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ATLS Test Questions & Correct Answers 2025–2026
| Advanced Trauma Life Support Updated Exam |
Verified Real Questions and Answers PDF Study
Guide
Get the ATLS 2025–2026 Test Questions and Answers — the most
accurate and updated resource for Advanced Trauma Life
Support exam preparation. This verified study guide includes real
exam-style questions, trauma case scenarios, step-by-step
explanations, and correct answers aligned with the 10th Edition ATLS
standards. Perfect for medical students, EMTs, nurses, and trauma
care professionals preparing for certification success.
1. Anatomy of hypopharynx -ANSWER: FAUCES
- Aperture by which mouth communicates with pharynx
Boundaries:
Superior = soft palate
Inferior = dorsum of tongue
Lateral = glossopalatine arches
PILLARS
Anterior pillar = glossopalatine arch
Posterior pillar = pharyngopalatine arch
PALATINE TONSILS
Masses between glossopalatine & pharyngopalatine arches
2. Airway maintenance techniques -ANSWER: 1) Chin-lift
2) Jaw thrust
1
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
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2 of 372 of 372 of 37
3) Oropharyngeal airway
- Do not use 180° rotation method for insertion in children as it can damage mouth
& pharynx
4) Nasopharyngeal airway
5) Extraglottic & supraglottic devices
i) LMA / Intubating LMA
ii) Laryngeal tube airway
iii) Multilumen oesophageal airway
3. Definitive airway -ANSWER: Tube placed in trachea with cuff inflated below
the vocal cords
3 types:
i) Orotracheal tubes
ii) Nasotracheal tubes
iii) Surgical airway
4. Indications for definitive airway -ANSWER: NEED FOR AIRWAY
PROTECTION
1) Severe maxillofacial fractures
2) Risk of obstruction
- Neck haematoma
- Laryngeal / tracheal injury
- Stridor
3) Risk for aspiration
- Bleeding
- Vomitng
4) Unconscious
NEED FOR VENTILATION
1) Inadequate respiratory effort
- Tachypnoea
- Hypoxia
- Hypercarbia
- Cyanosis
2) Massive blood loss & need for volume resusicitation
2
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
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3 of 373 of 373 of 37
3) Severe closed head injury + need for hyperventilation if neurological
deterioration occurs
4) Apnoea
- NM paralysis
- Unconscious
5. Contraindications to nasotracheal intubation -ANSWER: Fractures - facial /
frontal sinus / basilar skull / cribiform plate
Signs:
i) Nasal fracture
ii) Raccoon eyes (bilateral periorbital ecchymosis)
iii) Battle's sign (post-auricular ecchymosis)
iv) Rhinorrhoea / otorrhoea (CSF leakage)
Suxamethonium / succinylcholine - caution -ANSWER: Depolarising NM blocker
CAUTION
i) Hyperkalaemia
- Caution with severe crush injuries / burns / electrical injuries
ii) Malignant hyperthermia → uncontrolled skeletal muscle oxidative metabolism
Surgical airway -ANSWER: Surgical airway required when airway obstructed by:
- Oedema of glottis
- Laryngeal fracture
- Oropharyngeal haemorrhage
Surgical cricothyroidotomy preferred to tracheostomy:
i) Easier to perform
ii) Less bleeding
iii) Requires less time to perform
Needle cricothyroidotomy -ANSWER: a) Plastic cannula through cricothyroid
membrane
b) Connected to 15L O2
c) Jet insufflation - 1sec ON / 4 sec OFF
** Inadequate exhalation ∴ CO2 accumulates
** Can be used for 30-45 mins
3
