ATLS Practice
A 16 year old girl is rescued from a burning house. She has 25% partial thickness burns, and
the burned areas are hot to the touch. What is the appropriate treatment?
A. Apply ice to burned areas until cool to touch
B. Apply clean water to burned areas for up to 1-2 minutes
C. Apply iced water to burned areas until cool to touch
D. Do not apply anything to burned areas other than clean sheets - ANS-B. Apply clean
water to burned areas for up to 1-2 minutes
\A 23 year old female has won the "Let's-see-who-can-lean-the-farthest-backward-over-
the-second-story-balcony-railing contest. You arrive to find her boyfriend standing over her,
holding two beers, as she lies on the grass under the balcony. She opens her eyes to voice,
her skin is cool, clammy and ashen, respirations are rapid and shallow, radial pulses are too
rapid to count and thready. There is no external bleeding. She has flat neck veins, a normal
chest and abdomen and pelvis. Her boyfriend tells you that she has some kind of heart
problem but he doesn't know what. Placed on the monitor, she shows a wide-complex
tachycardia of about 280. What kind of shock is she suffering?
A. Hypovolemic shock
B. Relative hypovolemic (high-space) shock
C. Mechanical (obstructive) shock
D. Cardiogenic shock - ANS-D. Cardiogenic shock
\A 23 year old female has won the "Let's-see-who-can-lean-the-farthest-backward-over-
the-second-story-balcony-railing" contest. You arrive to find her boyfriend standing over her,
holding two beers, as she lies on the grass under the balcony. She opens her eyes to voice,
her skin is normal in color, respirations about 16 and unlabored, pulse 54 and a little weak at
the wrist, with no external bleeding. She has flat neck veins, a normal chest and abdomen
and a stable pelvis. First responders who arrived just before you, tell you that her pulse ox
reading is 94 and her blood pressure is 74/30. What type of shock is present?
A. Hypovolemic shock
B. Relative hypovolemic (high-space) shock
C. Mechanical (obstructive) shock
D. Cardiogenic shock - ANS-B. Relative hypovolemic (high-space) shock
\A 34 year old man has a gunshot wound to the right groin area. Arterial bleeding, which
cannot be controlled with direct pressure, is coming from the wound. The patient appears
confused, diaphoretic, and has weak peripheral pulses. What is the appropriate fluid
resuscitation for this patient?
A. Intravenous fluid at a "keep open" rate
B. Apply a hemostatic agent and gain intravenous access given enough fluid to maintain
peripheral pulses
C. Intravenous fluid at a wide open rate; give at least two liters, then reassess patient
D. No intravenous access should be established in this situation - ANS-B. Apply a
hemostatic agent and gain intravenous access given enough fluid to maintain peripheral
pulses
\A 34 year old man is injured in a motor vehicle collision. Physical examination is normal
, except for diffuse abdominal tenderness. He is conscious and vital signs obtained enroute to
the hospital are respirations 20 per ,minute, pulse rate is 120 per minute blood pressure
100/60; How should this patient be managed in the field?
A. Intravenous fluid at a "keep open" rate
B. Intravenous fluid at 20 ml/kg bolus
C. Fentanyl 100 mcg intravenous
D. Insert an oropharyngeal airway and assist ventilations - ANS-A. Intravenous fluid at a
"keep open" rate
\A 49 year old man is involved in a motor vehicle collision. First responders are doing CPR.
Findings include a distended abdomen and obviously deformed pelvis and a quick look at
the monitor shows asystole. Which of the following is the most appropriate act?
A. Establish intravenous access and administer a 20mL/kg bolus
B. Establish intravenous access and administer a 1 liter bolus
C. Establish intravenous access and administer a 2-4 liter bolus
D. Resuscitative efforts should not be started and the patient pronounced dead - ANS-D.
Resuscitative efforts should not be started and the patient pronounced dead
\Among the following, what is the most common cause of preventable trauma death in the
injured adult patient?
A. Airway obstruction
B. Cardiac tamponade
C. Hemorrhagic shock
D. Spinal injury - ANS-C. Hemorrhagic shock
\As intracerebral pressure rises, after an isolated head injury, what does the systolic blood
pressure do?
A. Stays the same
B. Decreases
C. Increases
D. Changes randomly - ANS-C. Increases
\Changes in which of the following is most useful to follow in the child with head injury?
A. Frequency of vomiting
B. Level of consciousness
C. Reflexes
D. Sensory exam - ANS-B. Level of consciousness
\Definitive control of the airway is achieved by ____________ - ANS-Endotracheal intubation
\Describe the 3 for 1 rule - ANS-Replace each mL of blood loss with 3 ml of crystalloid
solution
\Full thickness burn - ANS-Third degree burn
\Hemostatic agents applied directly to the source of bleeding must be used in conjunction
with:
A. direct pressure to the wound
B. tourniquets proximal to the wound
C. pressure points to arteries proximal to the wound
D. elevation of the wound above the level of the heart - ANS-A. direct pressure to the wound
\Hospital admission criteria for burn pt
(8) - ANS-1) Partial-thickness burns greater than 10% total BSA (TBSA)
2) Full-thickness burns greater than 2% TBSA
3) Burns involving the face, hands, genitalia, perineum, or major joints
4) Circumferential extremity burns
A 16 year old girl is rescued from a burning house. She has 25% partial thickness burns, and
the burned areas are hot to the touch. What is the appropriate treatment?
