ATLS 10TH EDITION TRIAGE APPENDIX F
TRIAGE SCENARIOS PATIENT A F COMPLETE
SOLUTIONS
◉ Which of the following should be performed FIRST in any patient
whose injuries may include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome.
Answer: D. Ensuring adequate oxygenation and ventilation
(ABC's)
◉ Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle
meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
,E. The associated brain damage is more severe in epidural
hematomas.
Answer: A. Cerebral contusions may coalesce to form an
intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
◉ An 18 year old male is brought to the ED after being 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 blood
pressure is 110/60, heart rate of 90, and respiratory rate of 34. After
ensuring a patent airway and inserting 2 large caliber IV lines, the
next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage.
Answer: A. Obtain a portable chest x-ray
need more info on chest, not abdomen
◉ Twenty seven people are severely injured in an aircraft crash at a
local airport. The principles of triage include:
,A. establish a triage site within the internal perimeter of the crash
site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest 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.
Answer: E. Produce the greatest number of survivors based on
available resources
◉ A 22 year old male sustains a shotgun wound to the shoulder and
chest at close range. His BP is 80/40 and HR 130. After 2 L of
crystalloid solution are rapidly infused, his BP increases to 122/84
and HR decreases to 100. He is tachypneic with RR of 28. On PE, his
breath sounds are decreased at the left upper chest with dullness on
percussion. A large caliber tube thoracostomy is inserted into the
fifth intercostal space with the return of 200 mL of blood and no air
leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest.
Answer: E. Repeat the physical exam of the chest
, decreased breath sounds w/dullness -> hemothorax, need tube to
drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension
pneumonia, need needle decompression followed by tube
◉ Which one of the following statements concerning spine 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 spine 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.
Answer: B. A vertebral injury is unlikely in the absence of physical
findings of a cord injury
◉ A 17 year old female is brought to the ED following a 6 feet fall
onto concrete. She is unresponsive and found to have a RR of 32, BP
of 90/60, and HR of 68. The FIRST step in treatment is:
TRIAGE SCENARIOS PATIENT A F COMPLETE
SOLUTIONS
◉ Which of the following should be performed FIRST in any patient
whose injuries may include multiple closed extremity fractures?
A. A thorough assessment of four limb perfusion
B. Manuevers to prevent necrosis of the skin
C. Extremity compartment syndrome release
D. Ensuring adequate oxygenation and ventilation
E. Evaluation for occult crush syndrome.
Answer: D. Ensuring adequate oxygenation and ventilation
(ABC's)
◉ Which of the following statements are correct?
A. Cerebral contusions may coalesce to form an intracerebral
hematoma
B. Epidural hematomas are usually seen in the frontal region
C. Subdural hematomas are caused by injury to the middle
meningeal artery
D. Subdural hematomas typically have a lenticular shape on CT
,E. The associated brain damage is more severe in epidural
hematomas.
Answer: A. Cerebral contusions may coalesce to form an
intracerebral hematoma
EM: Epidural, middle meningeal
SuB: Subdural, Bridging veins
◉ An 18 year old male is brought to the ED after being 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 blood
pressure is 110/60, heart rate of 90, and respiratory rate of 34. After
ensuring a patent airway and inserting 2 large caliber IV lines, the
next most appropriate step is to:
A. Obtain a portable chest x-ray
B. Administer a bolus of additional IV fluid
C. Perform a laparatomy
D. Obtain an abdominal CT scan
E. Perform diagnostic peritoneal lavage.
Answer: A. Obtain a portable chest x-ray
need more info on chest, not abdomen
◉ Twenty seven people are severely injured in an aircraft crash at a
local airport. The principles of triage include:
,A. establish a triage site within the internal perimeter of the crash
site
B. treat only the most severely injured patients first
C. immediately transport all patients to the nearest 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.
Answer: E. Produce the greatest number of survivors based on
available resources
◉ A 22 year old male sustains a shotgun wound to the shoulder and
chest at close range. His BP is 80/40 and HR 130. After 2 L of
crystalloid solution are rapidly infused, his BP increases to 122/84
and HR decreases to 100. He is tachypneic with RR of 28. On PE, his
breath sounds are decreased at the left upper chest with dullness on
percussion. A large caliber tube thoracostomy is inserted into the
fifth intercostal space with the return of 200 mL of blood and no air
leak. The most appropriate next step is:
A. Insert a foley catheter
B. Begin to transfuse O negative blood
C. Perform thoracotomy
D. Obtain a CT Chest/Abd
E. Repeat the physical exam of the chest.
Answer: E. Repeat the physical exam of the chest
, decreased breath sounds w/dullness -> hemothorax, need tube to
drain
vs.
decreased/absent breath sounds w/hyperresonance -> tension
pneumonia, need needle decompression followed by tube
◉ Which one of the following statements concerning spine 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 spine 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.
Answer: B. A vertebral injury is unlikely in the absence of physical
findings of a cord injury
◉ A 17 year old female is brought to the ED following a 6 feet fall
onto concrete. She is unresponsive and found to have a RR of 32, BP
of 90/60, and HR of 68. The FIRST step in treatment is:
