ATLS PROFESSIONAL EXAM REVIEW
WITH ACCURATE QUESTIONS AND
EXPERT ANSWERS
◉ Cyanide inhalation poisoning can occur in confined spaces and
sign of potential toxicity is persistent profound unexplained
metabolic acidosis.
Answer: THERE IS NO ROLE for hyperbaric oxygen therapy in the
primary resuscitation of a patient with critical burn injury.
◉ American Burn Association states 2 requirements for diagnosis
of smoke inhalation injury:
Answer: 1. exposure to combustible agent
2. signs of exposure to smoke in the lower airway, below the vocal
cords, seen on bronchoscopy.
A chest Xray and arterial blood gases should be ordered to
evaluate the pulmonary status of a patient with smoke inhalation
injury, but normal values on admission DO NOT exclude an
inhalation injury.
◉ The treatment of smoke inhalation injury is supportive.
Answer: Any patient with smoke inhalation injury and significant
burns greater than 20% TBSA should be intubated. IF the
patient's hemodynamic condition permits and spinal injury has
,been excluded, elevate the patient's head and chest 30 degrees to
help reduce neck and chest wall edema.
◉ True or false: Clinicians should provide burn resuscitation
fluids for deep partial and full thickness burns larger than 20%
TBSA
Answer: True. urine output monitoring is 0.5mL/kg/hr in adults
and should be maintained at 30-50cc/hr to minimize over
resuscitation
◉ in a burn patient, cardiac dysrhytmias may be the first sign of
hypoxia and electrolyte or acid base abnormalities.
Answer: therefore an ECG should be performed for cardiac
rhythm disturbances. Persistent acidemia in patients with burn
injuries may be due to under resuscitation or infusion of large
volumes of saline.
◉ Tachycardia is a poor indication for resuscitation in the burn
patient.
Answer: Adjust the fluid rate up or down based on the urine
output and recognize that factors such as inhalation injury, age of
patient, renal failure, diuretics, and alcohol can affect the volume
of resuscitation and urine output.
◉ True of false: Burn patients should get tetanus.
Answer: true
, ◉ Partial thickness burns
Answer: are characterized as either superficial partial thickness
(moist, painfully hypersensitive, , potentially blistered,
homogenously pink, and blanch to touch) or deep partial
thickness ( drier, less painful, potentially blistered, red or mottled
in appearance, and do not blanch to touch)
◉ Full thickness burns
Answer: appear leathery and skin may be white or translucent or
waxy white. surface area is painless to light touch or pinprick and
generally dry
◉ Compartment syndrome in burn patients:
Answer: Compartment syndrome can result from an increase in
pressure inside the compartment that interferes with perfusion to
the structures within that compartment. In burns, this condition
results from a combination of decreased skin elasticity and
increased edema in the soft tissue. A pressure > 30 mm Hg within
the compartment can lead to muscle necrosis and once the pulse
is gone it may be TOO LATE to save the muscle. so recognize the
signs early:
pain greater than expected and out of proportion to the injury
pain on passive stretch of the affected muscle
tense swelling of the affected compartment
paresthesias or altered sensation distal to the affected
compartment
WITH ACCURATE QUESTIONS AND
EXPERT ANSWERS
◉ Cyanide inhalation poisoning can occur in confined spaces and
sign of potential toxicity is persistent profound unexplained
metabolic acidosis.
Answer: THERE IS NO ROLE for hyperbaric oxygen therapy in the
primary resuscitation of a patient with critical burn injury.
◉ American Burn Association states 2 requirements for diagnosis
of smoke inhalation injury:
Answer: 1. exposure to combustible agent
2. signs of exposure to smoke in the lower airway, below the vocal
cords, seen on bronchoscopy.
A chest Xray and arterial blood gases should be ordered to
evaluate the pulmonary status of a patient with smoke inhalation
injury, but normal values on admission DO NOT exclude an
inhalation injury.
◉ The treatment of smoke inhalation injury is supportive.
Answer: Any patient with smoke inhalation injury and significant
burns greater than 20% TBSA should be intubated. IF the
patient's hemodynamic condition permits and spinal injury has
,been excluded, elevate the patient's head and chest 30 degrees to
help reduce neck and chest wall edema.
◉ True or false: Clinicians should provide burn resuscitation
fluids for deep partial and full thickness burns larger than 20%
TBSA
Answer: True. urine output monitoring is 0.5mL/kg/hr in adults
and should be maintained at 30-50cc/hr to minimize over
resuscitation
◉ in a burn patient, cardiac dysrhytmias may be the first sign of
hypoxia and electrolyte or acid base abnormalities.
Answer: therefore an ECG should be performed for cardiac
rhythm disturbances. Persistent acidemia in patients with burn
injuries may be due to under resuscitation or infusion of large
volumes of saline.
◉ Tachycardia is a poor indication for resuscitation in the burn
patient.
Answer: Adjust the fluid rate up or down based on the urine
output and recognize that factors such as inhalation injury, age of
patient, renal failure, diuretics, and alcohol can affect the volume
of resuscitation and urine output.
◉ True of false: Burn patients should get tetanus.
Answer: true
, ◉ Partial thickness burns
Answer: are characterized as either superficial partial thickness
(moist, painfully hypersensitive, , potentially blistered,
homogenously pink, and blanch to touch) or deep partial
thickness ( drier, less painful, potentially blistered, red or mottled
in appearance, and do not blanch to touch)
◉ Full thickness burns
Answer: appear leathery and skin may be white or translucent or
waxy white. surface area is painless to light touch or pinprick and
generally dry
◉ Compartment syndrome in burn patients:
Answer: Compartment syndrome can result from an increase in
pressure inside the compartment that interferes with perfusion to
the structures within that compartment. In burns, this condition
results from a combination of decreased skin elasticity and
increased edema in the soft tissue. A pressure > 30 mm Hg within
the compartment can lead to muscle necrosis and once the pulse
is gone it may be TOO LATE to save the muscle. so recognize the
signs early:
pain greater than expected and out of proportion to the injury
pain on passive stretch of the affected muscle
tense swelling of the affected compartment
paresthesias or altered sensation distal to the affected
compartment
