ADVANCED TRAUMA
LIFE SUPPORT EXAM
Comprehensive Study Guide & Practice Questions
Airway • Shock • Hemorrhage • Thoracic • Abdominal • Head & Spine • Burns • Pediatric • Geriatric
For educational use only • All rights reserved
,ADVANCED TRAUMA LIFE SUPPORT (ATLS) Study Guide
QUESTIONS & ANSWERS
Q1. Patients with a GCS of less than ___ usually require intubation.
Answer: 8
Q2. The "A" in ABCD stands for _______.
Answer: Airway maintenance with CERVICAL SPINE PROTECTION
Q3. You should assume that any patient in a multisystem trauma with an altered level of consciousness
or blunt injury above the clavicle has what type of injury?
Answer: Cervical spine injury
Q4. Flail chest is invariably accompanied by ______ which can interfere with blood oxygenation.
Answer: Pulmonary contusion — do NOT over fluid resuscitate these patients!
Q5. Hypotension is caused by _____ until proven otherwise.
Answer: Hypovolemia
Q6. When you don't have/can't get a blood pressure, what are three things to look for when evaluating
perfusion?
Answer: 1. Level of consciousness (brain perfusion) 2. Skin color (ashen face/grey extremities) 3. Pulse
(bilateral femoral — thready/tachy)
Q7. Elderly patients have a limited ability to ______ to compensate for blood loss.
Answer: Increase heart rate
Q8. Resuscitation fluids should be warmed to 39°C (102.2°F). Can you use a microwave to do this?
Answer: YES — for CRYSTALLOID ONLY (but NOT for blood products).
Q9. Urinary catheters are good for assessing renal perfusion and volume status. List 5 signs of urethral
injury that might prevent you from inserting one.
Answer: Blood at urethral meatus, perineal ecchymosis, blood in scrotum, high-riding/non-palpable prostate,
pelvic fracture
Q10. Which arm should you NOT put a pulse-ox on?
Answer: The arm with a blood pressure cuff on it
Q11. Name two anatomical things that can interfere with doing a FAST scan.
Answer: Obesity and intraluminal bowel gas
Q12. When should radiographs be obtained?
Answer: During the SECONDARY survey.
Q13. How do you get an AMPLE patient history?
Answer: A=Allergies, M=Medications, P=PMH/Pregnancy, L=Last meal, E=Events/Environment of injury
Q14. Why might you want a Bair Hugger for a patient who smells of alcohol?
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, ADVANCED TRAUMA LIFE SUPPORT (ATLS) Study Guide
Answer: Vasodilation can lead to hypothermia
Q15. What things are you looking for when you do a DRE in a trauma?
Answer: Blood, high-riding prostate (in males), and sphincter tone
Q16. What should you do for every female patient?
Answer: Pregnancy test (females of childbearing age)
Q17. Adult patients should maintain UOP of at least ___ mL/kg/hr. Kids should have at least ___
mL/kg/hr.
Answer: Adults: 0.5 mL/kg/hr | Kids: 1.0 mL/kg/hr
Q18. Preventing hypercarbia is critical in patients who have sustained a _____ injury.
Answer: Head
Q19. What two places would you LOOK at a patient if you suspect hypoxemia?
Answer: Lips and fingernail beds
Q20. Patients may be abusive and belligerent because of _____, so don't just assume it's due to drugs,
alcohol, or inherent personality.
Answer: Hypoxia
Q21. Can a patient breathe on their own after complete cervical cord transection?
Answer: Yes, if the phrenic nerves (C3–C5) are spared — resulting in 'abdominal' breathing. Intercostal
muscles will be paralyzed.
Q22. Can you use an OPA (Guedel) in a conscious patient?
Answer: No — it could make them vomit. An NPA (trumpet) would be okay.
Q23. Bougies are typically inserted blindly. How do you know you are in the trachea and not the
esophagus?
Answer: You can feel 'clicks' as the distal tip rubs against the cartilaginous tracheal rings, or it will deviate
right or left when entering a bronchus (usually at 50 cm).
Q24. What do you NOT want to hear if you auscultate a patient after placement of an ET tube?
Answer: Borborygmi — rumbling/gurgling noises suggesting esophageal insertion.
Q25. What is the RSI dose for etomidate?
Answer: 0.3 mg/kg (usually 20 mg)
Q26. What is the RSI dose for succinylcholine (sux)?
Answer: 1–2 mg/kg (usually 100 mg)
Q27. How does etomidate affect blood pressure?
Answer: It doesn't — no significant effect on BP. Ketamine will increase BP; propofol and thiopental will drop
BP.
Q28. A RSI dose of sux usually lasts about ___ minutes.
