ATLS ADVANCED TRAUMA LIFE SUPPORT (ATLS)
Question and Answer [2026] | UPDATED ACTUAL
Exam | Detailed Solutions
• The "A" in ABCD stands for ______. -✓✓ Airway maintenance with Cervical SPINE
protection
• You should assume that any patient in a multisystem trauma with an altered level of
consciousness or blunt injury above the clavice has what type of injury -✓✓ Cervical
Spine Injury
• Flail chest is invariably accompanied by _______ which can interfere with blood
oxygenation -✓✓ pulmonary contusion - do NOT over fluid resuscitate these patients.
• Hypotension is caused by ______ until proven otherwise. -✓✓ hypovolemia
• When you dont have a BP what are three things to look for when evaluating perfusion?
-✓✓ 1. level of consciousness (brain perfusion
2. Skin color (ashen face/grey extremities)
3. Pulse (bilateral femoral - thready/tachy)
• Elderly patients have a limited ability to ___________ to compensate for blood loss -
✓✓ increase heart rate
• Resuscitation fluids should be warmed to 39 Celsius -✓✓ Only for Cyrstalloids, NOT
for blood
• Urinary catheters are good for assessing renal perfusion and volume status. List 5
signs of urethral injury that might precent you from inserting one -✓✓ Blood at urethral
meatus, perineal ecchymosis, blood in scrotum, high-riding/non-palpable prostate,
pelvic fracture
• Which arm should you NOT put a pulse-ox on? -✓✓ The arm with the BP cuff
• 2 anatomical things that can interfere -✓✓ Obesity and intraluminal bowel gas
• When should radiographs be obtained? -✓✓ During the Secondary survey!
• How do get an ample patient history? -✓✓ Allergies
Medications
PMH/Pregnancy
Last meal
Events/Environment
,• Why might you want a Bair Hugger for a patient who smells of Alcohol? -✓✓
Vasodilation can lead to hypothermia
• What things are you looking for when you do a DRE in trauma -✓✓ Blood, high riding
prostate, sphincter tone,
• What should be done for every female patient -✓✓ Pregnancy test
• Adult patients should maintain UOP of at least _____mL/kg/hr. Kids should have at
least ______ mL/kg/hr -✓✓ Adults 0.5 mL/kg.hr
Kids 1.0 mL/kg/hr
• Preventing hypercarbia (hypercapnia) is critical in patients who have sustained a
_______ injury -✓✓ head
• What two places would you LOOK at a patient if you suspect hypoxemia? -✓✓ Lips
and fingernail beds
• Patients may be abusive and belligerent because of ______-, so don't just assume its
due to drugs, alcohol, or the fact they they are just inherently a jerk -✓✓ hypoxia
• Can a patient breath on their own after complete cervical cord transection -✓✓ Yes if
the phrenic nerves (C3-C5 are spared. This will result in 'abdominal' breathing. The
intercostal muscles will be paralyzed though
• Can you use an OPA (Guedel) in a conscious patient -✓✓ No, it could make them
vomit. An NPA (trumpet) would be okay.
• Bougies are typically inserted blindly, how do you know you are in the trachea and not
the esophagus? -✓✓ You can feel the clicks as the distal tip rubs against the
cartilaginous tracheal rings, or it will deviate right or left when entering either bronchus
(at 50 cm)
• What do yo NOT want to hear if you auscultate a patient after placement of an ET
tube? -✓✓ Borborygmi - rumbling or gurgling noices suggest esophageal insertion.
• What is the RSI dose for etomidate -✓✓ 0.3 mg/kg (usually 20 mg)
• What is the RSI dose for succinylcholine -✓✓ 1-2 mg/kg (usually 100 mg)
• How does etomidate affect blood pressure -✓✓ it doesnt -it shouldnt have any effect
on BP. Ketamine will increase BP, and propofol and thiopental will both drop BP.
