushed in a
press at a plywood factory.
Examination in the ED reveals a
flail segment of the patients
thorax. Primary resuscitation
includes high-flow oxygen
administration via a
nonrebreathing mask, and
initiation of Ringers lactate
solution. The patient exhibits
progressive confusion, cyanosis
and tachypnea. Management at
this time should consist of:
A. Intravenous sedation
B. External stabilization of the
chest wall
C. Increasing the FIO2 in the
inspired gas
D. Intercostal nerve blocks for
pain relief
E. Endotracheal intubation and
mechanical ventilation.
https://quizlet.com/466306232/atls-flash-cards/
31/98
4/29/23, 3:03 PM
Which of the following
ATLS
statements regarding patients
ATLS Flashcards | Quizlet
A. Log-rolling may be destabilizing to fractures from
T12 to L1
with thoracic spine injuries is
TRUE?
A. Log-rolling may be
destabilizing to fractures from
T12 to L1
B. Adequate immobilization can
be accomplished with the
scoop stretcher
C. Spinal cord injury below T10
usually spares bowel and
bladder function
D. Hyperflexion fractures in the
upper thoracic spine are
inherently unstable
E. These patients rarely present
with neurogenic shock in
association with cord injury.
During resuscitation, which one
D. Urinary out
of the following is the most
reliable as a guide to volume
replacement?
A. Heart rate
B. Hematocrit
C. Blood pressure
D. Urinary output
E. Jugular venous pressure
https://quizlet.com/466306232/atls-flash-cards/
32/98
4/29/23, 3:03 PM
A 24-year-old woman
ATLS
ATLS Flashcards | Quizlet
B. Upper airway protection
passenger in an automobile
strikes the wind screen with her
face during a head-on collision.
In the ED, she is talking and has
marked facial edema and
crepitus. The highest priority
should be given to:
A. Lateral c-spine x-ray
B. Upper airway protection
C. Carotid pulse assessment
D. Management of blod loss
E. Determination of associated
injuries
https://quizlet.com/466306232/atls-flash-cards/
33/98
4/29/23, 3:03 PM
The driver of a single car crash
ATLS
ATLS Flashcards | Quizlet
C. Assess placement of the endotracheal tube
is orotracheally intubated in the
field by prehospital personnel
after they identify a closed head
injury and determine that the
patient is unable to protect his
airway. In the ED, the patient
demonstrate decorticate
posturing bilaterally. He is being
ventilated with a bag-valve
device, but his breath sounds
are absent in the left
hemithorax. His blood pressure
is 160/80mmHg, heart rate is 70
beats per minute, and the pulse
oximeter displays a hemoglobin
oxygen saturation of 96%. The
next step in assessing and
managing this patient should be
to:
A. Determine the arterial blood
gases
B. Obtain a lateral cervical spine
x-ray
C. Assess placement of the
endotracheal tube
D. Perform needle
decompression of the left chest
E. Insert a thoracostomy in the
left hemithorax.
https://quizlet.com/466306232/atls-flash-cards/
34/98
4/29/23, 3:03 PM
The response to catecholamines
ATLS
ATLS Flashcards | Quizlet
B. Fetal hypoxia and distress
in an injured, hypovolemic
pregnant woman can be
expected to result in:
A. Placental abruption
B. Fetal hypoxia and distress
C. Fetal/maternal dysrhytmia
D. Improved uterine blood flow
E. Increased maternal renal
blood flow
A 22-year-old man sustains a
D. Repeat the primary survey and proceed with
gunshot wound to the left chest
transfer
and is transported to a small
community hospital at which
surgical capabilites are not
available. In the ED, a chest tube
is inserted and 700ml of blood
is evacuted. The trauma center
accepts the patient in transfer.
Just before the patient is placed
in an ambulance for transfer, his
blood pressure decreases to
80/68mmHg and his heart rate
increases to 136 beats per
minute. The next step should be
to:
A. Clamp the chest tube
B. Cancel the patients transfer
C. Perform an ED thoracotomy
D. Repeat the primary survey
and proceed with transfer
E. Delay the transfer until the
referring doctor can contact a
thoracic surgeon.
https://quizlet.com/466306232/atls-flash-cards/
35/98
4/29/23, 3:03 PM
A young woman sustains a
ATLS
ATLS Flashcards | Quizlet
A. Avoid hypotension
severe head injury as the result
of a motor vehicular crash. In
the ED, her GCS is 6. Her blood
pressure is 140/90 mmHg and
her heart rate 80 beats per
minute. She is intubated and is
being mechanically ventilated.
Her pupils are 3mm in size and
equally reactive to light. There is
no other apparent injury. The
most important principle to
follow in early management of
her head injury is to:
A. Avoid hypotension
B. Prevent secondary brain
injury
C. Agressively treat systemic
hypertension
D. Reduce meatbolic
requirements of the brain
E. Distinguish between
intracranial hematoma and
cerebral edema.
https://quizlet.com/466306232/atls-flash-cards/
36/98
4/29/23, 3:03 PM
A 6-year-old boy walking across
ATLS
the street is struck by the front
ATLS Flashcards | Quizlet
C. A pulmonary contusion may be present in the
absence of rib fractures
bumper of a sports utility
vehicle traveling at 32kph
(20mph). Which one of the
following statements is TRUE?
A. A flail chest is probable
B. A symptomatic cardiac
contusion is expected
C. A pulmonary contusion may
be present in the absence of rib
fractures
D. Transection of the thoracic
aorta is more likely than in an
adult patient
E. Rib fractures are commonly
found in children with this
mechanism of injury
https://quizlet.com/466306232/atls-flash-cards/
37/98
4/29/23, 3:03 PM
A 39-year-old man is admitted
ATLS
to the ED after an automobile
ATLS Flashcards | Quizlet
D. Attempt orotracheal intubation using 2 people and
inline stabilization of the cervical spine
collision. He is cyanotic, has
insufficient respiratory effort,
and has a GCS score of 6. His
full beard makes it difficult to fit
the oxygen facemask to his
face. The most appropriate next
step is to:
A. Perform a surgical
cricothyroidotomy
B. Attempt nasotracheal
intubation
C. Ventilate him with a bag-mask
device until c-spine injury can
be excluded
D. Attempt orotracheal
intubation using 2 people and
inline stabilization of the
cervical spine
E. Ventilate the patient with a
bag-mask device until his beard
can be shaved for a better mask
fit.
https://quizlet.com/466306232/atls-flash-cards/
38/98
4/29/23, 3:03 PM
A patient is brought to the ED
ATLS
20 minutes after a motor vehicle
ATLS Flashcards | Quizlet
E. Flaccidity of the lower extremities and loss of deep
tendon reflexes are expected.
crash. He is conscious and there
is no obvious external trauma.
He arrives at the hospital
completely immobilized on a
long spine board. His blood
pressure is 60/40mmHg and his
heart rate is 70 beats per
minute. His skin is warm. Which
one of the following statements
is true?
