ATLS test questions and
answers
ABCDE Mnemonic CORRECT ANSWERS: A - Airway with cervical spine
protection
B - Breathing
C - Circulation, stop bleeding
D - Disability or neurological status
E - Exposure (undress) & Environment (temperature control)
Breathing & ventilation - injuries that impair ventilation CORRECT ANSWERS:
Severe impairment:
* Tension pneumothorax
* Flail chest with pulmonary contusion
* Massive haemothorax
* Open pneumothorax
Lesser impairment
* Simple pneumothorax / haemothorax
* Rib #
* Pulmonary contusion
Circulation with heamorrhage control - assessing haemodynamic status
CORRECT ANSWERS: LEVEL OF CONSCIOUSNESS
Altered level of consciousness may indicate:
- ↓ circulating blood volume ∴ ↓ cerebral perfusion
SKIN COLOR
PULSE
* Full, regular pulse = normovolaemia
* Rapid, thready pulse ?hypovolaemia
Adjuncts to primary survey - ECG CORRECT ANSWERS: Indicators of blunt
cardiac injury:
DYSRHYTHMIAS:
* Tachycardia
* AF
* PVC
* ST changes
PEA can indicate:
* Cardiac tamponade
* Tension pneumothorax
* Hypovolaemia
Consider hypoxia & hypo-perfusion if:
* Bradycardia
,* Aberrant conduction
* Premature beats
Secondary survey CORRECT ANSWERS: Once primary survey (ABCDE) is
complete, resuscitation underway & vital functions normalisation has been
demonstrated
WHAT IS IT?
- Head to toe evaluation
- History
Secondary survey - AMPLE history CORRECT ANSWERS: A - Allergies
M - Medications
P - Past illnesses
- Pregnancy
L - Last meal
E - Events
- Environment related to injury
Blunt trauma CORRECT ANSWERS: - Seat belt
- Steering wheel deformation
- Damage to car + intrusion
- Ejection from vehicle
Secondary survey - Physical examination - HEAD CORRECT ANSWERS:
SCALP & HEAD:
- Lacerations / contusions / fractures
EYES:
- Visual acuity
- Pupillary size
- Haemorrhage - conjunctiva / fundus
- Penetrating injury
- Contact lenses
- Lens dislocation
- Ocular entrapment - assess eye movements
MAXILLOFACIAL STRUCTURES:
i) Palpate bony structures
ii) Assess occlusion
iii) Intraoral examination
iv) Assess soft tissues
*** Midface fractures may also include cribiform plate fractures ***
Secondary survey - Physical examination - CERVICAL SPINE & NECK
CORRECT ANSWERS: *** Presume pts with maxillofacial or head trauma have
unstable C-spine injury ***
- C-spine tenderness
- SC emphysema
, - Tracheal deviation
- Laryngeal #
- Carotid arteries - palapate & auscultate
? Seat belt mark
*** Do not explore wounds extending through platysma ***
Secondary survey - Physical examination - CHEST CORRECT ANSWERS: -
Visual evaluation
- Palpation including clavicles / ribs / sternum
AUSCULTATION
* High anterior ?pneumothorax
* Posterior bases ?haemothorax
--- Cardiac tamponade:
Distant heart sounds & decreased pulse pressure
--- Distended neck veins:
Tension pneumothorax / cardiac tamponade
Laryngeal trauma CORRECT ANSWERS: Laryngeal fracture is rare
- can present with acute airway obstruction
INDICATED BY:
i) Hoarseness
ii) Subcutaneous emphysema
iii) Palpable fracture
Objective signs of airway obstruction CORRECT ANSWERS: 1) OBSERVE
PATIENT
a) Agitation - hypoxia
b) Obtundation - hypercarbia
c) Cyanosis - hypoxaemia due to inadequate oxygenation
- Nail beds & circumoral
- Late finding
d) Retractions / use of accessory muscles
2) ABNORMAL SOUNDS
- Noisy breathing = obstructed breathing
i) Snoring / gurgling / crowing (stridor) - partial occlusion of larynx & pharynx
ii) Hoarseness (dysphonia) - functional, laryngeal obstruction
3) TRACHEAL POSITION
4) PATIENT BEHAVIOUR
- Absuive & belligerent pt maybe due to hypoxia
Oxygen delivery methods (BTS guidelines) CORRECT ANSWERS: RESERVOIR
MASK
- Delivers 60-90% O2
- 10-15 L/min
SIMPLE FACE MASK