, • A RSI dose of succinylcholine usually lasts about ___ minutes -✓✓ 5
• What hypnotic/sedative/induction agent do you NOT want to use for a severely burned
patient? -✓✓ Sux - patients with severe burns, crush injuries, hyperkalemia, or chronic
paralytic/neuromuscular disease should NOT get Sux because of hyperkalemia risk
• O2 should flow at 15L for needle cricothyroidotomy, and have a Y connector for
insufflation if possible. What size needle do you use for adults? Kids? -✓✓ Adults: 12-14
gauge
kids: 16-18 gauge
• Cricoid cartilage is the only circumferential support for the upper trachea in kids,
therefore surgical cricothyroidotomy is not recommeded for kids under the age of
________. -✓✓ 12
• In a 'normal' patient without significant chest wall injury or lung disease, needle
cricothyroidotomy can provide adequate oxygenation for approximately ______ minutes
-✓✓ 30-45
• For a patient with difficulty breathing, what things might you try before you provide a
surgical aurway -✓✓ Chin Lift, jaw-thrust (NOT head-tilt while maintaining c-spine
precautions), OPA (guedel), NPA (trumpet), LMA, Combitube, ET tube +- bougie
• How do you know if an OPA/Guedel is the correct size for the patient? -✓✓ A correctly
sized OPA will extend from the corner of the patients mouth to the external auditory
canal.
• What should you do with the balloon on an ET tube/LMA/foley before you insert it? -
✓✓ Inflate it to make sure it doesnt leak- then deflate and insert
• What size LMA do you use for Kid, woman/small man, large woman/man -✓✓ Kid: 3
Woman/Small Man: 4
Large woman/Man 5
C3,4,5 keep them all alive
• The proper size ET tube for an infant is -✓✓ The same size as the infants nostril or
little finger (3 for neonates, 3.5 for infants
• What size cuffed endotracheal tube do you use for an emergency cricothyroidotomy? -
✓✓ 5 or 6
• Use a size 3 ET tube for neonates
3.5 for infants for 0-6 months
4 fo infants 6-12 months
Question and Answer [2026] | UPDATED ACTUAL
Exam | Detailed Solutions
• The "A" in ABCD stands for ______. -✓✓ Airway maintenance with Cervical SPINE
protection
• You should assume that any patient in a multisystem trauma with an altered level of
consciousness or blunt injury above the clavice has what type of injury -✓✓ Cervical
Spine Injury
• Flail chest is invariably accompanied by _______ which can interfere with blood
oxygenation -✓✓ pulmonary contusion - do NOT over fluid resuscitate these patients.
• Hypotension is caused by ______ until proven otherwise. -✓✓ hypovolemia
• When you dont have a BP what are three things to look for when evaluating perfusion?
-✓✓ 1. level of consciousness (brain perfusion
2. Skin color (ashen face/grey extremities)
3. Pulse (bilateral femoral - thready/tachy)
• Elderly patients have a limited ability to ___________ to compensate for blood loss -
✓✓ increase heart rate
• Resuscitation fluids should be warmed to 39 Celsius -✓✓ Only for Cyrstalloids, NOT
for blood
• Urinary catheters are good for assessing renal perfusion and volume status. List 5
signs of urethral injury that might precent you from inserting one -✓✓ Blood at urethral
meatus, perineal ecchymosis, blood in scrotum, high-riding/non-palpable prostate,
pelvic fracture
• Which arm should you NOT put a pulse-ox on? -✓✓ The arm with the BP cuff
• 2 anatomical things that can interfere -✓✓ Obesity and intraluminal bowel gas
• When should radiographs be obtained? -✓✓ During the Secondary survey!