A. Vasoactive medications have
no role in the patients
management
B. The hypotension should be
managed with volume
resuscitation alone
C. Flexion and extension views
on the c-spine should be
performed early
D. Occult abdominal visceral
injuries can be excluded as a
cause of hypotension
E. Flaccidity of the lower
extremities and loss of deep
tendon reflexes are expected.
https://quizlet.com/466306232/atls-flash-cards/
39/98
4/29/23, 3:03 PM
The following are
ATLS
contraindications for tetanus
ATLS Flashcards | Quizlet
A. History of neurological reaction or severe
hypersensitivity to the product
toxoid administration:
A. History of neurological
reaction or severe
hypersensitivity to the product
B. Local side effects
C. Muscular spasm
D. Pregnancy
E. All of the above
After being involved in a motor
C. Exploratory laparotomy
vehicle crash, a 25-year-old
man is brought to a hospital with
a general surgeon on duty. He
has a GCS of 13 and complains
of abdominal pain. His blood
pressure was 80mmHg systolic
by palpation on arrival at the
hospital, but increases to 110/70
wit the administration of 2L of
IV-fluid. His heart rate remains
120 beats per minute. CT shows
an aortic injury and splenic
laceration with free abdominal
fluid. His blood pressure falls to
70mmHg after CT. The next step
is to
A. Contrast angiography
B. Transfer to a higher level
trauma center
C. Exploratory laparotomy
D. Transfuse packed red blood
cells
E. Transesophageal
echocardiography
https://quizlet.com/466306232/atls-flash-cards/
40/98
4/29/23, 3:03 PM
Which one of the following
ATLS
statements regarding abdominal
ATLS Flashcards | Quizlet
B. Leakage of amniotic fluid is an indication for
hospital admission
trauma in the pregnant patient is
TRUE?
A. The fetus is in jeopardy only
with major abdominal trauma
B. Leakage of amniotic fluid is
an indication for hospital
admission
C. Indications for peritoneal
lavage are different from those
in the non-pregnant patient
D. Penetration of an abdominal
hollow viscus is mor common
late than in early pregnancy
E. The secondary survey follows
a different pattern from that of
the non-pregnant patient
All of the following are
B. Carboxyhemoglobin level >4% (grensen er 10%)
indicators of inhalation injury
EXCEPT:
A. Singeing of the eyebrows
and nasal vibrissae
B. Carboxyhemoglobin level
>4%
C. Carbon deposits in the
mouth or nose and
carbonaceous sputum
D. Hoarseness
E. Face or neck burns
https://quizlet.com/466306232/atls-flash-cards/
41/98
4/29/23, 3:03 PM
A 32-year-old man right leg is
ATLS
ATLS Flashcards | Quizlet
D. Perform right lower extremity fasciotomy
trapped beneath his overturned
car for nearly 2 hours before he
is extricated. On arrival in the
ED, his right lower extremity is
cool, mottled, insensate, and
motionless. Despite normal vital
signs, pulses cannot be
palpated inferior to the femoral
artery, and the muscles of the
lower extremity are firm and
hard. During initial management
of this patient, which of the
following is most likely to
improve chances for limb
salvage?
A. Apply skeletal traction
B. Administering anticoagulant
drugs
C. Adminstering thrombolytic
therapy
D. Perform right lower extremity
fasciotomy
E. Immediately transferring the
patient to a trauma center.
https://quizlet.com/466306232/atls-flash-cards/
42/98
4/29/23, 3:03 PM
A patient arrives in the ED after
ATLS
ATLS Flashcards | Quizlet
C. Suction of the oropharynx
being beaten about the head
and face with a wooden club.
He is comatose and has a
palpable depressed skull
fracture. His face is swollen and
ecchymotic. He has gurgling
respirations and vomitus on his
face and clothing. The most
appropriate step after providing
supplemental oxygen and
elevating his jaw is to:
A. Request a CT-scan
B. Insert a gastric tube
C. Suction of the oropharynx
D. Obtain a lateral cervical spine
x-ray
E. Ventilate the patient with a
bag-mask
https://quizlet.com/466306232/atls-flash-cards/
43/98
4/29/23, 3:03 PM
A 64-year-old man, involved in
ATLS
a high-speed car crash, is
ATLS Flashcards | Quizlet
D. Call the receiving hospital and speak to the
surgeon on call
resuscitated initially in a small
hospital with limited resources.
He has a closed head injury with
a GCS score of 13. He has a
widened mediastinum on chest
x-ray with fractures of left ribs 2
through 4 but no
pneumothorax. After infusing 2
liters of crystalloid solution, his
blood pressure is 100/74, heart
rate is 110 beats per minute, and
respiratory rate is 18 breaths per
minute. He has gross hematuria
and a pelvic fracture. You
decide to transfer this patient to
a facility capable of providing a
higher level of care. The facility
is 128km (80 miles) away. Before
transfer, you should first:
A. Intubate the patient
B. Perform diagnostic peritoneal
lavage
C. Apply the pneumatic
antishock garment
D. Call the receiving hospital
and speak to the surgeon on
call
E. Discuss the advisability of
transfer with the patients family.
https://quizlet.com/466306232/atls-flash-cards/
44/98
4/29/23, 3:03 PM
During the third trimester of
ATLS
ATLS Flashcards | Quizlet
B. Decrease in the leukocyte count
pregnancy, all of the following
changes occur normally,
EXCEPT a:
A. Decrease in PaCO2
B. Decrease in the leukocyte
count
C. Reduce gastric emptying rate
D. Diminished residual lung
volume
E. Diminished pelvic ligament
tension
In managing the head-injury
A. Secure the airway
patient, the most important
initial step is to:
A. Secure the airway
B. Obtain c-spine film
C. Support the circulation
D. Control scalp hemorrhage
E. Determine GCS score
The first maneuver to improve
C. Administer supplemental oxygen
oxygenation after chest injury is:
A. Intubate the patient
B. Assess arterial blood gases
C. Administer supplemental
oxygen
D. Ascertain the need for a
chest tube
E. Obtain a chest x-ray
https://quizlet.com/466306232/atls-flash-cards/
45/98
4/29/23, 3:03 PM
A 25-year-old man, injured in a
ATLS
ATLS Flashcards | Quizlet
9
motor vehicular crash, is
admitted to the ED. His pupils
react sluggishly and his eyes
open to painful stimuli only. He
does not follow commands, but
he does moan periodically. His
right arm is deformed and does
not respond to painful stimulus;
however, his left hand reaches
purposefully toward the painful
stimulus. Both legs are stiffly
extended. His GCS score is:
A. 7
B. 8
C. 9
D. 10
E. 11
https://quizlet.com/466306232/atls-flash-cards/
46/98
4/29/23, 3:03 PM
A 20-year-old woman, at 32
ATLS
ATLS Flashcards | Quizlet
C. Perform needle decompression of the right chest
weeks gestation, is stabbed in
the upper right chest. In the ED,
her blood pressure is
80/60mmHg. She is gasping for
breath, extremely anxious, and
yelling for help. Breath sounds
are diminished in the right chest.
The most appropriate first step
is to:
A. perform tracheal intubation
B. Insert an oropharyngeal
airway
C. Perform needle
decompression of the right
chest
D. Manually displace the gravid
uterus to the left side of the
abdomen
E. Initiate 2 large-caliber
peripheral IV lines and
crystalloid infusion
Which one of the following
E. Respiratory rate of 40 breaths per minute
findings in an adult should
prompt immediate management
during primary survey?
A. Distended abdomen
B. GCS of 11
C. Temperature of 36,5
D. Heart rate of 120 beats per
minute
E. Respiratory rate of 40 breaths
per minute
https://quizlet.com/466306232/atls-flash-cards/
47/98
4/29/23, 3:03 PM
A trauma patient present to your
ATLS
emergency department with
ATLS Flashcards | Quizlet
E. Maintain inline immobilization and establish a
definitive airway
inspiratory stridor and a
suspected C-spine injury.
Oxygen saturation is 88% on
high-flow oxygen via a
nonrebreathing mask. The most
appropriate next step is to:
A. Apply cervical traction
B. Perform immediate
tracheostomy
C. Insert bilateral thoracostomy
tubes
D. Maintain 100% oxygen and
obtain immediate c-spine x-rays
E. Maintain inline immobilization
and establish a definitive airway
When apply the Rule of Nines to
C. The head is proportionally larger in infants than in
infants,
adults
A. It is not reliable
B. The body is proportionally
larger in infants than in adults
C. The head is proportionally
larger in infants than in adults
D. The legs are proportionally
larger in infants than in adults
E. The arms are proportionally
larger in infants than in adults
https://quizlet.com/466306232/atls-flash-cards/
48/98
4/29/23, 3:03 PM
A 60-year-old man sustains a
ATLS
ATLS Flashcards | Quizlet
D. Perform serial physical examinations
stab wound to the right
posterior flank. Witnesses state
the weapon was a small knife.
