ATLS test exam Questions and answers

1. When something crashes in sec- ondary survey, you... 2. If the question says you do not have capabilities, you will most likely GO BACK TO PRIMARY SURVEY PREPARE FOR AND DO NOT DELAY TRANSPORT 3. How much blood can femur lose 2L 4. What is always going to be the shock type to pick 5. What are the classes of hemor- rhagic shock 6. What is the EARLIEST predictor of shock at what class 7. What will be base deficit for class 2 shock? 8. What will be the deficit for class 4? 9. When will urine output start to decrease in shock? 10. When does BP start to fall in shock Hemorrhagic 0-15% is class 1 15-30 is class 2 30-40% is class 3 >40% is class 4 Narrowed pulse pressure in class 2 -2 to -6 meQ -10 or less Class 3 and 4 Class 3 11. What is GCS? E-4 V-5 M-6 Eye spont 4 To command 3 To pain 2 None 1 12. Two main reasons to think about why GCS goes down? 13. Why do you want to put in chest tube before needle decompres- sion? Verbal spont is 5 Verbal confused is 4 Inappropriate 3 Garbling is 2 None is 1 Motor spont is 6 Localize pain is 5 Withdrawal pain is 4 Decorticating (flexion) is 3 Decebrate (extension) is 2 None is 1 TBI Hemorrhagic shock SIMPLE PTX can turn into TENSION PTX 14. When is DPL useful over fast? No ultrasound available. 15. What is LEMON for airway paten- cy Look Evaluate Malay-ATI Obstruction Neck mobility 16. What is DEFINITIVE airway? Tube in trachea BELOW vocal cords 17. WHEN is surgical airway indicat- ed? 18. What is contraindicated with suspicion of basilar skull frx? 19. Peds kid with bicycle trauma is most likely goin to be? When you CANNOT do any other form of airway (2 attempts typically) OPA, put in gastric tube for suction be- cause it can go through up into cranium thru cribiform plate PANCREATIC injury 20. Organ tear is more common with? 21. What type of pelvic fracture is binder indicated in 22. If there is BLOOD at the meatus, then what do you need to do? 23. If patient is unstable, free air/blood on CT, peritoneal signs yield what? 24. What lab value is good for as- sessing hydration in burn pa- tient? 25. How do you determine differ- ence between PTX and tampon- ade? 26. Blowing air leak on chest tube is sign of? 27. Bowel sounds on chest auscul- tation are reflective of 28. Apical capping and widened me- diastinum are reflective of what? Penetrating injury Open book RUG first, because if you do a cyst gram you will be spilling into the abd cavity EMERGENT laparotomy URINE OUTPUT BREATH SOUNDS TRACHEOBRONCHIAL RUPTURE Diaphragm injury Aortic trauma 29. Circumferential burn? Escharotomy 30. What is main goal of priamry brain injury? 31. 2 big causes of secondary brain injury? Preventing secondary brain injury HYPOVOLEMIA and HYPOXEMIA 32. 32. Girl falls on her head, loses con- sciousness, and is now unsta- ble. What kind of hematoma is this? 33. What is more common, subdural or epidural EPIDURAL, *lucid interval* is common between time of injury and presentation Subdural 34. What is considered mid TBI? 13-15 35. T/o secondary management of mild TBI? CT repeat if first is abnormal OR GCS persists at under 15. Serial exams 36. Initial management of TBI? elevate head NS (3%) 37. Indications of transport to high- er Level of care with TBI? 38. Above what level can you get neurogenic shock 39. Description of neurogenic shock patient? 40. What is bulbovesicular reflex in- dicative of? 41. T/F: Stridor is LATE finding of airway damage in burn pt? Worsening GCS, GCS <8. Lesions on CT T6 NOT qualify as sacral sparing. If there is ANY motor or sensory function below level of injury, constitutes as incom- plete injury and should be documented appropriately TRUE 42. Initial management of burn? DRY dressing. NOT moist! 43. Transfer indications for burn? Partial thickness >40% BSA 44. What is dark urine reflective of in burn pt? 45. What do you constantly need to replenish burn pt? 46. What is GOAL urine output in burn? 47. What do you need to monitor for with rewarming in hypothermia RHABDO Cellular losses 2/2 inflammation 3-50mL per hour, BEST assessment of hydration ARRYTHMIA 48. MCC of cardiac arrest in kids? HYPOXIA 49. If you fail an IV in a kid what is next step? 50. What is crystalloid infusion unit for kids IO 20/kg 51. Two MCC of geriatric injuries? FALL, MVC