PHTLS Exam Review with Complete
Solutions
How many people die from trauma annually? - ANSWER-Over 5 million
What is the leading cause of trauma deaths? - ANSWER-MVA
Where do over 90% of trauma deaths occur? - ANSWER-Low-Middle income countries.
What is the leading cause of death in people aged 1-44? - ANSWER-Trauma
What are the goals of PHTLS? - ANSWER-Reduce morbidity and mortality from trauma,
and provide appropriate care to the patient in the field.
What is the PHTLS philosophy? - ANSWER-Deliver the patient to the right facility,
utilizing the right mode of transportation, in the right amount of time, as safely as
possible.
What are the components of scene assessment? - ANSWER-Safety, Pre arrival
information, arrival on scene, MOI, and Patients.
What is paramount for scene assessment? - ANSWER-Personal and Personnel safety.
What is the global view? - ANSWER-What you get before you get out of your vehicle.
What is the goal of the Primary Survey? - ANSWER-To immediately identify life
threatening situations and manage them as they are identified.
What are the components of the primary survey? - ANSWER-Airway, Breathing,
Circulation, Disability, Exposure
When does assessment of the incident begin? - ANSWER-Before arriving at the
patients side.
The findings of the scene assessment and primary survey help to determine what? -
ANSWER-If the patient is sick, not yet sick, or not sick
When should the secondary survey be completed? - ANSWER-Only if time and
situation permit.
,What are the components of the secondary survey? - ANSWER-Vital Signs, History,
Physical Examination, Treatment, Level of Care, Transportation, and Communication.
What are the components of a radio report? - ANSWER-Timely, Scene Description,
Number of Patients, Current Patient Status, Treatment Provided, ETA
What is a tracheal consideration with pediatric patients in regards to ETT intubation? -
ANSWER-Potential for right main-stem intubation.
What is the most common cause of airway obstruction in the trauma patient? -
ANSWER-The tongue.
When are basic maneuvers applied in regards to trauma airway management? -
ANSWER-First
When are advanced airway maneuvers performed for trauma patients? - ANSWER-
After basic, only if needed.
What is the goal of managing a patients airway? - ANSWER-Maintain an open and
patent airway that allows for adequate breathing, ventilation, and oxygenation.
What does airway management entail? - ANSWER-Anticipating difficulties and planning
for alternate methods of airway control.
What is ALWAYS the FIRST airway maneuver for the trauma patient? - ANSWER-
Trauma Jaw Thrust/Chin Lift
What should be considered SECOND for maintaining a patent airway in the trauma
patient? - ANSWER-OPA or NPA
What adjunct should be considered THIRD for airway management in the trauma
patient? - ANSWER-Supra-Glottic Airways
When should glottic airways be considered? - ANSWER-After jaw thrusts, OPA/NPA,
and Supra Glottic airways have failed.
What are some assessment criteria for Endotracheal Intubation? - ANSWER-Decreased
LOC (GCS<8), Inability to maintain patent airway, Upper Airway Burns, Signs of
pending airway obstructions.
Which type of airway management should be considered last? - ANSWER-Surgical.
What types of methods should be used to verify tube placement? - ANSWER-One
physiological and one mechanical method.
, When the patients breathing draws your attention you should...? - ANSWER-Assume
there is a problem until proven otherwise.
What are some s/s you are looking for in a trauma patients breathing assessment? -
ANSWER-Increased respiratory effort, visible trauma, paradoxical chest wall movement,
sucking chest wound.
Concerns with lateral impacts? - ANSWER-Less metal to protect people in car
Look for injuries to that same side of body
Concerns with rotational forces? - ANSWER-shearing forces to heart, liver, kidneys
What % of ejection victims die? - ANSWER-75
How much more likely are you to die if you are involved in a rollover? - ANSWER-6x
Concern with rear impacts? - ANSWER-whiplash injuries
Good thing about wearing helmets? - ANSWER-they save lives & decrease injuries
Auto vs. Ped facts? - ANSWER-Child - Freeze "deer in headlights", get drug under car,
multi-system trauma
Adult - turn & run, extremity trauma
Important aspects of falls? - ANSWER-15 feet or 3x their height & the surface they land
on = (severity of fall)
Body part they land on = (type of injury)
what are the 5 phases of bast injuries? - ANSWER-1. Primary - pressure wave, effects
hollow organs
2. Secondary - Bomb fragments
3. Tertiary - person in thrown, or falling debris
4. Quaternary - heat/thermal burns
5. Quinary - bio/chemical/implanted objects sprayed from the object
What is an intimate injury? - ANSWER-Stabbing. Close proximity. Look for more than
one wound, be cautious of "cone of injury, any direction", length of knife?
In regards to violence what should you do? - ANSWER-1. DONT BE THERE!!!!