His heart rate is 90 beats per
minute, blood pressure is
128/72mmHg and respiratory
rate is 24 breaths per minute.
The most appropriate action to
take at this time is to:
A. Perform a colonoscopy
B. Perform a barium enema
C. Perform an intravenous
pyelogram
D. Perform serial physical
examinations
E. Suture repair the wound and
outpatient follow up
The following are criteria for
D. Elevated central venous pressure
transfer to a burn center,
EXCEPT for:
A. Partial-thickness and fullthickness burns on greater than
10% of the BSA
B. Any full-thickness burn
C. Partial-thickness and fullthickness burn involving the
face, hands, feet, genitalia,
perineum and skin overlying
major joints
D. Elevated central venous
pressure
E. Inhalation injury
https://quizlet.com/466306232/atls-flash-cards/
49/98
4/29/23, 3:03 PM
Systolic blood pressure starts to
ATLS
ATLS Flashcards | Quizlet
C. Class 2
decrease in which class of
hemorrhage?
A. Class 0
B. Class 1
C. Class 2
D. Class 3
E. Class 4
A 7-year-old boy is brought to
B. Direct pressure on the wound
the ED by his parents several
minutes after he fell through a
window. He is bleeding
profusely from a 6-cm wound of
his medial right thigh. Immediate
management of the wound
should consist of:
A. Application of a torniquet
B. Direct pressure on the wound
C. Packing the wound with
gauze
D. Direct pressure on the
femoral artery at the groin
E. Debridement of devitalized
tissue
https://quizlet.com/466306232/atls-flash-cards/
50/98
4/29/23, 3:03 PM
For the patient with severe
ATLS
traumatic brain injury, profound
ATLS Flashcards | Quizlet
C. Cerebral vasoconstriction with diminished
perfusion
hypocarbia should be avoided
to prevent:
A. Respiratory alkalosis
B. Metabolic acidosis
C. Cerebral vasoconstriction
with diminished perfusion
D. Neurogenic pulmonary
edema
E. Shift of the oxyhemoglobin
dissociation curve.
A 33-year-old woman is
B. Cardiac tamponade
involved in a head-on motor
vehicle crash. It took 30 minutes
to extricate her from the car.
Upon arrival in the ED, her heart
rate is 120 beats per minute, BP
is 90/70mmHg, respiratory rate
is 16 breaths per minute, and
GCS is 15. Examination reveals
bilaterally equal breath sounds,
anterior chest wall ecchymosis,
and distended neck veins. Her
abdomen is flat, soft, and not
tender. Her pelvis is stable.
Palpable distal pulses are found
in all 4 extremities. Of the
following, the most likely
diagnosis is:
A. hemorrhagic shock
B. Cardiac tamponade
C. Massive hemothorax
D. Tension pneumothorax
E. Diaphragmatic rupture.
https://quizlet.com/466306232/atls-flash-cards/
51/98
4/29/23, 3:03 PM
A hemodynamically normal 10ATLS
ATLS Flashcards | Quizlet
D. Free peritoneal air demonstrated on follow up CT
year-old girls is admitted to the
pediatric intensive care unit for
observation after a grade III
(moderately severe) splenic
injury has been confirmed by
CT. Which of the following
mandates prompt laparotomy?
A. Serum amylase of 200
B. Leukocyte count of 14,000
C. Extraperitoneal bladder
rupture
D. Free peritoneal air
demonstrated on follow up CT
E. A fall in the hemoglobin level
from 12g/dl to 8g/dl over 24
hours
A 40-year-old woman
C. Anterior cord syndrome
restrained driver is transported
to the ED in full spinal
immobilization. She is
hemodynamically stable and
found to be paraplegic at the
level of T10. Neurologic
examination also determines
that there is loss of pain and
temperature sensation with
preservation of proprioception
and vibration. These finding are
consistent with the diagnosis of :
A. Central cord syndrome
B. Spinal shock syndrome
C. Anterior cord syndrome
D. Complete cord syndrome
E. Brown-Sequard syndrome
https://quizlet.com/466306232/atls-flash-cards/
52/98
4/29/23, 3:03 PM
Hemorrhage of 20% of the
ATLS
ATLS Flashcards | Quizlet
D. Tachycardia
patients blood volume is
associated usually with:
A. Oliguria
B. Confusion
C. Hypotension
D. Tachycardia
E. Blood transfusion
requirement
Which of the follow statements
B. Aspiration of bone marrow confirms appropriate
concerning intraosseous
positioning of the needle
infusion is TRUE?
A. Only crystalloid solutions
may be safely infused through
the needle
B. Aspiration of bone marrow
confirms appropriate
positioning of the needle
C. Intraosseous infusion is the
preferred route for volume
resuscitation in small children
D. Intraosseous infusion may be
utilized indefinitely
E. Swelling in the soft tissues
around the intraosseous site is
not a reason to discontinue
infusion.
https://quizlet.com/466306232/atls-flash-cards/
53/98
4/29/23, 3:03 PM
The most important, immediate
ATLS
step in the management of an
ATLS Flashcards | Quizlet
D. Placement of an occlusive dressing over the
wound
open pneumothorax is:
A. endotracheal intubation
B. Operation to close the wound
C. Placing a chest tube through
the chest wound
D. Placement of an occlusive
dressing over the wound
E. Initiation of 2 large-caliber IVs
with crystalloid solution
Which one of the following
C. Positive pregnancy test, Rh negative, and has torso
situations requires Rh
trauma
immunoglobulin administration
to an injured woman?
A. Negative pregnancy test, Rh
negative, and torso trauma
B. Positive pregnancy test, Rh
positive, and has torso trauma
C. Positive pregnancy test, Rh
negative, and has torso trauma
D. Positive pregnancy test, Rh
positive, and has an isolated
wrist fracture
E. Positive pregnancy test, Rh
negative, and has an isolated
wrist fracture
https://quizlet.com/466306232/atls-flash-cards/
54/98
4/29/23, 3:03 PM
A 22-year-old man is
ATLS
ATLS Flashcards | Quizlet
A. Reexamine the chest
hypotensive and tachycardic
after a shotgun wound to the
left shoulder. His BP is initially
80/40mmHg. After 2 liters of
crystalloid solution his blood
pressure increases to
122/84mmHg. His heart rate is
now 100 beats per minute and
his respiratory rate is 28 breaths
per minute. His breath sounds
are decreased in the left
hemithorax, and after initial IV
fluid resusciation, a closed tube
thoracostomy is performed for
decreased left breath sound
with the return of small amount
of blood and no air leak. After
chest tube insertion, the most
appropriate next step is to:
A. Reexamine the chest
B. Perform an aortogram
C. Obtain a CT-scan of the chest
D. Obtain arterial blood gas
analyses
E. Perform transesophageal
echocardiography
https://quizlet.com/466306232/atls-flash-cards/
55/98
4/29/23, 3:03 PM
A construction worker falls two
ATLS
ATLS Flashcards | Quizlet
E. Complete spine x-ray series
stories from a building and
sustain bilateral calcaneal
fractures. In the ED, he is alert,
vital signs are normal, and he is
complaining of severe pain in
both heels and his lower back.
