ATLS Test 1
A 20-year-vintage female that is 32 weeks gestation , is stabbed in the higher right chest. In
the emergency branch, her blood stress is 80/60 mm Hg. She is gasping for breath,
extraordinarily demanding, and yelling for assist. Breath sounds are diminished within the
proper chest. The most suitable first step is to:
Select one:
a.
Perform tracheal intubation
b.
Insert an oropharyngeal airway
c.
Carry out needle or finger decompression of the proper chest
d.
Manually displace the gravid uterus to the left facet of the stomach
e.
Provoke 2, large-caliber peripheral IV strains and crystalloid infusion - ANS-c.
Perform needle or finger decompression of the proper chest
A 22-12 months-antique woman athlete is stabbed in her left chest on the third interspace in
the anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
unsleeping and alert. Her heart charge is one hundred beats consistent with minute, blood
stress is 80/60 mm Hg, and respiratory fee is 20 breaths in step with minute. A chest x-ray
well-knownshows a huge left hemothorax. A left chest tube is positioned with an immediate
go back of 1600 mL of blood. The next management step for this affected person is to:
Select one:
a.
Carry out a thoracoscopy
b.
Carry out an arch aortogram
c.
Insert a second left chest tube
d.
Put together for an exploratory thoracotomy
e.
Perform a chest CT - ANS-d.
Prepare for an exploratory thoracotomy
A 22-yr-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/forty mm Hg. After preliminary fluid resuscitation his blood
stress will increase to 122/eighty four mm Hg. His heart fee is now 100 beats in step with
minute and his breathing charge is 28 breaths per minute. A tube thoracostomy is completed
for decreased left chest breath sounds with the return of a small amount of blood and no air
leak. After chest tube insertion, the maximum appropriate subsequent step is:
Select one:
a.
, Reexamine the chest
b.
Carry out an aortogram
c.
Acquire a CT experiment of the chest
d.
Attain arterial blood gas analyses
e.
Perform transesophageal echocardiography - ANS-A) Reexamine the chest
A 22-12 months-vintage guy sustains a gunshot wound to the left chest and is transported to
a small network clinic; no surgical competencies are to be had. In the emergency branch, a
chest tube is inserted and seven-hundred mL of blood is evacuated. The trauma center
accepts the patient in switch. Just before the patient is located inside the ambulance for
switch, his blood strain decreases to 80/sixty eight mm Hg and his coronary heart fee will
increase to 136 beats in line with minute. The subsequent step should be to:
Select one:
a.
Clamp the chest tube
b.
Cancel the patient's transfer
c.
Perform an emergency department thoracotomy
d.
Repeat the primary survey and continue with switch
e.
Delay the switch until the referring doctor can contact a thoracic general practitioner -
ANS-d.
Repeat the primary survey and proceed with transfer
A 23-yr-vintage guy sustains 4 stab wounds to the upper proper chest at some stage in an
altercation and is brought by using ambulance to a sanatorium that has full surgical abilities.
His wounds are all above the nipple. He is endotracheally intubated, closed tube
thoracostomy is completed, fluid resuscitation is initiated via 2 large-caliber IVs. FAST exam
does now not screen intraabdominal accidents. His blood stress now's 60/zero mm Hg, heart
price is one hundred sixty beats consistent with minute, and breathing price is 14 breaths in
step with minute (ventilated with 100% O2). 1500 mL of blood has tired from the right chest.
The maximum suitable next step in managing this patient is to
Select one:
a.
Perform diagnostic peritoneal lavage
b.
Gain a CT of the chest
c.
Perform an angiography
d.
Urgently transfer the affected person to the working room
e.
Straight away transfer the patient to a trauma middle - ANS-d.
Urgently transfer the affected person to the operating room
A 20-year-vintage female that is 32 weeks gestation , is stabbed in the higher right chest. In
the emergency branch, her blood stress is 80/60 mm Hg. She is gasping for breath,
extraordinarily demanding, and yelling for assist. Breath sounds are diminished within the
proper chest. The most suitable first step is to:
Select one:
a.
Perform tracheal intubation
b.
Insert an oropharyngeal airway
c.
Carry out needle or finger decompression of the proper chest
d.
Manually displace the gravid uterus to the left facet of the stomach
e.
Provoke 2, large-caliber peripheral IV strains and crystalloid infusion - ANS-c.
Perform needle or finger decompression of the proper chest
A 22-12 months-antique woman athlete is stabbed in her left chest on the third interspace in
the anterior axillary line. On admission to the ED and 15 minutes after the incident, she is
unsleeping and alert. Her heart charge is one hundred beats consistent with minute, blood
stress is 80/60 mm Hg, and respiratory fee is 20 breaths in step with minute. A chest x-ray
well-knownshows a huge left hemothorax. A left chest tube is positioned with an immediate
go back of 1600 mL of blood. The next management step for this affected person is to:
Select one:
a.
Carry out a thoracoscopy
b.
Carry out an arch aortogram
c.
Insert a second left chest tube
d.
Put together for an exploratory thoracotomy
e.
Perform a chest CT - ANS-d.
Prepare for an exploratory thoracotomy
A 22-yr-old man is hypotensive and tachycardic after a shotgun wound to the left shoulder.
His blood pressure is initially 80/forty mm Hg. After preliminary fluid resuscitation his blood
stress will increase to 122/eighty four mm Hg. His heart fee is now 100 beats in step with
minute and his breathing charge is 28 breaths per minute. A tube thoracostomy is completed
for decreased left chest breath sounds with the return of a small amount of blood and no air
leak. After chest tube insertion, the maximum appropriate subsequent step is:
Select one:
a.
, Reexamine the chest
b.
Carry out an aortogram
c.
Acquire a CT experiment of the chest
d.
Attain arterial blood gas analyses
e.
Perform transesophageal echocardiography - ANS-A) Reexamine the chest
A 22-12 months-vintage guy sustains a gunshot wound to the left chest and is transported to
a small network clinic; no surgical competencies are to be had. In the emergency branch, a
chest tube is inserted and seven-hundred mL of blood is evacuated. The trauma center
accepts the patient in switch. Just before the patient is located inside the ambulance for
switch, his blood strain decreases to 80/sixty eight mm Hg and his coronary heart fee will
increase to 136 beats in line with minute. The subsequent step should be to:
Select one:
a.
Clamp the chest tube
b.
Cancel the patient's transfer
c.
Perform an emergency department thoracotomy
d.
Repeat the primary survey and continue with switch
e.
Delay the switch until the referring doctor can contact a thoracic general practitioner -
ANS-d.
Repeat the primary survey and proceed with transfer
A 23-yr-vintage guy sustains 4 stab wounds to the upper proper chest at some stage in an
altercation and is brought by using ambulance to a sanatorium that has full surgical abilities.
His wounds are all above the nipple. He is endotracheally intubated, closed tube
thoracostomy is completed, fluid resuscitation is initiated via 2 large-caliber IVs. FAST exam
does now not screen intraabdominal accidents. His blood stress now's 60/zero mm Hg, heart
price is one hundred sixty beats consistent with minute, and breathing price is 14 breaths in
step with minute (ventilated with 100% O2). 1500 mL of blood has tired from the right chest.
The maximum suitable next step in managing this patient is to
Select one:
a.
Perform diagnostic peritoneal lavage
b.
Gain a CT of the chest
c.
Perform an angiography
d.
Urgently transfer the affected person to the working room
e.
Straight away transfer the patient to a trauma middle - ANS-d.
Urgently transfer the affected person to the operating room
