ATLS (Ch 1-3: Initial
Assessment/Management, Airway,
Shock)
✅✅
A Class ___ Hemorrhage represents with smallest volume of blood loss that is
consistently associated with a drop in systolic BP - -III
A patient with inadequate perfusion, marked tachycardia and tachypnea,
✅✅
significant mental status change, and a measurable fall in systolic BP most
likely has a Class __ hemorrhage - -III or IV - almost always require
blood transfusion
1st priority is stopping the hemorrhage
Adult patients should maintain UOP of at least: - ✅✅-0.5 mL/kg/hr, kids 1.0
mL/kg/hr
AMPLE patients history - ✅✅-Allergies
Medications
PMH/Pregnancy
Last oral intake
Events/environment of injury
✅✅
Any patient who is cool and tachycardic is considered to be in __ until proven
otherwise - -In shock
✅✅
Approximately __% of body's total blood volume is located in venous circuit -
-70%
✅✅
Blood on the floor + 4 more is a mnemonic for blood loss where? -
-Chest, pelvic, retroperitoneum (pelvis), thigh (femur)
✅✅
Blood volume of obese person is calculated based upon their __ body weight -
-ideal body weight
✅✅
Bougies are typically inserted blindly, how do you know you're in the trachea
and not esophagus? - -Clicks as distal tip rubs against tracheal rings, or
will deviate R or L when entering bronchus (usually at 50 cm)
, Calculate total blood volume in adult - ✅✅-70 mL per kg of body weight
70 kg = 5 L of circulating blood (70x70 = 4900)
Calculate total blood volume in child - ✅✅-Body weight in kg x 80-90 mL
✅✅
Can a patient breathe on their own after complete cervical cord transection? -
-Yes if phrenic nerves (C3-C5) are spared - this will result in abdominal
breathing, intercostal muscles will be paralyzed though.
Can isolated intracranial injuries cause neurogenic shock? - ✅✅-NO
Can you use an OPA in a conscious patient? - ✅✅-No, gag reflex would
make them vomit
✅✅
Compensatory mechanisms may preclude a measurable fall in systolic BP up
until __% of patients blood volume is lost. - -up to 30%
Cricoid cartilage is only circumferential support for upper trachea in kids,
✅✅
therefore surgical cric not recommended in kids under the age of __ -
-12 yo
Definition of tachycardia depends on the patient's age. What HR is considered
✅✅
tachycardic for infants, toddlers/preschoolers, school age/prepubescent,
adults? - -Infants >160
Toddlers/preschool >140
School age >120
Adults >100
Each mL of blood loss should be replaced with __ mL of crystalloid, thus
✅✅
allowing for replacement of plasma volume lost into interstitial and intracellular
spaces - -3 mL
✅✅
Elderly patients have a limited ability to __ to compensate for blood loss. -
-Increase HR
Elderly patients may not exhibit tachycardia in response to hypovolemia
✅✅
because of limited cardiac response to catecholamines. Why else? -
-Beta blocker or pacemaker
Assessment/Management, Airway,
Shock)
✅✅
A Class ___ Hemorrhage represents with smallest volume of blood loss that is
consistently associated with a drop in systolic BP - -III
A patient with inadequate perfusion, marked tachycardia and tachypnea,
✅✅
significant mental status change, and a measurable fall in systolic BP most
likely has a Class __ hemorrhage - -III or IV - almost always require
blood transfusion
1st priority is stopping the hemorrhage
Adult patients should maintain UOP of at least: - ✅✅-0.5 mL/kg/hr, kids 1.0
mL/kg/hr
AMPLE patients history - ✅✅-Allergies
Medications
PMH/Pregnancy
Last oral intake
Events/environment of injury
✅✅
Any patient who is cool and tachycardic is considered to be in __ until proven
otherwise - -In shock
✅✅
Approximately __% of body's total blood volume is located in venous circuit -
-70%
✅✅
Blood on the floor + 4 more is a mnemonic for blood loss where? -
-Chest, pelvic, retroperitoneum (pelvis), thigh (femur)
✅✅
Blood volume of obese person is calculated based upon their __ body weight -
-ideal body weight
✅✅
Bougies are typically inserted blindly, how do you know you're in the trachea
and not esophagus? - -Clicks as distal tip rubs against tracheal rings, or
will deviate R or L when entering bronchus (usually at 50 cm)
, Calculate total blood volume in adult - ✅✅-70 mL per kg of body weight
70 kg = 5 L of circulating blood (70x70 = 4900)
Calculate total blood volume in child - ✅✅-Body weight in kg x 80-90 mL
✅✅
Can a patient breathe on their own after complete cervical cord transection? -
-Yes if phrenic nerves (C3-C5) are spared - this will result in abdominal
breathing, intercostal muscles will be paralyzed though.
Can isolated intracranial injuries cause neurogenic shock? - ✅✅-NO
Can you use an OPA in a conscious patient? - ✅✅-No, gag reflex would
make them vomit
✅✅
Compensatory mechanisms may preclude a measurable fall in systolic BP up
until __% of patients blood volume is lost. - -up to 30%
Cricoid cartilage is only circumferential support for upper trachea in kids,
✅✅
therefore surgical cric not recommended in kids under the age of __ -
-12 yo
Definition of tachycardia depends on the patient's age. What HR is considered
✅✅
tachycardic for infants, toddlers/preschoolers, school age/prepubescent,
adults? - -Infants >160
Toddlers/preschool >140
School age >120
Adults >100
Each mL of blood loss should be replaced with __ mL of crystalloid, thus
✅✅
allowing for replacement of plasma volume lost into interstitial and intracellular
spaces - -3 mL
✅✅
Elderly patients have a limited ability to __ to compensate for blood loss. -
-Increase HR
Elderly patients may not exhibit tachycardia in response to hypovolemia
✅✅
because of limited cardiac response to catecholamines. Why else? -
-Beta blocker or pacemaker