Lower extremity pulses are
strong and there is no
deformity. The suspected
diagnosis is most likely to be
confirmed by:
A. Angiography
B. Compartment pressures
C. Retrograde urethrogram
D. Doppler-ultrasound studies
E. Complete spine x-ray series
https://quizlet.com/466306232/atls-flash-cards/
56/98
4/29/23, 3:03 PM
A 22-year-old female athlete is
ATLS
ATLS Flashcards | Quizlet
D. Prepare for an exploratory thoracotomy
stabbed in her left chest at the
third interspace in the anterior
axillary line. On admission to the
ED and 15 minutes after the
incident, she is awake and alert.
Her heart rate is 100 beats per
minute, BP 80/60mmHg, and
respiratory rate is 20 breaths per
minute. A chest x-ray reveals a
large left hemithorax. A left
chest tube is placed with an
immediate return of 1600ml of
blood. The next management
step for this patient is:
A. perform a thoracoscopy
B. Perform an arch aortogram
C. Insert a second left chest
tube
D. Prepare for an exploratory
thoracotomy
E. Perform a chest CT
https://quizlet.com/466306232/atls-flash-cards/
57/98
4/29/23, 3:03 PM
A 56-year-old man is thrown
ATLS
ATLS Flashcards | Quizlet
C. Breath sounds
violently against the steering
wheel of his truck during a
motor vehicle crash. On arrival
in the ED he is diaphoretic and
complaining of chest pain. His
BP is 60/40mmHg and his
respiratory rate is 40 breaths
per minute. Which of the
following best differentiates
cardiac tamponade from
tension pneumothorax as the
cause of his hypotension?
A. Tachycardia
B. Pulse volume
C. Breath sounds
D. Pulse pressure
E. Jugular venous pressure
https://quizlet.com/466306232/atls-flash-cards/
58/98
4/29/23, 3:03 PM
All of the following are true of
ATLS
the Mallampati classification
ATLS Flashcards | Quizlet
A. Class IV is the easiest intubation, while Class 1 is the
most difficult
EXCEPT:
A. Class IV is the easiest
intubation, while Class 1 is the
most difficult
B. It helps assess for difficult
intubations
C. It is part of the LEMON
assessment
D. It comprises a visual
assessment of the distance from
the tongue base to the roof of
the mouth, and therefore the
amount of space there is to
work
E. A poor Mallampati score is
associated with a higher
incidens of obstructive sleep
apnea.
https://quizlet.com/466306232/atls-flash-cards/
59/98
4/29/23, 3:03 PM
A 23-year-old man sustains
ATLS
ATLS Flashcards | Quizlet
D. Urgently transfer the patient to the operating room
three stab wounds to the upper
right chest during an altercation
and is brought by ambulance to
a hospital that has full surgical
capabilities. His wounds are all
above the nipple. He is
endotracheally intubates,
closed tube thoracostomy is
performed, and 2 liters of
crystalloid solution are infused
through 2 large-caliber IVs. His
BP i 60/0mmHg, heart rate is 160
beats per minute, and
respiratory rate is 14 breaths per
minute (ventilated with 100%
O2). 1500ml of blood has
drained from the right chest. The
most appropriate next step in
managing this patient is to:
A. Perform FAST
B. Obtain a CT of the chest
C. Perform angiography
D. Urgently transfer the patient
to the operating room
E. Immediately transfer the
patient to a trauma center.
https://quizlet.com/466306232/atls-flash-cards/
60/98
4/29/23, 3:03 PM
Which of the following signs is
ATLS
ATLS Flashcards | Quizlet
E. ETT above carina on chest x-ray
LEAST reliable for diagnosing
esophageal intubation?
A. Symmetrical chest movement
B. End-tidal CO2 presence by
colorimetry
C. Bilateral breath sounds
D. Oxygen saturation > 92%
E. ETT above carina on chest xray
Which one of the following
C. Severe maxillofacial fractures
signs necessitates a definitive
airway in severe trauma
patients?
A. Facial lacerations
B. Repeated vomiting
C. Severe maxillofacial fractures
D. Sternal fracture
E. GCS score of 12
https://quizlet.com/466306232/atls-flash-cards/
61/98
4/29/23, 3:03 PM
Which one of the following
ATLS
statements is correct?
ATLS Flashcards | Quizlet
A. Cerebral contusion may coalesce to form an
intracerebral hematoma
A. Cerebral contusion may
coalesce to form an
intracerebral hematoma
B. Epidural hematomas are
usually seen in frontal region
C. Subdural hematomas are
caused by injury to the middle
meningeal artery
D. Subdural hematomas
typically have a lenticular shape
on CTscan
E. The associated brain damage
is more severe in epidural
hematomas.
An 18 year old male is brought
A. Obtain a chest x-ray
to the ED after having been
shot. He has one bullet wound
just below the right clavicle and
another just below the costal
margin in the right posterior
axillary line. His BP is 110/60, HR
is 90bpm, and RR is 34bpm.
After ensuring a patent airway
and inserting 2 large caliber iv
line, the next appropriate step is
to:
A. Obtain a chest x-ray
B. Adminster a bolus of
additional iv fluid
C. Perform a laparotomy
D. Obtain abdominal CT-scan
E. Perform DPL
https://quizlet.com/466306232/atls-flash-cards/
62/98
4/29/23, 3:03 PM
An 8 year old boy falls
ATLS
ATLS Flashcards | Quizlet
D. Admit the patient to the ICU
4,5meters from a tree and is
brought to the ED by his familiy.
His vital signs are normal, but he
complains of left upper
quadrant pain. An abdominal CT
scan reveals a moderately
severe laceration of the spleen.
The receiving institution does
not have 24 hour a day
operating room capabilities. The
most appropriate management
of this patient would be:
A. Type and crossmatch for
blood
B. Request consultation of a
pediatrician
C. Transfer the patient to a
trauma center
D. Admit the patient to the ICU
E. Prepare the patient for
surgery the next day
https://quizlet.com/466306232/atls-flash-cards/
63/98
4/29/23, 3:03 PM
A construction worker falls from
ATLS
ATLS Flashcards | Quizlet
A. FAST
a scaffold and is transferred to
the ED. His HR is 124 bpm and
BP is 85/60mmHg. He
complains of lower abdominal
pain. After assessing the airway
and chest, immobilizing the cspine and initiating fluid
resuscitation, the next step is to
perform
A. FAST
B. Detailed neurological exam
C. Rectal exam
D. Cervical c-spine x-ray
E. Urethral catheterization.
https://quizlet.com/466306232/atls-flash-cards/
64/98
4/29/23, 3:03 PM
A 22 year old male sustains a
ATLS
ATLS Flashcards | Quizlet
E. Repeat the physical examination of the chest
shotgun wound to the left
shoulder and chest at close
range. His BP is 80/40mmHg
and his HR is 130bpm. After 2
liters of crystalloid solution are
rapidly infused, his BP increases
to 122/84, and HR decreases to
100bpm. He is tachypneic with
RR of 28. On physical
examination, his breath sounds
are decreased at the left upper
chest with dullness on
percussion. A large caliber (36
french) tube thoracostomy is
inserted in the fifth intercostal
space with the return of 200ml
of blood and no air leak. The
most appropriate next step is to:
A. insert a foley catheter
B. Begin to transfuse o-negative
blood
C. Perform thoracotomy
D. Obtain a CT-scan of chest
and abdomen
E. Repeat the physical
examination of the chest
https://quizlet.com/466306232/atls-flash-cards/
65/98
4/29/23, 3:03 PM
Which one of the following
ATLS
statements concerning spine
ATLS Flashcards | Quizlet
D. Diaphragmatic breathing in an unconscious patient
who has fallen is a sign of spine injury
and spinal cord trauma is true?