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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, *@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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Assessing adequate oxygenation -ANSWER: PULSE OXIMETRY
- Measures O2 sats of arterial blood
- Does not measure PaO2
** Sats ≥95% suggests adequate peripheral arterial oxygentaion (PaO2 >70mmHg
or 9.3kPa)
NOTE:
i) Requires intact peripheral perfusion
ii) Cannot distinguish oxyhaemoglobin from carboxyhaemoglobin /
metheamoglobin
LIMITED USEFULNESS IN:
a) Vasoconstriction
b) CO poisoning
c) Profound anaemia (Hb <5g/dL)
d) Hypothermia (<30°)
When is pulse oximetry unreliable? -ANSWER: i) Poor peripheral perfusion
ii) Severe anaemia
iii) High levels of carboxyhaemoglobin or methaemoglobin
iv) High levels of circulating dye (e.g. indocyanine green / methylene blue)
v) Excessive pt movement
vi) Intense ambient light
Oxygen dissociation curve -ANSWER: * Describes relationship between pO2 (x)
& O2 sats (y)
* Hb binds 4 O2 molecules reversibly
* Binding of first molecule is difficult but facilitates binding of subsequent
molecules
FACTORS AFFECTING CURVE
RIGHT SHIFT = Hb has decreased affinity for oxygen
- Difficult for Hb to bind O2 / easier to release
- Increases pO2 in tissues (e.g. during exercise / shock)
LEFT SHIFT = Hb has increased affinity for O2
- Binds O2 more easily / releases it less easily
4
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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ATLS Test Questions & Correct Answers 2025–2026
| Advanced Trauma Life Support Updated Exam |
Verified Real Questions and Answers PDF Study
Guide
Get the ATLS 2025–2026 Test Questions and Answers — the most
accurate and updated resource for Advanced Trauma Life
Support exam preparation. This verified study guide includes real
exam-style questions, trauma case scenarios, step-by-step
explanations, and correct answers aligned with the 10th Edition ATLS
standards. Perfect for medical students, EMTs, nurses, and trauma
care professionals preparing for certification success.
1. Anatomy of hypopharynx -ANSWER: FAUCES
- Aperture by which mouth communicates with pharynx
Boundaries:
Superior = soft palate
Inferior = dorsum of tongue
Lateral = glossopalatine arches
PILLARS
Anterior pillar = glossopalatine arch
Posterior pillar = pharyngopalatine arch
PALATINE TONSILS
Masses between glossopalatine & pharyngopalatine arches
2. Airway maintenance techniques -ANSWER: 1) Chin-lift
2) Jaw thrust
1
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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2 of 372 of 372 of 37
3) Oropharyngeal airway
- Do not use 180° rotation method for insertion in children as it can damage mouth
& pharynx
4) Nasopharyngeal airway
5) Extraglottic & supraglottic devices
i) LMA / Intubating LMA
ii) Laryngeal tube airway
iii) Multilumen oesophageal airway
3. Definitive airway -ANSWER: Tube placed in trachea with cuff inflated below
the vocal cords
3 types:
i) Orotracheal tubes
ii) Nasotracheal tubes
iii) Surgical airway
4. Indications for definitive airway -ANSWER: NEED FOR AIRWAY
PROTECTION
1) Severe maxillofacial fractures
2) Risk of obstruction
- Neck haematoma
- Laryngeal / tracheal injury
- Stridor
3) Risk for aspiration
- Bleeding