• How do get an ample patient history? -✓✓ Allergies
Medications
PMH/Pregnancy
Last meal
Events/Environment
,• Why might you want a Bair Hugger for a patient who smells of Alcohol? -✓✓
Vasodilation can lead to hypothermia
• What things are you looking for when you do a DRE in trauma -✓✓ Blood, high riding
prostate, sphincter tone,
• What should be done for every female patient -✓✓ Pregnancy test
• Adult patients should maintain UOP of at least _____mL/kg/hr. Kids should have at
least ______ mL/kg/hr -✓✓ Adults 0.5 mL/kg.hr
Kids 1.0 mL/kg/hr
• Preventing hypercarbia (hypercapnia) is critical in patients who have sustained a
_______ injury -✓✓ head
• What two places would you LOOK at a patient if you suspect hypoxemia? -✓✓ Lips
and fingernail beds
• Patients may be abusive and belligerent because of ______-, so don't just assume its
due to drugs, alcohol, or the fact they they are just inherently a jerk -✓✓ hypoxia
• Can a patient breath on their own after complete cervical cord transection -✓✓ Yes if
the phrenic nerves (C3-C5 are spared. This will result in 'abdominal' breathing. The
intercostal muscles will be paralyzed though
• Can you use an OPA (Guedel) in a conscious patient -✓✓ No, it could make them
vomit. An NPA (trumpet) would be okay.
• Bougies are typically inserted blindly, how do you know you are in the trachea and not
the esophagus? -✓✓ You can feel the clicks as the distal tip rubs against the
cartilaginous tracheal rings, or it will deviate right or left when entering either bronchus
(at 50 cm)
• What do yo NOT want to hear if you auscultate a patient after placement of an ET
tube? -✓✓ Borborygmi - rumbling or gurgling noices suggest esophageal insertion.
• What is the RSI dose for etomidate -✓✓ 0.3 mg/kg (usually 20 mg)
• What is the RSI dose for succinylcholine -✓✓ 1-2 mg/kg (usually 100 mg)
• How does etomidate affect blood pressure -✓✓ it doesnt -it shouldnt have any effect
on BP. Ketamine will increase BP, and propofol and thiopental will both drop BP.
, • A RSI dose of succinylcholine usually lasts about ___ minutes -✓✓ 5
• What hypnotic/sedative/induction agent do you NOT want to use for a severely burned
patient? -✓✓ Sux - patients with severe burns, crush injuries, hyperkalemia, or chronic
paralytic/neuromuscular disease should NOT get Sux because of hyperkalemia risk
• O2 should flow at 15L for needle cricothyroidotomy, and have a Y connector for
insufflation if possible. What size needle do you use for adults? Kids? -✓✓ Adults: 12-14
gauge
kids: 16-18 gauge
• Cricoid cartilage is the only circumferential support for the upper trachea in kids,
therefore surgical cricothyroidotomy is not recommeded for kids under the age of
________. -✓✓ 12
• In a 'normal' patient without significant chest wall injury or lung disease, needle
cricothyroidotomy can provide adequate oxygenation for approximately ______ minutes
-✓✓ 30-45
• For a patient with difficulty breathing, what things might you try before you provide a
surgical aurway -✓✓ Chin Lift, jaw-thrust (NOT head-tilt while maintaining c-spine
precautions), OPA (guedel), NPA (trumpet), LMA, Combitube, ET tube +- bougie
• How do you know if an OPA/Guedel is the correct size for the patient? -✓✓ A correctly
sized OPA will extend from the corner of the patients mouth to the external auditory
canal.
• What should you do with the balloon on an ET tube/LMA/foley before you insert it? -
✓✓ Inflate it to make sure it doesnt leak- then deflate and insert
• What size LMA do you use for Kid, woman/small man, large woman/man -✓✓ Kid: 3
Woman/Small Man: 4
Large woman/Man 5
C3,4,5 keep them all alive
• The proper size ET tube for an infant is -✓✓ The same size as the infants nostril or
little finger (3 for neonates, 3.5 for infants
• What size cuffed endotracheal tube do you use for an emergency cricothyroidotomy? -
✓✓ 5 or 6
• Use a size 3 ET tube for neonates
3.5 for infants for 0-6 months
4 fo infants 6-12 months
