ATLS
25 yo woman within the third trimester of preganacy is brought to the ED following a high
speed MVA. She is conscious, and her important symptoms are RR 16, HR a hundred and
twenty, BP 70/50. The laboratory consequences show a PaCO2 of 50mmHg/5.3kPa
(everyday range 35-45). Which one of the following statments concerning this affected
person is actual?
A. Fetal assessment ought to take priority
b. Logrolling the affected person to the right will decompress the vena cava
c. Rh immuno therapy sshould be straight away adminstered
d. Regular PaCO2 is concerning for forthcoming RR
e. Vasopressors must accept to the patient - ANS-d. Regular PaCO2 is regarding for
imminent RR
30 year old male gift with a stab wound to the stomach. BP is 60/34, HR one hundred thirty,
RR 25 and GCS thirteen E3V4M6. Neck veins are flat and chest exam is apparent with
bilateral breath sounds. Optimal resuscitation should consist of:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base extra is normal
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy even as beginning fluid resuscitation - ANS-E. Preparation for
laparotomy even as starting up fluid resuscitation
A 14 yr vintage lady is delivered to the ED after falling from a horse. Cervical spinal
movement is constrained wit ha difficult collar and cervical blocks and she or he is
immobilized on a protracted backbone board. Which of the subsequent IS TRUE
REGARDING Cervical backbone x-ray:
A. More than 20% of those patients may have cervical backbone damage
B. Cervical backbone harm is excluded if no abnormalities are located on lateral cervical
backbone xray
C. Are not wanted if she is wide awake, alert, neurologically normal, and has no neck pain or
midline tenderness
D. Should be accomplished earlier than adressing capacity breating or circulatory problems
E. She ought to reamin on teh long spine board until imaging excluded injuries - ANS-C. Are
not wanted if she is conscious, alert, neurologically regular, and has no neck ache or midline
tenderness
A 15 year old is added to the ED after being concerned in a MVA. He was intubated by
means of emergency clinical personnal with next bilateral breath sounds consistent with their
report. Upon arrival to the ED the patients O2 saat is 92%, coronary heart ninety six, and
blood pressure one hundred fifty/eighty five. Breath sounds are reduced in the left facet of
the thorax. The subsequent step is
a. Immediate needle cricothyroidotomy
b. On the spot needle thoracentesis
c. Chest tube insertion
d. Reconsider the location of the endotracheal tube
, e. Reap a chest CT - ANS-d. Reassess the location of the endotracheal tube
A 15 yr vintage male present following a motorbike crash. INitial examinations reveals
ordinary important signs and symptoms. There is a massive bruise over his epigastrium that
extends to the left flank. He has no different apparent accidents. A CT-experiment of the
abdomen display a ruptured spleen surrounded with the aid of a big hematoma and fluid
within the pelvis. The subsequent step in the sufferers management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS-D. Surgical seek advice from
A 22 12 months vintage male present following a bike crash. He complains of the lack of
ability to transport his legs. His BP is eighty/50, HR 70, RR 18 and GCS 15. Oxygen
saturation is ninety nine% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are
ordinary. Extremities are regular. His management ought to be:
A: 1L of iv . Crystalloid and two devices 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 no longer respond - ANS-E. 1 L
of cystalloid and vasopressors if blood strain does now not respond
A 22 yr 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 will increase
to 122/eighty four, and HR decreases to 100bpm. He is tachypneic with RR of 28. On bodily
exam, his breath sounds are decreased on the left higher chest with dullness on percussion.
A tube thoracostomy is inserted within the 5th intercostal space with the return of 200ml of
blood and no air leak. The maximum suitable subsequent step is to:
a. Degree blood pressure again
b. Start transfuse O negative blood
c. Wait until the chest xray is completed
d. Acquire a CT test of the chest and abdomen
e. Repeat the physical examination of the chest - ANS-e. Repeat the bodily exam of the
chest
A 22 yo male is introduced to the ED after being assaulted in a bar. On intial examination,
his essential signs and symptoms are normal and his Glasgow Coma scale is V5E4M6. A
specific indication for a head CT is
a. Prescence of hemotympanum
b. Complains of headache
c. Prescense of 10cm scapl laceration
d. Prescence of mandibular fracture
e. Records of assault - ANS-a. Prescence of hemotympanum
a 23 yo production worker is added to the ED after falling more than 9 meters from
scaffolding. He is stated to have landed on his feet and then been unable to endure weight.
His important signs are heart a hundred and forty, blood pressure 96/60 mmHg, resp rate 36.
He is complaining of lower abdbominal and decrease limb pain, and has apparent deformity
of both decrease legs with bilateral open tibial fractures. WHich one of the following
statements regarding this patient is true?
A. Pelvic injury may be ruled out, primarily based at the MOI
25 yo woman within the third trimester of preganacy is brought to the ED following a high
speed MVA. She is conscious, and her important symptoms are RR 16, HR a hundred and
twenty, BP 70/50. The laboratory consequences show a PaCO2 of 50mmHg/5.3kPa
(everyday range 35-45). Which one of the following statments concerning this affected
person is actual?