2. Retreat
3. Defuse the situation (word ninja)
4. Defend yourself
30 - 2, Can Do = what color? - ANSWER-Green
Solutions
How many people die from trauma annually? - ANSWER-Over 5 million
What is the leading cause of trauma deaths? - ANSWER-MVA
Where do over 90% of trauma deaths occur? - ANSWER-Low-Middle income countries.
What is the leading cause of death in people aged 1-44? - ANSWER-Trauma
What are the goals of PHTLS? - ANSWER-Reduce morbidity and mortality from trauma,
and provide appropriate care to the patient in the field.
What is the PHTLS philosophy? - ANSWER-Deliver the patient to the right facility,
utilizing the right mode of transportation, in the right amount of time, as safely as
possible.
What are the components of scene assessment? - ANSWER-Safety, Pre arrival
information, arrival on scene, MOI, and Patients.
What is paramount for scene assessment? - ANSWER-Personal and Personnel safety.
What is the global view? - ANSWER-What you get before you get out of your vehicle.
What is the goal of the Primary Survey? - ANSWER-To immediately identify life
threatening situations and manage them as they are identified.
What are the components of the primary survey? - ANSWER-Airway, Breathing,
Circulation, Disability, Exposure
When does assessment of the incident begin? - ANSWER-Before arriving at the
patients side.
The findings of the scene assessment and primary survey help to determine what? -
ANSWER-If the patient is sick, not yet sick, or not sick
When should the secondary survey be completed? - ANSWER-Only if time and
situation permit.
,What are the components of the secondary survey? - ANSWER-Vital Signs, History,
Physical Examination, Treatment, Level of Care, Transportation, and Communication.
What are the components of a radio report? - ANSWER-Timely, Scene Description,
Number of Patients, Current Patient Status, Treatment Provided, ETA
What is a tracheal consideration with pediatric patients in regards to ETT intubation? -
ANSWER-Potential for right main-stem intubation.
What is the most common cause of airway obstruction in the trauma patient? -
ANSWER-The tongue.
When are basic maneuvers applied in regards to trauma airway management? -
ANSWER-First
When are advanced airway maneuvers performed for trauma patients? - ANSWER-
After basic, only if needed.
What is the goal of managing a patients airway? - ANSWER-Maintain an open and
patent airway that allows for adequate breathing, ventilation, and oxygenation.
What does airway management entail? - ANSWER-Anticipating difficulties and planning
for alternate methods of airway control.
What is ALWAYS the FIRST airway maneuver for the trauma patient? - ANSWER-
Trauma Jaw Thrust/Chin Lift
What should be considered SECOND for maintaining a patent airway in the trauma
patient? - ANSWER-OPA or NPA
What adjunct should be considered THIRD for airway management in the trauma
patient? - ANSWER-Supra-Glottic Airways
When should glottic airways be considered? - ANSWER-After jaw thrusts, OPA/NPA,
and Supra Glottic airways have failed.
What are some assessment criteria for Endotracheal Intubation? - ANSWER-Decreased
LOC (GCS<8), Inability to maintain patent airway, Upper Airway Burns, Signs of
pending airway obstructions.
Which type of airway management should be considered last? - ANSWER-Surgical.
What types of methods should be used to verify tube placement? - ANSWER-One
physiological and one mechanical method.
, When the patients breathing draws your attention you should...? - ANSWER-Assume
there is a problem until proven otherwise.
What are some s/s you are looking for in a trauma patients breathing assessment? -
ANSWER-Increased respiratory effort, visible trauma, paradoxical chest wall movement,
sucking chest wound.
Concerns with lateral impacts? - ANSWER-Less metal to protect people in car
Look for injuries to that same side of body
Concerns with rotational forces? - ANSWER-shearing forces to heart, liver, kidneys
What % of ejection victims die? - ANSWER-75
How much more likely are you to die if you are involved in a rollover? - ANSWER-6x
Concern with rear impacts? - ANSWER-whiplash injuries
Good thing about wearing helmets? - ANSWER-they save lives & decrease injuries
Auto vs. Ped facts? - ANSWER-Child - Freeze "deer in headlights", get drug under car,
multi-system trauma
Adult - turn & run, extremity trauma
Important aspects of falls? - ANSWER-15 feet or 3x their height & the surface they land
on = (severity of fall)
Body part they land on = (type of injury)
what are the 5 phases of bast injuries? - ANSWER-1. Primary - pressure wave, effects
hollow organs
2. Secondary - Bomb fragments
3. Tertiary - person in thrown, or falling debris
4. Quaternary - heat/thermal burns
5. Quinary - bio/chemical/implanted objects sprayed from the object
What is an intimate injury? - ANSWER-Stabbing. Close proximity. Look for more than
one wound, be cautious of "cone of injury, any direction", length of knife?
In regards to violence what should you do? - ANSWER-1. DONT BE THERE!!!!
2. Retreat
3. Defuse the situation (word ninja)
4. Defend yourself
30 - 2, Can Do = what color? - ANSWER-Green