- Vomitng
4) Unconscious
NEED FOR VENTILATION
1) Inadequate respiratory effort
- Tachypnoea
- Hypoxia
- Hypercarbia
- Cyanosis
2) Massive blood loss & need for volume resusicitation
2
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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3) Severe closed head injury + need for hyperventilation if neurological
deterioration occurs
4) Apnoea
- NM paralysis
- Unconscious
5. Contraindications to nasotracheal intubation -ANSWER: Fractures - facial /
frontal sinus / basilar skull / cribiform plate
Signs:
i) Nasal fracture
ii) Raccoon eyes (bilateral periorbital ecchymosis)
iii) Battle's sign (post-auricular ecchymosis)
iv) Rhinorrhoea / otorrhoea (CSF leakage)
Suxamethonium / succinylcholine - caution -ANSWER: Depolarising NM blocker
CAUTION
i) Hyperkalaemia
- Caution with severe crush injuries / burns / electrical injuries
ii) Malignant hyperthermia → uncontrolled skeletal muscle oxidative metabolism
Surgical airway -ANSWER: Surgical airway required when airway obstructed by:
- Oedema of glottis
- Laryngeal fracture
- Oropharyngeal haemorrhage
Surgical cricothyroidotomy preferred to tracheostomy:
i) Easier to perform
ii) Less bleeding
iii) Requires less time to perform
Needle cricothyroidotomy -ANSWER: a) Plastic cannula through cricothyroid
membrane
b) Connected to 15L O2
c) Jet insufflation - 1sec ON / 4 sec OFF
** Inadequate exhalation ∴ CO2 accumulates
** Can be used for 30-45 mins
3
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
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3 of 373 of 373 of 37
, *@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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4 of 374 of 374 of 37
Assessing adequate oxygenation -ANSWER: PULSE OXIMETRY
- Measures O2 sats of arterial blood
- Does not measure PaO2
** Sats ≥95% suggests adequate peripheral arterial oxygentaion (PaO2 >70mmHg
or 9.3kPa)
NOTE:
i) Requires intact peripheral perfusion
ii) Cannot distinguish oxyhaemoglobin from carboxyhaemoglobin /
metheamoglobin
LIMITED USEFULNESS IN:
a) Vasoconstriction
b) CO poisoning
c) Profound anaemia (Hb <5g/dL)
d) Hypothermia (<30°)
When is pulse oximetry unreliable? -ANSWER: i) Poor peripheral perfusion
ii) Severe anaemia
iii) High levels of carboxyhaemoglobin or methaemoglobin
iv) High levels of circulating dye (e.g. indocyanine green / methylene blue)
v) Excessive pt movement
vi) Intense ambient light
Oxygen dissociation curve -ANSWER: * Describes relationship between pO2 (x)
& O2 sats (y)
* Hb binds 4 O2 molecules reversibly
* Binding of first molecule is difficult but facilitates binding of subsequent
molecules
FACTORS AFFECTING CURVE
RIGHT SHIFT = Hb has decreased affinity for oxygen
- Difficult for Hb to bind O2 / easier to release
- Increases pO2 in tissues (e.g. during exercise / shock)
LEFT SHIFT = Hb has increased affinity for O2
- Binds O2 more easily / releases it less easily
4
~~&@ @!&* ^##!&#!** * DO N OT EX PLORE W OU NDS EXTEN DING TH ROUGH PLATYSMA ***
SECONDA RY SURVEY - PHYSICA L EXAMI NATION - CHEST CORRE CT ANSWE RS: - VISUAL EVALUATION
- PALPATI ON I NCLUDI NG CLAVICLES / RIBS / STE RNUM
AUSCULTATI ON
* HIGH ANTE RIOR ?PNE UMOTH ORA X
* POSTERI OR BASES ?HAEMOTH ORAX
--- CARD IAC TAMP ONADE:
DISTANT HEART SOUNDS & DE CREASED PULSE PRESSU RE