- Delivers 40-60% O2
answers
ABCDE Mnemonic CORRECT ANSWERS: A - Airway with cervical spine
protection
B - Breathing
C - Circulation, stop bleeding
D - Disability or neurological status
E - Exposure (undress) & Environment (temperature control)
Breathing & ventilation - injuries that impair ventilation CORRECT ANSWERS:
Severe impairment:
* Tension pneumothorax
* Flail chest with pulmonary contusion
* Massive haemothorax
* Open pneumothorax
Lesser impairment
* Simple pneumothorax / haemothorax
* Rib #
* Pulmonary contusion
Circulation with heamorrhage control - assessing haemodynamic status
CORRECT ANSWERS: LEVEL OF CONSCIOUSNESS
Altered level of consciousness may indicate:
- ↓ circulating blood volume ∴ ↓ cerebral perfusion
SKIN COLOR
PULSE
* Full, regular pulse = normovolaemia
* Rapid, thready pulse ?hypovolaemia
Adjuncts to primary survey - ECG CORRECT ANSWERS: Indicators of blunt
cardiac injury:
DYSRHYTHMIAS:
* Tachycardia
* AF
* PVC
* ST changes
PEA can indicate:
* Cardiac tamponade
* Tension pneumothorax
* Hypovolaemia
Consider hypoxia & hypo-perfusion if:
* Bradycardia
,* Aberrant conduction
* Premature beats
Secondary survey CORRECT ANSWERS: Once primary survey (ABCDE) is
complete, resuscitation underway & vital functions normalisation has been
demonstrated
WHAT IS IT?
- Head to toe evaluation
- History
Secondary survey - AMPLE history CORRECT ANSWERS: A - Allergies
M - Medications
P - Past illnesses
- Pregnancy
L - Last meal
E - Events
- Environment related to injury
Blunt trauma CORRECT ANSWERS: - Seat belt
- Steering wheel deformation
- Damage to car + intrusion
- Ejection from vehicle
Secondary survey - Physical examination - HEAD CORRECT ANSWERS:
SCALP & HEAD:
- Lacerations / contusions / fractures
EYES:
- Visual acuity
- Pupillary size
- Haemorrhage - conjunctiva / fundus
- Penetrating injury
- Contact lenses
- Lens dislocation
- Ocular entrapment - assess eye movements
MAXILLOFACIAL STRUCTURES:
i) Palpate bony structures
ii) Assess occlusion
iii) Intraoral examination
iv) Assess soft tissues
*** Midface fractures may also include cribiform plate fractures ***
Secondary survey - Physical examination - CERVICAL SPINE & NECK
CORRECT ANSWERS: *** Presume pts with maxillofacial or head trauma have
unstable C-spine injury ***
- C-spine tenderness
- SC emphysema
, - Tracheal deviation
- Laryngeal #
- Carotid arteries - palapate & auscultate
? Seat belt mark
*** Do not explore wounds extending through platysma ***
Secondary survey - Physical examination - CHEST CORRECT ANSWERS: -
Visual evaluation
- Palpation including clavicles / ribs / sternum
AUSCULTATION
* High anterior ?pneumothorax
* Posterior bases ?haemothorax
--- Cardiac tamponade:
Distant heart sounds & decreased pulse pressure
--- Distended neck veins:
Tension pneumothorax / cardiac tamponade
Laryngeal trauma CORRECT ANSWERS: Laryngeal fracture is rare
- can present with acute airway obstruction
INDICATED BY:
i) Hoarseness
ii) Subcutaneous emphysema
iii) Palpable fracture
Objective signs of airway obstruction CORRECT ANSWERS: 1) OBSERVE
PATIENT
a) Agitation - hypoxia
b) Obtundation - hypercarbia
c) Cyanosis - hypoxaemia due to inadequate oxygenation
- Nail beds & circumoral
- Late finding
d) Retractions / use of accessory muscles
2) ABNORMAL SOUNDS
- Noisy breathing = obstructed breathing
i) Snoring / gurgling / crowing (stridor) - partial occlusion of larynx & pharynx
ii) Hoarseness (dysphonia) - functional, laryngeal obstruction
3) TRACHEAL POSITION
4) PATIENT BEHAVIOUR
- Absuive & belligerent pt maybe due to hypoxia
Oxygen delivery methods (BTS guidelines) CORRECT ANSWERS: RESERVOIR
MASK
- Delivers 60-90% O2
- 10-15 L/min
SIMPLE FACE MASK
- Delivers 40-60% O2