Page 3
LIFE SUPPORT EXAM
Comprehensive Study Guide & Practice Questions
Airway • Shock • Hemorrhage • Thoracic • Abdominal • Head & Spine • Burns • Pediatric • Geriatric
For educational use only • All rights reserved
,ADVANCED TRAUMA LIFE SUPPORT (ATLS) Study Guide
QUESTIONS & ANSWERS
Q1. Patients with a GCS of less than ___ usually require intubation.
Answer: 8
Q2. The "A" in ABCD stands for _______.
Answer: Airway maintenance with CERVICAL SPINE PROTECTION
Q3. You should assume that any patient in a multisystem trauma with an altered level of consciousness
or blunt injury above the clavicle has what type of injury?
Answer: Cervical spine injury
Q4. Flail chest is invariably accompanied by ______ which can interfere with blood oxygenation.
Answer: Pulmonary contusion — do NOT over fluid resuscitate these patients!
Q5. Hypotension is caused by _____ until proven otherwise.
Answer: Hypovolemia
Q6. When you don't have/can't get a blood pressure, what are three things to look for when evaluating
perfusion?
Answer: 1. Level of consciousness (brain perfusion) 2. Skin color (ashen face/grey extremities) 3. Pulse
(bilateral femoral — thready/tachy)
Q7. Elderly patients have a limited ability to ______ to compensate for blood loss.
Answer: Increase heart rate
Q8. Resuscitation fluids should be warmed to 39°C (102.2°F). Can you use a microwave to do this?
Answer: YES — for CRYSTALLOID ONLY (but NOT for blood products).
Q9. Urinary catheters are good for assessing renal perfusion and volume status. List 5 signs of urethral
injury that might prevent you from inserting one.
Answer: Blood at urethral meatus, perineal ecchymosis, blood in scrotum, high-riding/non-palpable prostate,
pelvic fracture
Q10. Which arm should you NOT put a pulse-ox on?
Answer: The arm with a blood pressure cuff on it
Q11. Name two anatomical things that can interfere with doing a FAST scan.
Answer: Obesity and intraluminal bowel gas
Q12. When should radiographs be obtained?
Answer: During the SECONDARY survey.
Q13. How do you get an AMPLE patient history?
Answer: A=Allergies, M=Medications, P=PMH/Pregnancy, L=Last meal, E=Events/Environment of injury
Q14. Why might you want a Bair Hugger for a patient who smells of alcohol?
Page 2
, ADVANCED TRAUMA LIFE SUPPORT (ATLS) Study Guide
Answer: Vasodilation can lead to hypothermia
Q15. What things are you looking for when you do a DRE in a trauma?
Answer: Blood, high-riding prostate (in males), and sphincter tone
Q16. What should you do for every female patient?
Answer: Pregnancy test (females of childbearing age)
Q17. Adult patients should maintain UOP of at least ___ mL/kg/hr. Kids should have at least ___
mL/kg/hr.
Answer: Adults: 0.5 mL/kg/hr | Kids: 1.0 mL/kg/hr
Q18. Preventing hypercarbia is critical in patients who have sustained a _____ injury.
Answer: Head
Q19. What two places would you LOOK at a patient if you suspect hypoxemia?
Answer: Lips and fingernail beds
Q20. Patients may be abusive and belligerent because of _____, so don't just assume it's due to drugs,
alcohol, or inherent personality.
Answer: Hypoxia
Q21. Can a patient breathe on their own after complete cervical cord transection?
Answer: Yes, if the phrenic nerves (C3–C5) are spared — resulting in 'abdominal' breathing. Intercostal
muscles will be paralyzed.
Q22. Can you use an OPA (Guedel) in a conscious patient?
Answer: No — it could make them vomit. An NPA (trumpet) would be okay.
Q23. Bougies are typically inserted blindly. How do you know you are in the trachea and not the
esophagus?
Answer: You can feel 'clicks' as the distal tip rubs against the cartilaginous tracheal rings, or it will deviate
right or left when entering a bronchus (usually at 50 cm).
Q24. What do you NOT want to hear if you auscultate a patient after placement of an ET tube?
Answer: Borborygmi — rumbling/gurgling noises suggesting esophageal insertion.
Q25. What is the RSI dose for etomidate?
Answer: 0.3 mg/kg (usually 20 mg)
Q26. What is the RSI dose for succinylcholine (sux)?
Answer: 1–2 mg/kg (usually 100 mg)
Q27. How does etomidate affect blood pressure?
Answer: It doesn't — no significant effect on BP. Ketamine will increase BP; propofol and thiopental will drop
BP.
Q28. A RSI dose of sux usually lasts about ___ minutes.
Page 3