A. A normal lateral c-spine film
excludes injury
B. A vertebral injury is unlikely in
the absence of physical findings
of a cord injury
C. A patient with a suspected
injury requires immobilization on
a short spine
D. Diaphragmatic breathing in
an unconscious patient who has
fallen is a sign of spine injury
E. Determination of whether a
spinal cord lesion is complete
or incomplete must be made in
the primary survey
https://quizlet.com/466306232/atls-flash-cards/
66/98
4/29/23, 3:03 PM
A 20 year old athlete is involved
ATLS
ATLS Flashcards | Quizlet
A. Neurogenic shock
in a motorcycle crash. When he
arrives in the ED, he shouts that
he cannot move his legs. On
physical examination, there are
noe abnormalities of the chest,
abdomen or pelvis. The patient
has no sensation in his legs and
cannot move them, but his arms
are moving. The patients RR is
28 bpm, HR is 88bpm and BP is
80/60mmHg. He is pale and
sweaty. What is the most likely
cause of this condition?
A. Neurogenic shock
B. Cardiogenic shock
C. Abdominal hemorrhage
D. Myocardial contusion
E. Hyperthermia.
A 28 year old male is brought to
A. GCS
the ED. He was involved in a
fight in which he was beaten
with a wooden stick. His chest
shows multiple severe bruises.
His airway is clear, RR is 22, HR
is 126 and systolic BP is
90mmHg. Which one of the
following should be performed
during the primary survey?
A. GCS
B. Cervical spine x-ray
C. TT-administration
D. Blood alcohol level
E. Rectal exam
https://quizlet.com/466306232/atls-flash-cards/
67/98
4/29/23, 3:03 PM
Which one of the following
ATLS
statements is true regarding
ATLS Flashcards | Quizlet
C. Blood transfusion can be delievered through an
intraosseous access
access in pediatric
resuscitation?
A. Intraosseous access should
only be considered after five
percutaneous attempts
B. Cut down at the ankle is a
preferred initial access
technique
C. Blood transfusion can be
delievered through an
intraosseous access
D. Internal jugular cannulation is
the next preferred opinion when
percutaneous venous access
fails
E. Intraosseous cannulation
should be first choice for access
Regarding shock in the child,
D. The absolute volume of blood loss required to
which of the following is FALSE?
produce shock is the same as in adults
A. Vital signs are age-related
B. Children have greater
physiologic reserves than do
adults
C. Tachycardia is the primary
physiologic response to
hypervolemia
D. The absolute volume of
blood loss required to produce
shock is the same as in adults
E. An initial fluid bolus for
resuscitation should
approximate 20ml/kg of Ringers
lactate
https://quizlet.com/466306232/atls-flash-cards/
68/98
4/29/23, 3:03 PM
A young man sustain a gunshot
ATLS
ATLS Flashcards | Quizlet
C. Control internal hemorraghe operatively
wound to the abdomen and is
brought promptly to the ED by
prehospital personnel. His skin
is cool and diaphoretic, and he
is confused. His pulse is thready
and his femoral pulse is only
weakly palpable. The definitive
treatment in managing this
patient is to
A. Administer 0.neg blood
B. Apply external warming
devices
C. Control internal hemorraghe
operatively
D. Apply pneumatic anti shock
garment
E. Infuse large volumes of IV
crystalloid solution
A four-year-old girl, weighing
B. 400ml (20ml/kg)
approximately 20kg is admitted
in shock after an automobile
crash. The initialt fluid challenge
or bolus should consist of
Ringers lactate solution in the
volume of
A. 200ml
B. 400ml
C. 440ml
D. 600ml
E. 880ml
https://quizlet.com/466306232/atls-flash-cards/
69/98
4/29/23, 3:03 PM
All of the following are
ATLS
ATLS Flashcards | Quizlet
E. Needle-impenetrable sterile gloves
considered minimal precautions
for the prevention of the spread
of communicable diseases
during resuscitation, EXCEPT:
A. goggles
B. Face mask
C. Water-impervious gown
D. Water-impervious leggings
E. Needle-impenetrable sterile
gloves
30-year-old woman fell down
Epidural hematoma
four stair landing on concrete.
Unconscious for 5 minutes after
the fall, full consciousness
during 10 minute transport to
hospital, GCS 15, complaint is a
slight headache, 30 minute later
she is unresponsive with GCS 6
and left pupil is large.
A young male fallen from height
Pulmonary contusion
with obvious flail chest. ABG
shows pH 7,47. What is the cause
of this abnormality?
Cushings triad which occurs in
Bradycardia with irregular respirations and isolated
cases of increased intracranial
increase in SYSTOLIC BLOOD PRESSURE
pressure?
https://quizlet.com/466306232/atls-flash-cards/
70/98
4/29/23, 3:03 PM
In comparison with young
ATLS
ATLS Flashcards | Quizlet
D. Less brain contusions
adults, elderly patients exhibit
which of the following
regarding brain injuries?
A. Increased cerebral blood
flow
B. Less stretching of the
bridging veins
C. Less subdural hematomas
D. Less brain contusions
E. Less mobility with angular
acceleration and deceleration
Which of the following will be
Subcapsular hematoma of the spleen (becauase it is a
missed by DPL?
retroperitoneal organ)
Burn victim, core temperature is
C. Oxygen mask
34C. Whats next?
A. Escharotomy
B. Rewarm
C. Oxygen mask
D...
E..
Which of the following is
D. Widened symphysis pubis
NORMAL in pregnancy?
A. increased residual lung
volume
B. Decreased plasma volume
C. Decreased total RBC mass
D. Widened symphysis pubis
E.
https://quizlet.com/466306232/atls-flash-cards/
71/98
4/29/23, 3:03 PM
A 34-year-old man is brought to
ATLS
the ED after being pinned to the
ATLS Flashcards | Quizlet
C. Is consistent with blood loss from bilateral femoral
fracture
wall of building by a cement
truck. He is in obvious shock,
and has deformities and marked
swelling of both thighs.
