PHTLS and Trauma Review Questions and answers

How many people die from trauma annually? Over 5 million What is the leading cause of trauma deaths? MVA Where do over 90% of trauma deaths occur? Low-middle income countries What is the leading cause of death in people aged 1-44? Trauma What are the goals of PHTLS? Reduce morbidity and mortality from trauma, and provide appropriate care to the patient in the field What is the PHTLS philosophy? 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? Safety, pre-arrival information, arrival on-scene, MOI, and patients What is paramount for scene assessment? Personal and Personnel safety What is the global view? What you get before you get out of your vehicle What is the goal of the Primary Survey? To immediately identify life threatening situations and manage them as they are identified What are the components of the Primary Survey? Airway, Breathing, Circulation, Disability, Exposure When does assessment of the incident begin? Before arriving at the patient's side The findings of the scene assessment and primary survey help to determine what? If the patient is sick, not yet sick, or not sick When should the secondary survey be completed? Only if time and situation permit What are the components of the secondary survey? Vital signs, History, Physical Examination, Treatment, Level of Care, Transportation, and Communication What are the components of a radio report? Timely, Scene Description, Number of Patients, Current Patient Status, Treatment Provided, ETA What is a tracheal consideration with pediatric patients in regards to ET intubation? Potential for right main-stem intubation What is the most common cause of airway obstruction in the trauma patient? The tongue When are basic maneuvers applied in regards to trauma airway management? First When are advanced airway maneuvers performed for trauma patients? After basic, only if needed What is the goal of managing a patient's airway? Maintain an open and patent airway that allows for adequate breathing, ventilation, and oxygenation What does airway management entail? Anticipating difficulties and planning for alternate methods of airway control What is always the first airway maneuver for the trauma patient? Trauma Jaw Thrust / Chin Lift What should be considered second for maintaining a patent airway in a trauma patient? OPA or NPA What adjunct should be considered third for airway management in the trauma patient? Supra-Glottic Airways When should glottic airways be considered? After jaw thrusts, OPA/NPA, and Supra-Glottic airways have failed What are some assessment criteria for Endotracheal Intubation? 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? Surgical What types of methods should be used to verify tube placement? One physiological and mechanical method When the patient's breathing draws your attention, you should: Assume there is a problem until proven otherwise What are some signs and symptoms you are looking for in a trauma patient's breathing assessment? Increased respiratory effort, visible trauma, paradoxical chest wall movement, sucking chest wound What are some signs and symptoms you are feeling for in a trauma patient's breathing assessment? Boney crepitus, subcutaneous emphysema What is the biggest difference between a simple and a tension pneumothorax? A tension pneumothorax has a hemodynamic compromise Which ribs are most at risk for rib fractures? Ribs 4-8 laterally What is the most common cause of hemothorax? Fractures to ribs 4-8 What are common complaints of rib fractures? Pain and Shortness of Breath Under what circumstances should you withhold oxygen from a patient? Never withhold oxygen from a patient in respiratory distress When should you assist ventilations? When the respiratory rate is above 28 or less than 10 What is the ventilatory rate for adults? 10-12 bpm for 500-800 cc What is the ventilatory rate for children? 16-20 bpm for 100-500 cc or good chest rise What is the ventilatory rate for infants? 25 bpm for 6-8 mL/kg What end tidal CO2 reading should you maintain? 35-45 mm Hg Where should a needed decompression be placed? 2nd intercostal space mid clavicular line, over the 3rd rib What is shock? A result of inadequate energy production to sustain life What are the brain, heart and lungs tolerance to hypoxia? 4-6 minutes What are the kidneys, liver and GI tracts tolerance to hypoxia? 45-90 minutes