ATLS Complete Solution Gaded A+

ATLS Complete Solution Gaded A+ A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconsious and has no detectable blood pressure. Optimale immediate management is to: A. Perform a FAST B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and urinary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive - D. Transfer the patient to the operating room, while initiating fluid therapy A 22 year old male present following a motorcycle crash. He complains of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His management should be: A: 1L of iv . crystalloid and two units of pRBCs B. 1L of iv. crystalloid, mannitol and iv steroids C. 1 unit of albumin and compression stockings D. Vasopressors and laparotomy E. 1 L of cystalloid and vasopressors if blood pressure does not respond - E. 1 L of cystalloid and vasopressors if blood pressure does not respond Which of the following is MOST RELIABLE to confirm endotracheal intubation? a. presence of breath sounds bilaterally b. absence of borborygmi in the epigatrium on ascultation c. presence of CO2 in exhaled air via capnography d. appearance of fog in the endotracheal tube e. chest xray with endotracheal tube tip appearing above the carina - e. chest xray with endotracheal tube tip appearing above the carina A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with multiple facial injuries, is lethargic, and is in severe respiratoy distress. Respiratory support is not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next is: A.Administer heliox and racemic epinephrine B. Perform nasotracheal intubation C.Perform surgical cricothyroidotomy D.Repeat orotracheal intubation E. Perform needle cricothyroidotomy with jet insufflation - E. Perform needle cricothyroidotomy with jet insufflation A 28 year olf male is brought to the ED. He was involved in a fight, during which he was beaten with a wooden stick. His chest shows multiple severe bruises. His arway is clear, resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following should be performed during the primary survey a. glasgow coma b. tetanus status c. cervical spine xray d. blood alcohol level e. rectal exam - a. glasgow coma an 18yo male is brought to the emergency department after being dumped by a large wave while surfing. He landed head first on the firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to move his lower extremities. He appears calm and asks if he will ever walk again. The most appropriate next step is to: a. reassure patient that he will walk again b. proceed to a more detailed neuro exam c. obtain c spin xrays d. begin infusion of vasopressors e. begin bolus of warm IV crystalloid - e. begin bolus of warm IV crystalloid Whic one of the following statements is true regarding access in pediatric resuscitation? a. intraosseous access should be considered only after 5 percutaneous attempts b. cutdown at teh ankle is the preferred initial access technique c. internal jugular cannulation is the next preferred option when percutaneous venous access fails d. intraosseous cannulation should be the first choice e. blood transfusion can be delivered through intraosseous access - e. blood transfusion can be delivered through intraosseous access a 35 year old female ustains multiple linjuries in a MVA and is transported to a small hospital. She has a GCS of V2E2M2. Spinal motion restrictions are in place. ET is performed, IV and wamred fluids are administered. She remains hemodynamically normal, and preparations are made to transfer to another facility for definitive neuro care. Which of the following tests or treatment should occur before transport? a. ct abdomen and chest b. chest xray c. lateral cervical spine xray d. admin of methlyprednisolone e. transfusion of 2 units packed RBCs - b. chest xray A 22 year old male sustains a shotgun wound to the left shoulder and chest at close range. His BP is 80/40mmHg and his HR is 130bpm. Fluid resusciation is initiated, his BP increases to 122/84, and HR decreases to 100bpm. He is tachypneic with RR of 28. On physical examination, his breath sounds are decreased at the left upper chest with dullness on percussion. A tube thoracostomy is inserted in the fifth intercostal space with the return of 200ml of blood and no air leak. The most appropriate next step is to: a. measure blood pressure again b. begin transfuse O negative blood c. wait until the chest xray is completed d. obtain a CT scan of the chest and abdomen e. repeat the physical exam of the chest - e. repeat the physical exam of the chest