Although no open wound are
present, his shock:
A. Cannot be explained without
concomitant pelvic fracture
B. Signifies a loss of
approximately 15%
C. Is consistent with blood loss
from bilateral femoral fracture
D. Will likely be reversed if
appropriate traction splint are
applied
E. Cannot be explained by his
observed injuries unless a major
arterial injury exist
Prior to passage of urinary
C. Examine the rectum and perineum
catheter in a man, it is essential
to:
A. Examine the abdomen
B. Determine pelvic stability
C. Examine the rectum and
perineum
D. Perform a retrograde
urethrogram
E. Know the history and
mechanism of injury
https://quizlet.com/466306232/atls-flash-cards/
72/98
4/29/23, 3:03 PM
The best guide for adequate
ATLS
ATLS Flashcards | Quizlet
A. Adequate urinary output
fluid resuscitation of the burn
patient is:
A. Adequate urinary output
B. Reversal of systemic acidosis
C. Normalization of the heart
rate
D. A normal central venous
pressure
E. 4ml/kg/percent body
burn/24 hours
https://quizlet.com/466306232/atls-flash-cards/
73/98
4/29/23, 3:03 PM
A 36-year-old woman is beaten
ATLS
about the head and face and is
ATLS Flashcards | Quizlet
D. Transfer the patient to a neurosurgeon without
performing a CT-scan
brought to the local community
hospital in full spinal
immobilization. Her BP is 13088,
HR 70/minutes, and RR
18/minute. Pulse oximetry
indicated 98% while she was
given 100% O2 via a non
rebreather mask. Her airway is
clear. She has marked swellings
on her face and several
lacerations of her scalp that are
not actively bleeding. She does
not respond to verbal stimuli,
but localizes to painful stiumuli
and opens her eyes. She moves
all extremities equally. The
remainder of her physical exam
is normal. There is no
neurosurgeon at the local
hospital. After ensuring the
patient airway, the most
appropriate course of action is
to:
A. Admit the patient to the
hospital for observation
B. Obtain x-ray of her facial
bones prior to transfer
C. Obtain complete x-ray
evaluation of the cervical spine
D. Transfer the patient to a
neurosurgeon without
performing a CT-scan
E. Perform DPL or request
abdominal ultrasonography
https://quizlet.com/466306232/atls-flash-cards/
74/98
4/29/23, 3:03 PM
For the trauma patient with
ATLS
ATLS Flashcards | Quizlet
C. Cerebral vasodilatation
cerebral edema, hypercarbia
should be avoided to prevent:
A. metabolic acidosis
B. Respiratory acidosis
C. Cerebral vasodilatation
D. Neurogenic pulmonary
edema
E. Reciprocal high level of
PaCO2
https://quizlet.com/466306232/atls-flash-cards/
75/98
4/29/23, 3:03 PM
A 29 y/o male is brought to the
ATLS
ED after being involved in a
ATLS Flashcards | Quizlet
D. Is not necessary if the CT-scan of the chest is
normal
motor vehicular collision when
his car struck a bridge
abutment. He is intoxicated, has
GCS 13 and complains of
abdominal pain. His BP was
80mmHg systolic by palpation
on admission, but rapidly
increased to 110/70 with the
administration of IV fluid. His
heart rate is 120/minute. The
chest x-ray show loss of aortic
know, widening of mediastinum,
no rib fracture and no
hemopneumothorax. Contrast
angiography:
A. Is not indicated
B. Should be performed after
CT scan of the chest
C. Is positive ofr aortic rupture
in 80% of similar cases
D. Is not necessary if the CTscan of the chest is normal
E. Should be performed after
DPL
https://quizlet.com/466306232/atls-flash-cards/
76/98
4/29/23, 3:03 PM
Important screening x-rays to
ATLS
ATLS Flashcards | Quizlet
D. Cervical spine, chest and pelvis
obtain in the multiple system
trauma patient are:
A. Skull, chest and abdomen
B. Chest, abdomen and pelvis
C. Skull cervical spine and
pelvis
D. Cervical spine, chest and
pelvis
E. Cervical spine, chest and
abdomen
All of the following statement
C. It provides a continuous measurement of the
regarding pulse oxymetry are
partial pressure of oxygen
true EXCEPT
A. excessive surrounding room
light can interfere with the
accuracy of the reading
B. Significant levels of
dysfunctional hemoglobin can
affect the accuracy of the
reading
C. It provides a continuous
measurement of the partial
pressure of oxygen
D. It is dependent on differential
light absorption by oxygenated
and deoxygenated hemoglobin
E. It provides a continuous, noninvasiv measurement of pulse
rate that is updated with each
HR
https://quizlet.com/466306232/atls-flash-cards/
77/98
4/29/23, 3:03 PM
Bronchial intubation at the right
ATLS
ATLS Flashcards | Quizlet
A. The trachea is relatively short
or left mainstem bronchus can
easily occuring during infant
endotracheal intubation
because
A. The trachea is relatively short
B. The distance from the lips to
the larynx is relatively short
C. The use of tubes without
cuffs allow the tube to slip
easily
D. The mainstem bronchi are
less angulated in their relation
to the trachea
E. Do litte friction exist between
endotracheal tube and the wall
of the trachea.
https://quizlet.com/466306232/atls-flash-cards/
78/98
4/29/23, 3:03 PM
A 52 y/o woman sustaining 50%
ATLS
ATLS Flashcards | Quizlet
?A. Ensure adequate tissue perfusion
total body surface burns in an
explosion. She has burns around
the chest and both upper arms.
Adequate resuscitation is
initiated. She is nasotracheally
intubated and is being
mechanically ventilated. Her
CarboxyHb level is 10%. Her
arterial blood gas reveals PaO2
of 40mmHg, PaCo2 of 60mmHg
and pH of 7,25. Appropriate
immediate management at the
time is to
A. Ensure adequate tissue
perfusion
B. Increase the rate of fluid
resuscitation
C. Add PEEP
D. Reassess for the presence of
pneumothorax
E. Administer IV narcotics in
small amounts
All of the following suggest
E. Absence of a palpable prostate on rectal exam
urethral injury EXCEPT
A. scrotal hematoma
B. Blood in rectal lumen
C. Blod in external urethral
meatus
D. High riding prostate on rectal
exam
E. Absence of a palpable
prostate on rectal exam
https://quizlet.com/466306232/atls-flash-cards/
79/98
4/29/23, 3:03 PM
Which one of the following is
ATLS
ATLS Flashcards | Quizlet
A. Moist heat
recommended method for
threating frostbite?
A. Moist heat
B. Early amputation
C. Padding and elevation
D. Vasodilators and heparin
E. Topical application of
silversulphadiazine
A 32-year-old mans right leg is
D. Performing lower extremity fasciotomies
trapped beneath his overturned
car for nearly two hours before
he is extricated. On arrival in the
ED, both lower extremities are
cool, mottled, insensate and
motionless. Despite normal vital
signs, pulses cannot be
palpated below the femoral
vessels and the muscles of the
lower extremities are firm and
hard. During the initial
management of this patient,
which of the followin is most
likely to improve chances for
limb salvage?
A. Apply skeletal traction
B. Administering anticoagulant
drugs
C. Administering trombolytic
thearpy
D. Performing lower extremity
fasciotomies
E. Immediately transfer the
patient to a trauma care
https://quizlet.com/466306232/atls-flash-cards/
80/98
4/29/23, 3:03 PM
A 26 y/o seat belted driver is
ATLS
ATLS Flashcards | Quizlet
B. Undergo promp celiotomy
brought to the ED after a car
crash. Primary survey reveals no
evidence of serious injury
except for diffuse, mild
abdominal tenderness. Bowel
sounds are hypoactive and liver
dullness is questionable.
Abdominal films reveal free air.
The patient should
A. Undergo peritoneal lavage
B. Undergo promp celiotomy
C. Have a contrast x-ray of her
GI-tract
D. Be carefully observed for
further evidence of
intraabdominal injury
E. Be suspected of having a
ruptured diaphragm and
accompanying pneumothorax.
The least likely cause of a
C. Hyperglycemia
depressed level of consiousness
in the multisystem injured
patient is:
A. shock
B. Head injury
C. Hyperglycemia
D. Impaired oxygenation
E. Alcohol and other drugs
https://quizlet.com/466306232/atls-flash-cards/
81/98
4/29/23, 3:03 PM
Which one of the following
ATLS
statements concerning massive
ATLS Flashcards | Quizlet
E. The condition should be suspected in situations
with shock and unilateral absent breath sounds
hemothorax is true?
A. It is usually caused by blunt
thoracic trauma
B. It is commonly confused with
pneumothorax
C. The diagnosis should be
confirmed by upright, plain
chest x-ray prior to treatment
D. The initial draining of 1000ml
of blood after chest tube
insertion requires immediate
thoracotomy
E. The condition should be
suspected in situations with
shock and unilateral absent
breath sounds
During primary and secondary
D. A spinal fracture has been excluded by x-ray
survey, the patient injured by
blunt trauma should be
completely immobilized until
A. The neurologic exam has
been completed
B. The patient is transferred to
definitive care
C. The patient is able to indicate
that he has no neck pain
D. A spinal fracture has been
excluded by x-ray
E. The patient complains of
potential pressure sores due to
the spine board.
https://quizlet.com/466306232/atls-flash-cards/
82/98
4/29/23, 3:03 PM
Cervical spine injury
ATLS
A. Is excluded by a normal
ATLS Flashcards | Quizlet
E. May be first manifested by neurologic deficit after
movement of the neck
neurologic exam
B. Is not present if the patient
has normal range of motion
C. Can be detected safely by
careful flexion and extension of
the neck
D. Can be excluded by a
crosstable lateral x-ray of the cspine
E. May be first manifested by
neurologic deficit after
movement of the neck
https://quizlet.com/466306232/atls-flash-cards/
83/98
4/29/23, 3:03 PM
An 18 y/o man is brought to the
ATLS
ATLS Flashcards | Quizlet
C. Be treated for hypovolemic shock
ED after smashing his
motorcycle into a tree. He is
conscious and alert, but
paralyzed in both legs and
arms. His skin is pale and cold.
