ATLS CASE SCENARIO CDEM SELF STUDY
PRACTICE SOLUTION 2026 COMPLETE
QUESTIONS WITH ANSWERS GRADED A+
◉ how can you avoid a secondary brain injury in a TBI patient?
Answer: maintain cerebral perfusion (adequate BP), maintain o2,
maintain ventilation (pac02 b/w 35-40), maintain normal temp and
coag
◉ in what scenario is hyperventilation recommended for a patient
with a TBI? Answer: rapid neuro deterioration
◉ best agent for analgesia and sedation of a TBI patient? why?
Answer: short acting IV opioids (morphine, fentanyl, dilaudid)
allows for neuro reassessment
◉ signs/sx of neuroworsening Answer: sudden pupil dilation or
asymmetry, cushings triad
◉ what is cushings triad? what does it indicate? Answer: wide pulse
pressure, bradycardia, irregular respirations
, neurocognitive worsening
◉ initial tx for a TBI patient Answer: elevate HOB, transient
hyperventilation, hyperosmolar tx UNDER NEUROSURGERY
GUIDANCE
◉ what are the 3 main steps of initial management for a spinal
injury? Answer: 1. SPINAL MOTION RESTRICTION
2. c-spine clearance
3. recognize neuro shock!!!
◉ what is required to be able to CLINICALLY clear a c spine?
Answer: patient MUST BE AWAKE and ALERT to assess for pain
◉ signs of neurological shock Answer: warm pink flushed skin,
bradycardia, spinal injury
◉ list some ways to prevent hypothermia in the trauma patient
Answer: warm blankets, warmed fluids, inc ventilation air temp
◉ list some adjuncts to the primary survey Answer: ekg, pulse ox,
cxr, pelvic xr, FAST/eFAST, physical exam, urinary/gastric catheter
PRACTICE SOLUTION 2026 COMPLETE
QUESTIONS WITH ANSWERS GRADED A+
◉ how can you avoid a secondary brain injury in a TBI patient?
Answer: maintain cerebral perfusion (adequate BP), maintain o2,
maintain ventilation (pac02 b/w 35-40), maintain normal temp and
coag
◉ in what scenario is hyperventilation recommended for a patient
with a TBI? Answer: rapid neuro deterioration
◉ best agent for analgesia and sedation of a TBI patient? why?
Answer: short acting IV opioids (morphine, fentanyl, dilaudid)
allows for neuro reassessment
◉ signs/sx of neuroworsening Answer: sudden pupil dilation or
asymmetry, cushings triad
◉ what is cushings triad? what does it indicate? Answer: wide pulse
pressure, bradycardia, irregular respirations
, neurocognitive worsening
◉ initial tx for a TBI patient Answer: elevate HOB, transient
hyperventilation, hyperosmolar tx UNDER NEUROSURGERY
GUIDANCE
◉ what are the 3 main steps of initial management for a spinal
injury? Answer: 1. SPINAL MOTION RESTRICTION
2. c-spine clearance
3. recognize neuro shock!!!
◉ what is required to be able to CLINICALLY clear a c spine?
Answer: patient MUST BE AWAKE and ALERT to assess for pain
◉ signs of neurological shock Answer: warm pink flushed skin,
bradycardia, spinal injury
◉ list some ways to prevent hypothermia in the trauma patient
Answer: warm blankets, warmed fluids, inc ventilation air temp
◉ list some adjuncts to the primary survey Answer: ekg, pulse ox,
cxr, pelvic xr, FAST/eFAST, physical exam, urinary/gastric catheter