--- DISTENDED NECK VEINS:
TENSION PNEUM OTH ORAX / CARDIA C TAMPONADE
LARYN GEAL TRA UMA CORRE CT ANSWE RS: LA RYNGEA L FRACT URE IS RA RE
- CAN P RESENT WITH ACUTE AI RWAY OBSTRUCTI ON
INDICATED BY:
I) HOA RSENESS
II) SUBCUTANE OUS EM PHYSEMA
III) PALPABLE FRACTU RE
OBJECTIVE SIG NS OF AIRWAY OBST RUCTION CORRE CT ANSWE RS: 1) OBSE RVE PATIENT
A) AGITATION - HYP OXIA
B) OBTU NDATION - HY PERCARBIA
C) CYA NOSIS - HY POXAEMIA DUE TO I NADEQUATE OXY GENATI ON
- NAIL BEDS & CIRCUM ORAL
- LATE FINDI NG
D) RET RACTI ONS / USE OF ACCESSORY MUSCLES
2) ABN ORMAL SOU NDS
- NOISY BREATH ING = OBST RUCTE D BREATHING
I) SNORING / GU RGLI NG / CROWIN G (ST RIDOR) - PARTIA L OCCLUSION OF LA RYN X & PHA RYN X
II) HOA RSENESS (DYSP HON IA) - FU NCTI ONA L, LARYNGEA L OBST RU CTION
3) TRACHEAL P OSITION
4) PATIENT BEHAVIOUR
- ABSUIVE & BELLIGE RENT PT MAYBE DU E TO HYP OXIA
OXYGE N DELIVE RY METH ODS (BTS G UIDE LINES ) CORRE CT ANSWE RS: RESE RVOI R MASK
- DELIVE RS 60-9 0% O2
- 10-15 L/ MIN
SIMPLE FACE MASK
- DELIVE RS 40-6 0% O2
- 5-1 0 L/MI N
- FLOWS <5 L/ MIN CA N CAUSE IN CREASED RESISTANCE T O BREATHING + POSSI BLE CO2 BUI LD UP
NASAL CANN ULAE
- ADJUSTABLE FLOW G IVES WIDE OXYGEN D OSE RAN GE
(1-6 L/MI N GIVE FIO2 ~ 24-50%)
CAUSES OF COMPROMISED VENTI LATION CORRECT ANSW ERS: I ) AIRWAY OBST RUCT ION
II) ALTE RED VENTI LATORY MECHAN ICS
- CHEST T RAUMA → PAI NFUL BREATHI NG
- PRE XISTING LU NG DISEASE
III) CNS DEPRESSI ON
- INT RACRAN IAL INJU RY → A BNORMAL BREAT HING PATTE RN
- C-S PINAL CORD INJU RY → DIAP HRAGMATI C BREATHIN G
-COMPLETE C-SPINAL CORD TRA NSECTI ON (S PARES PH RENI C NE RVE, C3 -4) → ABD O BREATHING & INT ERCOSTAL M USCLE PARALYSIS
OBJECTIVE SIG NS OF INADE QUATE VENTI LATION CORRE CT ANSWE RS: CH EST WALL MOVEMENT
? SYMMETRICAL CHEST WA LL EX CU RSION
- ASYMMETRY → SPLI NTING OF RI B CAGE OR FLAI L CHEST
AUSCULTATI ON
- RAPID RR = RESPI RATORY DISTRESS
PULSE OXIMETE R
- INFORMATION ABOUT O2 SATS & PERI PHE RAL PE RFUSION
PREDI CTING DIFFI CU LT AIRWAYS CORRECT ANS WERS: FACT ORS THAT MAY P REDI CT DIFFICU LTIES WIT H AIRWAY MAN OEUV RES:
I) C-SPINE I NJURY
II) C-SPINE A RTHRIT IS
III) MAXI LLOFACIAL / MAN DIBULAR T RAUMA
IV) LIMITED M OUTH OPE NING
V) OBESITY
VI) ANATOMI CAL VARIATIONS
- RECEDING CHIN
- OVERBITE
- SHORT, MUSCULAR NECK
LEMON ASSESSMENT OF DIFFICU LT INT UBATI ON CORRECT ANS WERS: L = LOOK E XTERNALLY
?CHARACTE RISTIC KNOWN T O CAUSE DIFFICULT I NTU BATION / VENTILATI ON
- SMALL M OUTH OR JAW / LARGE OVERBITE / FACIAL T RAUMA
EVALUATE 3-3 -2 RULE
TO ALLOW ALIGNME NT OF PHA RYNG EAL, LA RYNGEA L & ORA L AXES, FOLLOWIN G RELATI ONSHI P MUST BE OBSE RVED
A) 3 FINGE RS BREADT H DISTANCE BETWEE N IN CISOR TEETH
B) 3 FIN GER BREADTH D ISTANCE BETWEE N HYOI D BONE & CHIN
C) 2 FIN GER BREADTH DISTA NCE BETWEE N THYROID N OTCH & FLOOR OF M OUTH
M = MALLAMPATI
VISUALISE HYPOPHARY NX
MALLAMPATI CLASSIFICATION CORRECT ANS WERS: PT UP RIGHT OR SUP INE - OPE N MOUT H & P ROTRU DE TON GUE
CLASSIFICATIONS:
CLASS I
SOFT PALATE, UVU LA, FAUCES, PI LLARS VISIBLE
CLASS II
SOFT PALATE, UVU LA, FAUCES VISIBLE
CLASS III
SOFT PALATE, BASE OF UVU LA VISIBLE
CLASS IV
HARD PALATE ONLY VISI BLE
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
*@*^%^#!*&^*&^!()(@*&$*@10/23/2026,
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4 of 374 of 374 of 37
