ADVANCED TRAUMA LIFE SUPPORT
KEYS QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Patients with GSC of less than _____ usually require intubation - ANSWER 8
The "A" in ABCD stands for ______. - ANSWER 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 - ANSWER Cervical Spine Injury
Flail chest is invariably accompanied by _______ which can interfere with blood oxygenation - ANSWER
pulmonary contusion - do NOT over fluid resuscitate these patients.
Hypotension is caused by ______ until proven otherwise. - ANSWER hypovolemia
When you dont have a BP 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)
Elderly patients have a limited ability to ___________ to compensate for blood loss - ANSWER increase
heart rate
Resuscitation fluids should be warmed to 39 Celsius - ANSWER 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 - ANSWER 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? - ANSWER The arm with the BP cuff
,2 anatomical things that can interfere - ANSWER Obesity and intraluminal bowel gas
When should radiographs be obtained? - ANSWER During the Secondary survey!
How do get an ample patient history? - ANSWER Allergies
Medications
PMH/Pregnancy
Last meal
Events/Environment
Why might you want a Bair Hugger for a patient who smells of Alcohol? - ANSWER Vasodilation can lead
to hypothermia
What things are you looking for when you do a DRE in trauma - ANSWER Blood, high riding prostate,
sphincter tone,
What should be done for every female patient - ANSWER Pregnancy test
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
Preventing hypercarbia (hypercapnia) is critical in patients who have sustained a _______ injury -
ANSWER head
What two places would you LOOK at a patient if you suspect hypoxemia? - ANSWER 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 - ANSWER hypoxia
, Can a patient breath on their own after complete cervical cord transection - ANSWER 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 - ANSWER 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? -
ANSWER 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? - ANSWER
Borborygmi - rumbling or gurgling noices suggest esophageal insertion.
What is the RSI dose for etomidate - ANSWER 0.3 mg/kg (usually 20 mg)
What is the RSI dose for succinylcholine - ANSWER 1-2 mg/kg (usually 100 mg)
How does etomidate affect blood pressure - ANSWER 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 - ANSWER 5
What hypnotic/sedative/induction agent do you NOT want to use for a severely burned patient? -
ANSWER 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? - ANSWER Adults: 12-14 gauge
kids: 16-18 gauge
KEYS QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Patients with GSC of less than _____ usually require intubation - ANSWER 8
The "A" in ABCD stands for ______. - ANSWER 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 - ANSWER Cervical Spine Injury
Flail chest is invariably accompanied by _______ which can interfere with blood oxygenation - ANSWER
pulmonary contusion - do NOT over fluid resuscitate these patients.
Hypotension is caused by ______ until proven otherwise. - ANSWER hypovolemia
When you dont have a BP 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)
Elderly patients have a limited ability to ___________ to compensate for blood loss - ANSWER increase
heart rate
Resuscitation fluids should be warmed to 39 Celsius - ANSWER 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 - ANSWER 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? - ANSWER The arm with the BP cuff
,2 anatomical things that can interfere - ANSWER Obesity and intraluminal bowel gas
When should radiographs be obtained? - ANSWER During the Secondary survey!
How do get an ample patient history? - ANSWER Allergies
Medications
PMH/Pregnancy
Last meal
Events/Environment
Why might you want a Bair Hugger for a patient who smells of Alcohol? - ANSWER Vasodilation can lead
to hypothermia
What things are you looking for when you do a DRE in trauma - ANSWER Blood, high riding prostate,
sphincter tone,
What should be done for every female patient - ANSWER Pregnancy test
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
Preventing hypercarbia (hypercapnia) is critical in patients who have sustained a _______ injury -
ANSWER head
What two places would you LOOK at a patient if you suspect hypoxemia? - ANSWER 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 - ANSWER hypoxia
, Can a patient breath on their own after complete cervical cord transection - ANSWER 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 - ANSWER 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? -
ANSWER 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? - ANSWER
Borborygmi - rumbling or gurgling noices suggest esophageal insertion.
What is the RSI dose for etomidate - ANSWER 0.3 mg/kg (usually 20 mg)
What is the RSI dose for succinylcholine - ANSWER 1-2 mg/kg (usually 100 mg)
How does etomidate affect blood pressure - ANSWER 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 - ANSWER 5
What hypnotic/sedative/induction agent do you NOT want to use for a severely burned patient? -
ANSWER 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? - ANSWER Adults: 12-14 gauge
kids: 16-18 gauge
