ITLS Question and Answer [2026] | UPDATED
ACTUAL Exam | Final Review
• What does "OPIM" stand for? -✓✓ Other Potentially Infectious Material
• What equipment should you always take with you for trauma patients? -✓✓ -PPE
(Personal Protection Equipment)
-Patient transport device (stretcher, long spine board, and so on) with effective
strapping and head motion-restriction device
-Rigid cervical extrication collar of an appropriate size
-Oxygen and airway equipment, which should include suction equipment and a
BVM (Bag-Valve Mask)
-Trauma box (bandage material, hemostatic agent, tourniquet, blood pressure cuff,
stethoscope)
• What are some of the potential injury patterns for a mechanism of Injury of
frontal impact? (Name 8) -✓✓ -Cervical-spine fracture
-Flail chest
-Myocardial contusion
-Pneumothorax
-Aortic disruption
-Spleen or liver laceration
-Posterior hip dislocation
-Knee dislocation
• What are some of the potential injury patterns for a mechanism of lateral impact
(T-bone)? (Name 8) -✓✓ -Contralateral neck sprain
,-Cervical-spine fracture
-Lateral flail chest
-Pneumothorax
-Aortic disruption
-Diaphragmatic rupture
-Laceration of liver, kidney or spleen
-Pelvic fracture
• What are potential injury patterns for a mechanism of ejection? -✓✓ Exposure to
all mechanisms (and mortality increased)
• What are some of the potential injury patterns for a mechanism of Injury of
pedestrian vs. car? (Name 4) -✓✓ -Head injury
-Aortic disruption
-Abdominal visceral injuries
-Fracture pelvis and lower extremities
• What is "index of suspicion"? -✓✓ The medical provider's estimate of a disease
or injury being present in a patient. A high index of suspicion means there is a high
probability the injury is present. A low index of suspicion means there is a low risk
of the injury.
• List the two basic mechanisms of motion injury -✓✓ Blunt and penetrating
• Identify the three collisions associated with a motor-vehicle collision (MVC) -
✓✓ 1. Machine collision
2. Body collision
,3. Organ collision resulting in rupture, shearing, or bruising
• Name the five common forms of MVCs -✓✓ 1. Frontal-impact (head-on
collision)
2. Lateral-impact (T-bone collision)
3. Rear-impact collision
4. Rollover collision
5. Rotational collision
• Using the three collisions associated with a MVC, relate at least three frontal-
impact collisions to potential patient injuries to deformity of the vehicle, interior
structures and body structures. -✓✓ Machine collision = Deformed front end
Body collision = Spider-web pattern of windshield
Organ collision = Coup/contracoup brain, soft-tissue injury (scalp, face, neck),
hyperextension/flexion of the cervical spine
Machine collision = Deformed front end
Body collision = Steering wheel ring fracture, deformity and column displacement
Organ collision = Traumatic tattooing of patient's skin
Machine collision = Deformity of vehicle
Body collision = Dashboard fracture and deformity
Organ collision = Facial trauma, coup/contracoup brain, hyperextension/flexion of
the cervical spine, pelvis, hip and knee trauma
• Using the three collisions associated with a MVC, relate at least three lateral-
impact collisions to potential patient injuries to deformity of the vehicle, interior
, structures and body structures. -✓✓ Machine collision = Deformed driver or
passenger side
Body collision = Degree of door deformity (ex: armrest bent, outward or inward
bowing of door)
Organ collision = This cannot be predicted by external exam alone. Instead,
consider organs beneath areas of external injury:
-Head = Coup/contracoup
-Neck = Ranging from cervical-muscle strain to fracture or subluxation with
neurologic deficit
-Upper arm and shoulder = Injuries appear on the side of the impact and are
common, as are injuries to the lower extremities
-Thorax/abdomen = Injuries from soft-tissue injuries to flail chest, lung contusion,
pneumothorax, hemothorax, or possible traumatic aortic dissection. Injuries
include those to solid and hollow organs
-Pelvis/legs = Pelvic, hip or femur fractures. Pelvic injuries may also include
dislocation, bladder rupture and urethral injuries
• Describe potential injuries associated with proper and improper use of seat
restraints, headrest and air bags in a head-on collision -✓✓ Proper use of seat
restraint = Facial, head or neck injuries such as fractures, dislocations or spinal-
cord injuries; Clavicle fractures (at the point where the chest strap crosses) and
chest-wall injuries; Internal organ damage
Improper use of seat restraint = Abdominal or lumbar spine injury; No restraint
could possibly lead to ejection of vehicle
Improper use of headrest = (second impact) Hyperextension of the cervical spine
Proper use of air bags = Injuries from a second impact after deflation can lead to
striking the steering wheel leading to internal injuries (thus, check under the