A. Apply ice to burned areas until cool to touch
B. Apply clean water to burned areas for up to 1-2 minutes
C. Apply iced water to burned areas until cool to touch
D. Do not apply anything to burned areas other than clean sheets - ANS-B. Apply clean
water to burned areas for up to 1-2 minutes
\A 23 year old female has won the "Let's-see-who-can-lean-the-farthest-backward-over-
the-second-story-balcony-railing contest. You arrive to find her boyfriend standing over her,
holding two beers, as she lies on the grass under the balcony. She opens her eyes to voice,
her skin is cool, clammy and ashen, respirations are rapid and shallow, radial pulses are too
rapid to count and thready. There is no external bleeding. She has flat neck veins, a normal
chest and abdomen and pelvis. Her boyfriend tells you that she has some kind of heart
problem but he doesn't know what. Placed on the monitor, she shows a wide-complex
tachycardia of about 280. What kind of shock is she suffering?
A. Hypovolemic shock
B. Relative hypovolemic (high-space) shock
C. Mechanical (obstructive) shock
D. Cardiogenic shock - ANS-D. Cardiogenic shock
\A 23 year old female has won the "Let's-see-who-can-lean-the-farthest-backward-over-
the-second-story-balcony-railing" contest. You arrive to find her boyfriend standing over her,
holding two beers, as she lies on the grass under the balcony. She opens her eyes to voice,
her skin is normal in color, respirations about 16 and unlabored, pulse 54 and a little weak at
the wrist, with no external bleeding. She has flat neck veins, a normal chest and abdomen
and a stable pelvis. First responders who arrived just before you, tell you that her pulse ox
reading is 94 and her blood pressure is 74/30. What type of shock is present?
A. Hypovolemic shock
B. Relative hypovolemic (high-space) shock
C. Mechanical (obstructive) shock
D. Cardiogenic shock - ANS-B. Relative hypovolemic (high-space) shock
\A 34 year old man has a gunshot wound to the right groin area. Arterial bleeding, which
cannot be controlled with direct pressure, is coming from the wound. The patient appears
confused, diaphoretic, and has weak peripheral pulses. What is the appropriate fluid
resuscitation for this patient?
A. Intravenous fluid at a "keep open" rate
B. Apply a hemostatic agent and gain intravenous access given enough fluid to maintain
peripheral pulses
C. Intravenous fluid at a wide open rate; give at least two liters, then reassess patient
D. No intravenous access should be established in this situation - ANS-B. Apply a
hemostatic agent and gain intravenous access given enough fluid to maintain peripheral
pulses
\A 34 year old man is injured in a motor vehicle collision. Physical examination is normal
, except for diffuse abdominal tenderness. He is conscious and vital signs obtained enroute to
the hospital are respirations 20 per ,minute, pulse rate is 120 per minute blood pressure
100/60; How should this patient be managed in the field?
A. Intravenous fluid at a "keep open" rate
B. Intravenous fluid at 20 ml/kg bolus
C. Fentanyl 100 mcg intravenous
D. Insert an oropharyngeal airway and assist ventilations - ANS-A. Intravenous fluid at a
"keep open" rate
\A 49 year old man is involved in a motor vehicle collision. First responders are doing CPR.
Findings include a distended abdomen and obviously deformed pelvis and a quick look at
the monitor shows asystole. Which of the following is the most appropriate act?
A. Establish intravenous access and administer a 20mL/kg bolus
B. Establish intravenous access and administer a 1 liter bolus
C. Establish intravenous access and administer a 2-4 liter bolus
D. Resuscitative efforts should not be started and the patient pronounced dead - ANS-D.
Resuscitative efforts should not be started and the patient pronounced dead
\Among the following, what is the most common cause of preventable trauma death in the
injured adult patient?
A. Airway obstruction
B. Cardiac tamponade
C. Hemorrhagic shock
D. Spinal injury - ANS-C. Hemorrhagic shock
\As intracerebral pressure rises, after an isolated head injury, what does the systolic blood
pressure do?
A. Stays the same
B. Decreases
C. Increases
D. Changes randomly - ANS-C. Increases
\Changes in which of the following is most useful to follow in the child with head injury?
A. Frequency of vomiting
B. Level of consciousness
C. Reflexes
D. Sensory exam - ANS-B. Level of consciousness
\Definitive control of the airway is achieved by ____________ - ANS-Endotracheal intubation
\Describe the 3 for 1 rule - ANS-Replace each mL of blood loss with 3 ml of crystalloid
solution
\Full thickness burn - ANS-Third degree burn
\Hemostatic agents applied directly to the source of bleeding must be used in conjunction
with:
A. direct pressure to the wound
B. tourniquets proximal to the wound
C. pressure points to arteries proximal to the wound
D. elevation of the wound above the level of the heart - ANS-A. direct pressure to the wound
\Hospital admission criteria for burn pt
(8) - ANS-1) Partial-thickness burns greater than 10% total BSA (TBSA)
2) Full-thickness burns greater than 2% TBSA
3) Burns involving the face, hands, genitalia, perineum, or major joints
4) Circumferential extremity burns