He complains of thirst and
difficulty in breathing. His airway
is clear. His BP is 60/40 and his
pulse is 140 bpm. Breath sounds
are full and equal bilaterally. He
should
A. Undergo exploratory
celiotomy
B. Be treated for neurogenic
shock
C. Be treated for hypovolemic
shock
D. Undergo immediate
nasotracheal intubation
E. be placed in cervical traction
tongs before any other
treatment is instituted
The principle of balanced
A) Permissive hypotension and early plasma infusion
resuscitation is:
A) Permissive hypotension and
early plasma infusion
B) Equal amounts of crystalloid
and colloids
C) Simultaneous management
of breathing and circulation
D) Maintenance of a normal
acid base balance
E) Achieving a pulse rate <90
https://quizlet.com/466306232/atls-flash-cards/
84/98
4/29/23, 3:03 PM
Healthy young male in a motor
ATLS
ATLS Flashcards | Quizlet
A) Placement of a pelvic binder
vehicle crash is brought to the
emergency department with a
blood pressure of 84/60, pulse
123, GCS 10. The patient moans
when his pelvis is palpated.
After initiating fluid
resuscitation, the next step in
management is:
A) Placement of a pelvic binder
B) Transfer to a trauma center
C) Pelvic x-ray
D) Insert urinary catheter
E) Repeat examination of pelvis
22 year old male fall from 2m,
Tracheobronchal injury
large right pneumothorax. Chest
tube placed, connected to
drainage. Control x-ray shows
pneumothorax, third x-ray
reveals pneumothorax
Which one of the following is
C. Increased cardiac output
not a feature of neurogenic
shock?
A. Increased venous capaitance
B. Decreased systemic vascular
resistance
C. Increased cardiac output
D. Warm skin
https://quizlet.com/466306232/atls-flash-cards/
85/98
4/29/23, 3:03 PM
Tension pneumothorax
ATLS
ATLS Flashcards | Quizlet
...
can be caused by:
A. Flail chest
B. Cardiac tamponade
C. Clamping of a chest
tube
D. All of the above
Which one of the
...
following brain stem
reflexes is not assessed
when assessing for brain
death?
A. Dolls eyes
B. Oculovestibular reflex
C. Gag reflex
D. Argyll Robertson
pupil
What is the simplest way
...
to open the airway in an
unconscious patient?
A. Pull out the tongue
B. Tilt head and lift chin
C. Lift neck from behind
D. Jaw thrust
What is the approximate
...
time the brain can be
anoxic before
developing irreversible
damage?
A. 10 min
B. 5 min
C. 2 min
D. 20 min
https://quizlet.com/466306232/atls-flash-cards/
86/98
4/29/23, 3:03 PM
You are treating a truama
ATLS
ATLS Flashcards | Quizlet
A. Gum elastic bougie
patient and attempt a definitive
airway by intubation. However,
the vocal cords are not visible.
What tool would be the most
valuable for achieving
successful intubation?
A. Gum elastic bougie
B. Lateral cervical spine x-ray
C. Nasopharyngeal airway
D. Oxygen
E. Laryngeal mask airway
A 79 year old female is involved
D. Vigorous fluid resuscitation may be associated with
in a motor vehicle crash and
cardiorespiratory failure
presents to the ED. She is on
Coumadin and a beta blocker.
Which of the following
statements is true concerning
her management?
A. The risk of subdural
hemorrhage is decreased
B. Absence of tachycardia
indicates that the patient is
hemodynamically normal
C. Non-operative management
of abdominal injuries is more
likely to be successful in older
adults than in younger patients
D. Vigorous fluid resuscitation
may be associated with
cardiorespiratory failure
D. epinephrine should be
infused immediately for
hypotension
https://quizlet.com/466306232/atls-flash-cards/
87/98
4/29/23, 3:03 PM
The most common acid base
ATLS
ATLS Flashcards | Quizlet
B. Changes in ventilation?
disturbance encountered in
injured pediatric patients is
caused by:
A. Hemorrhage
B. Changes in ventilation
C. Renal failure
D. Injudicious bicarbonate
administration
E. Insufficient sodium chloride
administration
A 17 year old female is brought
D. Applying oxygen and maintaining airway
to the ED following a 2 meter
fall onto concrete. She is
unresponsive and found to have
a RR of 32, BP 90/60 and HR 68.
The first step in treatment is:
A. Adminstering vasopressors
B. Establishing
Establish
IV access for
drug-assisted intubation
C. Seeking the cause of her
decreased level of
consciousness
D. Applying oxygen and
maintaining airway
E. Excluding hemorrhage as a
cause of shock
https://quizlet.com/466306232/atls-flash-cards/
88/98
4/29/23, 3:03 PM
A 25 year old male is brought to
ATLS
the ED following a bar fight. He
ATLS Flashcards | Quizlet
B. CT scanning is an important part of neurological
assessment
has altered consciousness, open
his eyes on command, moans
Han har GCS på 10-11, således passer det ikke med
without forming discernible
svaralternativ D som tilsvarer GCS <9. Ettersom GCS
words, and localizes to painful
er >8 passer heller ikke svaralternativ C. E er feil da
stimuli. Which one of the
det ikke kan gi så lav GCS
following statements
concerning this patient is true?
A. Hyperoxia should be avoided
B. CT scanning is an important
part of neurological assessment
C. Mandatory intubation to
protect his airway is required
D. His GCS suggest severe head
injury
E. His level of consciousness
can be solely attributed to
elevated blood alcohol.
https://quizlet.com/466306232/atls-flash-cards/
89/98
4/29/23, 3:03 PM
ATLS Flashcards | Quizlet
Which one of the following
ATLS
A. Urethral injuries are associated with pelvic
statements regarding
fractures
genitourinary injuries is true?
B er feil - det er pasienter med makroskopisk
A. Urethral injuries are
hematuri og/eller pas. med mikroskopisk hematuri og
associated with pelvic fractures
sjokk som det er aktuelt å gjøre CT av. C kan være
B. All patients with microscopic
riktig, men kan ikke si det sikkert at det er nyrene som
hematuria require evaluation of
er blødningskilden. D er feil - ekstraperitoneal
genitourinary tract
blæreskade behandles med kateter, og E er feil da
C. Patient presenting with gross
man først må undersøke for uretraskade
hematuria and shock will have a
major renal injury as the source
of hemorrhage
D. Intraperitoneal bladder
injuries are usually managed
definitively with a urinary
catether
E. Urinary catheters should be
placed in all patients with pelvic
fractures during the primary
survey
Cardiac tamponade:
A. Requires surgical intervention
A. Requires surgical intervention
B. Is defintively managed by
needle pericardiocentesis
C. Is easily diagnosed by
discovery of Becks triad in the
ED
D. Is indicated by Kussmaul
breathing
E. Is most common with blunt
thoracic trauma and anterior rib
fractures
https://quizlet.com/466306232/atls-flash-cards/
90/98
4/29/23, 3:03 PM
A 6 month old infant, being held
ATLS
in her mothers arms, is ejected
ATLS Flashcards | Quizlet
A. perform needle cricothyroidotomy with jet
insufflation
on impact from a vehicle that is
struck head on by an oncoming
car traveling at 65kph. The infant
arrives in the ED with multiple
facial injuries, is lethargic, and is
in severe respiratoy distress.
