ADVANCED TRAUMA LIFE SUPPORT(ATLS) EXAM LATEST 2025 REAL
QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+
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
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
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.
When you don’t 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 prevent 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
Patients with GSC of less than _____ usually require intubation
8
The "A" in ABCD stands for ______.
Airway maintenance with Cervical SPINE protection
What do you NOT want to hear if you auscultate a patient after placement of an ET tube?
Borborygmi - rumbling or gurgling noises 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 doesn’t -it shouldn’t 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 recommended 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
airway
Chin Lift, jaw-thrust (NOT head-tilt while maintaining c-spine precautions), OPA (guedel), NPA
(trumpet), LMA, Combi tube, ET tube +- bougie
What should you do with the balloon on an ET tube/LMA/foley before you insert it?
Inflate it to make sure it doesn’t 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 infant’s 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 for infants 6-12 months
How do you calculate what size ET tube to use or toddlers and kids?
Age/4 +4mm = internal diameter
Shock is defined as an abnormality of the circulatory system that results in inadequate organ
perfusion and tissue oxygenation. what are the 4 different types
Neurogenic, cardiogenic, hypovolemic, septic
The most common cause of shock in the injured trauma patient is _________.
QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+
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
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
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.
When you don’t 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 prevent 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
Patients with GSC of less than _____ usually require intubation
8
The "A" in ABCD stands for ______.
Airway maintenance with Cervical SPINE protection
What do you NOT want to hear if you auscultate a patient after placement of an ET tube?
Borborygmi - rumbling or gurgling noises 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 doesn’t -it shouldn’t 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 recommended 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
airway
Chin Lift, jaw-thrust (NOT head-tilt while maintaining c-spine precautions), OPA (guedel), NPA
(trumpet), LMA, Combi tube, ET tube +- bougie
What should you do with the balloon on an ET tube/LMA/foley before you insert it?
Inflate it to make sure it doesn’t 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 infant’s 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 for infants 6-12 months
How do you calculate what size ET tube to use or toddlers and kids?
Age/4 +4mm = internal diameter
Shock is defined as an abnormality of the circulatory system that results in inadequate organ
perfusion and tissue oxygenation. what are the 4 different types
Neurogenic, cardiogenic, hypovolemic, septic
The most common cause of shock in the injured trauma patient is _________.