ACTUAL Exam | Final Review
• What does "OPIM" stand for? -✓✓ Other Potentially Infectious Material
• What equipment should you always take with you for trauma patients? -✓✓ -PPE
(Personal Protection Equipment)
-Patient transport device (stretcher, long spine board, and so on) with effective
strapping and head motion-restriction device
-Rigid cervical extrication collar of an appropriate size
-Oxygen and airway equipment, which should include suction equipment and a
BVM (Bag-Valve Mask)
-Trauma box (bandage material, hemostatic agent, tourniquet, blood pressure cuff,
stethoscope)
• What are some of the potential injury patterns for a mechanism of Injury of
frontal impact? (Name 8) -✓✓ -Cervical-spine fracture
-Flail chest
-Myocardial contusion
-Pneumothorax
-Aortic disruption
-Spleen or liver laceration
-Posterior hip dislocation
-Knee dislocation
• What are some of the potential injury patterns for a mechanism of lateral impact
(T-bone)? (Name 8) -✓✓ -Contralateral neck sprain
,-Cervical-spine fracture
-Lateral flail chest
-Pneumothorax
-Aortic disruption
-Diaphragmatic rupture
-Laceration of liver, kidney or spleen
-Pelvic fracture
• What are potential injury patterns for a mechanism of ejection? -✓✓ Exposure to
all mechanisms (and mortality increased)
• What are some of the potential injury patterns for a mechanism of Injury of
pedestrian vs. car? (Name 4) -✓✓ -Head injury
-Aortic disruption
-Abdominal visceral injuries
-Fracture pelvis and lower extremities
• What is "index of suspicion"? -✓✓ The medical provider's estimate of a disease
or injury being present in a patient. A high index of suspicion means there is a high
probability the injury is present. A low index of suspicion means there is a low risk
of the injury.
• List the two basic mechanisms of motion injury -✓✓ Blunt and penetrating
• Identify the three collisions associated with a motor-vehicle collision (MVC) -
✓✓ 1. Machine collision
2. Body collision
,3. Organ collision resulting in rupture, shearing, or bruising
• Name the five common forms of MVCs -✓✓ 1. Frontal-impact (head-on
collision)
2. Lateral-impact (T-bone collision)
3. Rear-impact collision
4. Rollover collision
5. Rotational collision
• Using the three collisions associated with a MVC, relate at least three frontal-
impact collisions to potential patient injuries to deformity of the vehicle, interior
structures and body structures. -✓✓ Machine collision = Deformed front end
Body collision = Spider-web pattern of windshield
Organ collision = Coup/contracoup brain, soft-tissue injury (scalp, face, neck),
hyperextension/flexion of the cervical spine
Machine collision = Deformed front end
Body collision = Steering wheel ring fracture, deformity and column displacement
Organ collision = Traumatic tattooing of patient's skin
Machine collision = Deformity of vehicle
Body collision = Dashboard fracture and deformity
Organ collision = Facial trauma, coup/contracoup brain, hyperextension/flexion of
the cervical spine, pelvis, hip and knee trauma
• Using the three collisions associated with a MVC, relate at least three lateral-
impact collisions to potential patient injuries to deformity of the vehicle, interior
, structures and body structures. -✓✓ Machine collision = Deformed driver or
passenger side
Body collision = Degree of door deformity (ex: armrest bent, outward or inward
bowing of door)
Organ collision = This cannot be predicted by external exam alone. Instead,
consider organs beneath areas of external injury:
-Head = Coup/contracoup
-Neck = Ranging from cervical-muscle strain to fracture or subluxation with
neurologic deficit
-Upper arm and shoulder = Injuries appear on the side of the impact and are
common, as are injuries to the lower extremities
-Thorax/abdomen = Injuries from soft-tissue injuries to flail chest, lung contusion,
pneumothorax, hemothorax, or possible traumatic aortic dissection. Injuries
include those to solid and hollow organs
-Pelvis/legs = Pelvic, hip or femur fractures. Pelvic injuries may also include
dislocation, bladder rupture and urethral injuries
• Describe potential injuries associated with proper and improper use of seat
restraints, headrest and air bags in a head-on collision -✓✓ Proper use of seat
restraint = Facial, head or neck injuries such as fractures, dislocations or spinal-
cord injuries; Clavicle fractures (at the point where the chest strap crosses) and
chest-wall injuries; Internal organ damage
Improper use of seat restraint = Abdominal or lumbar spine injury; No restraint
could possibly lead to ejection of vehicle
Improper use of headrest = (second impact) Hyperextension of the cervical spine
Proper use of air bags = Injuries from a second impact after deflation can lead to
striking the steering wheel leading to internal injuries (thus, check under the