Respiratory support is not
effective using a bag mask
device, and her oxygen
saturation is falling. Repeated
attempts at orotracheal
intubation are unsuccessful. the
most appropriate procedure to
perform next is:
A. perform needle
cricothyroidotomy with jet
insufflation
B. Administer heliox and racemic
epinephrine
C. Perform nasotracheal
intubation
D. Perform surgical
cricothyroidotomy
E. Repeat orotracheal intubation
Which one of the following
E. Forearm fracture
injuries is adressed in the
secondary survey?
A. Bilateral femur fractures with
obvious deformity
B. Open fracture with bleeding
C. Mid thigh amputation
D. Unstable pelvic fracture
E. Forearm fracture
https://quizlet.com/466306232/atls-flash-cards/
91/98
4/29/23, 3:03 PM
A 22 year old male present
ATLS
following a motorcycle crash.
ATLS Flashcards | Quizlet
B. 2L of iv crystalloid and vasopressors if BP does not
respond
He complains of the inability to
move his legs. His BP is 80/50,
HR 70, RR 18 and GCS 15.
Oxygen saturation is 99% on 21
nasal prongs. Chest x-ray, pelvic
x-ray and FAST are normal.
Extremities are normal. His
management should be:
A: 2L of iv . crystalloid and two
units of pRBCs
B. 2L of iv crystalloid and
vasopressors if BP does not
respond
C. 2L of iv. crystalloid, mannitol
and iv steroids
D. Vasopressors and laparotomy
E. 1 unit of albumin and
compression stockings
https://quizlet.com/466306232/atls-flash-cards/
92/98
4/29/23, 3:03 PM
A 35 year old female sustains
ATLS
ATLS Flashcards | Quizlet
C. Chest x-ray
multiple injuries in a motor
vehicle crash and is transported
to a small hospital in full spinal
protection. She has a GCS of 4
and is being mechanically
ventilaed. I.v access is
established and warmed
establish
crystalloid is infused. She
remains hemodynamically
normal and full spinal
protection is maintained.
Preparations are made to
transfer her to another facility
for definitive neurosurgical care.
Prior to transport, which of the
following tents or treatments is
mandatory?
A. FAST exam
B. Lateral cervical spine xray
C. Chest x-ray
D. Administration of
methylprednisolon
E. CT of abdomen
https://quizlet.com/466306232/atls-flash-cards/
93/98
4/29/23, 3:03 PM
A 22 year old male is assaulted
ATLS
ATLS Flashcards | Quizlet
D. Presence of hemotympanum
in a bar. A semi-rigid cervical
collar is applied and he is
immobilized on a spine board.
On initial examination, his vital
signs are normal, and his GCS is
15. Which of the following is an
indication for CT in this patient
with possible minor traumatic
brain injury?
A. Blood alcohol concentration
of 0,16%
B. Presence of an isolated 10cm
scalp laceration
C. Presence of a mandibular
fracture
D. Presence of hemotympanum
E. History of assault
Which one of the following
D. Cerebral blood flow is increased when PaCO2 is
statement is true?
below 30mmHg --> below 50mmHg
A. Hypotonic fluids should be
used to limit brain edema in
patients with severe head injury
B. Elevated intracranial pressure
will not affect cerebral
perfusion
C. CSF cannot be displaced
from cranial vault
D. Cerebral blood flow is
increased when PaCO2 is below
30mmHg --> below 50mmHg
E. Autoregulation of cerebral
blood flow normally occurs
between cerebral perfusion
pressure of 50 to 150mmHg
https://quizlet.com/466306232/atls-flash-cards/
94/98
4/29/23, 3:03 PM
A 40 year old obese patient
ATLS
ATLS Flashcards | Quizlet
B. Insert a defintive airway
with GCS of 8 requries a CT
scan. Before transfer to the
scanner, you should:
A. give more sedative drugs
B. Insert a defintive airway
C. Insert a multilumen
esophageal airway
D. Request a lateral cervical
spine film
E. insert a nasogastric tube
A 30 year old male is brought
B. Pulmonary contusion
toe the hospital after falling 6
meters. Inspection reveals an
obvious flail chest on the right.
The patient is tachypneic. Breath
sounds are present and
symmetrical. There is no
significant hyperresonance or
dullness. Arterial blood gas
obtained while the patient
recieves oxygen by face mask
are: PaO2 of 45mmHg (6Kpa),
PaCO2 of 28mmHg (3,7 Kpa)
and pH of 7,47. The component
of injury that most likely
responsible for abnormalities in
this patients blood gas is:
A. Hypoventilation
B. Pulmonary contusion
C. Hypovolemia
D. Small pneumothorax
E. Flail chest
https://quizlet.com/466306232/atls-flash-cards/
95/98
4/29/23, 3:03 PM
ATLS Flashcards | Quizlet
A 14 year old female is brought
ATLS
C. Are not needed if she is awake, alert,
to the ED after falling from a
neurologically normal, and has no neck pain or
horse. She is immobilized on a
midline tenderness
long spine board with a hard
collar and blocks. Cervical spine
x-ray:
A. Will show cervical spine injury
in more than 20% of these
patients
B. Will exclude cervical spine
injury if no abnormalities are
found on the x-rays
C. Are not needed if she is
awake, alert, neurologically
normal, and has no neck pain or
midline tenderness
D. Should be performed before
adressing potential breating or
circulatory problems
E. May show atlanto-occipital
dislocation if the Powers ratio is
<1 --> 1:noraml, >1 anterior, <1
posterior
The most specific test to
C. CT of abdomen and pelvis
evaluate for injuries of solid
abdominal organ is:
A. Abdominal x-ray
B. Abdominal ultrasound
C. DPL
D. Frequent abdominal
examination
C. CT of abdomen and pelvis
https://quizlet.com/466306232/atls-flash-cards/
96/98
4/29/23, 3:03 PM
The most important
ATLS
ATLS Flashcards | Quizlet
B. Multiple organ failure
consequence of inadequate
organ perfusion is:
A. Vasodilatation
B. Multiple organ failure
C. Decreased base deficit
D. Acute glomerulonephritis
E. Increased cellular ATP
production
A 23 year old construction
D. X-ray of the chest and pelvis are important
worker is brought toe the ED
adjuncts in his assessment
after falling more than 9 meters
from scaffolding. He is
complaining bitterly of lower
abdominal and lower limb pain,
and has obvious deformity of
both lower legs with bilateral
open tibial fractures. Which one
of the following statement
concerning this patient is true?
A. Pelvic injury can be ruled out
based on the mechanism of
injury
B. Blood loss from the lower
limb is most likely cause of his
hypotension
C. Spinal cord injury is the most
likely cause of his hypotension
D. X-ray of the chest and pelvis
are important adjuncts in his
assessment
E. Aortic injury is the most likely
cause of his tachycardia.
https://quizlet.com/466306232/atls-flash-cards/
97/98
4/29/23, 3:03 PM
A 82 year old male falls down
ATLS
five stairs and presents to the
ATLS Flashcards | Quizlet
E. Intracranial hemorrhage will become symptomatic
more quickly
ED. All following statements are
true statements regarding his
condition compared to a
younger patient with similar
mechanism, except:
A. He is more likely to have had
a contracted circulatory volume
prior to his injury
B. His risk of cervical spine injury
is increased due to
degeneration, stenosis and loss
of disk compressibility
C. His risk of occult fractures is
increased
D. His risk of bleeding may be
increased
E. Intracranial hemorrhage will
become symptomatic more
quickly
https://quizlet.com/466306232/atls-flash-cards/
98/98