ATLS Review 2025/2026
A 22yo M is hypotensive and tachycardia after a shotgun wound to the L shoulder.
His BP is initially 80/40. After 2L of fluids his BP increases to 122/84. HR is 100bpm
and his RR is 28. Breath sounds are decreased in the left hemithorax, and a closed
tube thoracotomy is performed with a small amount of blood return and no air
leak. What is the next step? - ANSWER
Reexamine the chest
A construction worker falls 2 stories and suffers bilateral calcanea fractures. He
now is having back pain. What would confirm diagnosis? - ANSWER
Complete spine x-ray series
What is the principle of balanced resuscitation? - ANSWER
permissive hypotension and early plasma infusion
In managing a head-injured patient, what is the most important initial step? -
ANSWER Secure the airway
,A previously healthy 70kg man suffered ~2L of acute blood loss. Which
appropriately applies to this patient? - ANSWER
His systolic BP will be decreased with a narrowed pulse pressure
NOT his pulse pressure will be widened, urinary output at lower level of normal,
tachy but no BP change, or maintained systolic BP with elevated diastolic BP
The physiologic hypovolemia of pregnancy has clinical significance in the
management of severely injured, gravid woman by: - ANSWER
increasing the volume of blood to produce maternal hypotension
The best assessment of fluid resuscitation of the burn patient is - ANSWER
adequate urinary output
The diagnosis of shock MUST include: - ANSWER
evidence of inadequate organ perfusion
, A 7yo M is brought to the ED by his parents several minutes after falling through a
window. He is bleeding from a 6cm wound on the medial right thigh. Immediate
management of the wound should include? - ANSWER
Direct pressure on the wound
**For the patient with severe traumatic brain injury, around HYPOCARBIA (dec
CO2) should be avoided in order to prevent what? - ANSWER
cerebral vasoconstriction with diminished perfusion.
**A 25yo M is brought in to a facility with a general surgeon after being in an
MVA, CT shows aortic injury and spe=lenic lac with abdominal fluid, BP is 70mm
Hg after CT. What is the next step? - ANSWER
exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the
pregnant patient is true? - ANSWER
leakage of amniotic fluid is indication for hospital admission
What is the first maneuver to improve oxygenation after chest injury? -
ANSWER administer supplemental O2
A 22yo M is hypotensive and tachycardia after a shotgun wound to the L shoulder.
His BP is initially 80/40. After 2L of fluids his BP increases to 122/84. HR is 100bpm
and his RR is 28. Breath sounds are decreased in the left hemithorax, and a closed
tube thoracotomy is performed with a small amount of blood return and no air
leak. What is the next step? - ANSWER
Reexamine the chest
A construction worker falls 2 stories and suffers bilateral calcanea fractures. He
now is having back pain. What would confirm diagnosis? - ANSWER
Complete spine x-ray series
What is the principle of balanced resuscitation? - ANSWER
permissive hypotension and early plasma infusion
In managing a head-injured patient, what is the most important initial step? -
ANSWER Secure the airway
,A previously healthy 70kg man suffered ~2L of acute blood loss. Which
appropriately applies to this patient? - ANSWER
His systolic BP will be decreased with a narrowed pulse pressure
NOT his pulse pressure will be widened, urinary output at lower level of normal,
tachy but no BP change, or maintained systolic BP with elevated diastolic BP
The physiologic hypovolemia of pregnancy has clinical significance in the
management of severely injured, gravid woman by: - ANSWER
increasing the volume of blood to produce maternal hypotension
The best assessment of fluid resuscitation of the burn patient is - ANSWER
adequate urinary output
The diagnosis of shock MUST include: - ANSWER
evidence of inadequate organ perfusion
, A 7yo M is brought to the ED by his parents several minutes after falling through a
window. He is bleeding from a 6cm wound on the medial right thigh. Immediate
management of the wound should include? - ANSWER
Direct pressure on the wound
**For the patient with severe traumatic brain injury, around HYPOCARBIA (dec
CO2) should be avoided in order to prevent what? - ANSWER
cerebral vasoconstriction with diminished perfusion.
**A 25yo M is brought in to a facility with a general surgeon after being in an
MVA, CT shows aortic injury and spe=lenic lac with abdominal fluid, BP is 70mm
Hg after CT. What is the next step? - ANSWER
exploratory laparotomy
Which one of the following statements regarding abdominal trauma in the
pregnant patient is true? - ANSWER
leakage of amniotic fluid is indication for hospital admission
What is the first maneuver to improve oxygenation after chest injury? -
ANSWER administer supplemental O2