A. Fetal assessment ought to take priority
b. Logrolling the affected person to the right will decompress the vena cava
c. Rh immuno therapy sshould be straight away adminstered
d. Regular PaCO2 is concerning for forthcoming RR
e. Vasopressors must accept to the patient - ANS-d. Regular PaCO2 is regarding for
imminent RR
30 year old male gift with a stab wound to the stomach. BP is 60/34, HR one hundred thirty,
RR 25 and GCS thirteen E3V4M6. Neck veins are flat and chest exam is apparent with
bilateral breath sounds. Optimal resuscitation should consist of:
A. Transfusion of FFP and platelets
B. 500ml of hypertonic saline and transfusion of pRBCs
C. Resuscitation with crystalloid and pRBC until base extra is normal
D. Fluid resuscitation and angioembolization
E. Preparation for laparotomy even as beginning fluid resuscitation - ANS-E. Preparation for
laparotomy even as starting up fluid resuscitation
A 14 yr vintage lady is delivered to the ED after falling from a horse. Cervical spinal
movement is constrained wit ha difficult collar and cervical blocks and she or he is
immobilized on a protracted backbone board. Which of the subsequent IS TRUE
REGARDING Cervical backbone x-ray:
A. More than 20% of those patients may have cervical backbone damage
B. Cervical backbone harm is excluded if no abnormalities are located on lateral cervical
backbone xray
C. Are not wanted if she is wide awake, alert, neurologically normal, and has no neck pain or
midline tenderness
D. Should be accomplished earlier than adressing capacity breating or circulatory problems
E. She ought to reamin on teh long spine board until imaging excluded injuries - ANS-C. Are
not wanted if she is conscious, alert, neurologically regular, and has no neck ache or midline
tenderness
A 15 year old is added to the ED after being concerned in a MVA. He was intubated by
means of emergency clinical personnal with next bilateral breath sounds consistent with their
report. Upon arrival to the ED the patients O2 saat is 92%, coronary heart ninety six, and
blood pressure one hundred fifty/eighty five. Breath sounds are reduced in the left facet of
the thorax. The subsequent step is
a. Immediate needle cricothyroidotomy
b. On the spot needle thoracentesis
c. Chest tube insertion
d. Reconsider the location of the endotracheal tube
, e. Reap a chest CT - ANS-d. Reassess the location of the endotracheal tube
A 15 yr vintage male present following a motorbike crash. INitial examinations reveals
ordinary important signs and symptoms. There is a massive bruise over his epigastrium that
extends to the left flank. He has no different apparent accidents. A CT-experiment of the
abdomen display a ruptured spleen surrounded with the aid of a big hematoma and fluid
within the pelvis. The subsequent step in the sufferers management is:
A. Splenic artery embolization
B. Pneumococcal vaccine
C. Urgent laparotomy
D. Surgical consult
E. Transfer to a pediatrician - ANS-D. Surgical seek advice from
A 22 12 months vintage male present following a bike crash. He complains of the lack of
ability to transport his legs. His BP is eighty/50, HR 70, RR 18 and GCS 15. Oxygen
saturation is ninety nine% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are
ordinary. Extremities are regular. His management ought to be:
A: 1L of iv . Crystalloid and two devices 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 no longer respond - ANS-E. 1 L
of cystalloid and vasopressors if blood strain does now not respond
A 22 yr 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 will increase
to 122/eighty four, and HR decreases to 100bpm. He is tachypneic with RR of 28. On bodily
exam, his breath sounds are decreased on the left higher chest with dullness on percussion.
A tube thoracostomy is inserted within the 5th intercostal space with the return of 200ml of
blood and no air leak. The maximum suitable subsequent step is to:
a. Degree blood pressure again
b. Start transfuse O negative blood
c. Wait until the chest xray is completed
d. Acquire a CT test of the chest and abdomen
e. Repeat the physical examination of the chest - ANS-e. Repeat the bodily exam of the
chest
A 22 yo male is introduced to the ED after being assaulted in a bar. On intial examination,
his essential signs and symptoms are normal and his Glasgow Coma scale is V5E4M6. A
specific indication for a head CT is
a. Prescence of hemotympanum
b. Complains of headache
c. Prescense of 10cm scapl laceration
d. Prescence of mandibular fracture
e. Records of assault - ANS-a. Prescence of hemotympanum
a 23 yo production worker is added to the ED after falling more than 9 meters from
scaffolding. He is stated to have landed on his feet and then been unable to endure weight.
His important signs are heart a hundred and forty, blood pressure 96/60 mmHg, resp rate 36.
He is complaining of lower abdbominal and decrease limb pain, and has apparent deformity
of both decrease legs with bilateral open tibial fractures. WHich one of the following
statements regarding this patient is true?
A. Pelvic injury may be ruled out, primarily based at the MOI
