ATLS EXAM QUESTION AND ANSWERS 2023 SOLUTION

ATLS EXAM QUESTION AND ANSWERS 2023 SOLUTION A 23-year-old man is brought immediately to the ED from the hospitals parking lot where he was shot in the lower abdomen. Examination reveals a single bullet wound. He is breathing and has a thready pulse. However, he is unconscious and has no detectable blood pressure. Optimal immediate management is to: A. Perform a FAST B. Initiate infusion of packed red blood cells C. Insert a nasogastric tube and urinary catheter D. Transfer the patient to the operating room, while initiating fluid therapy E. Initiate fluid therapy to return his blood pressure to normotensive - ANSWER - D. Transfer the patient to the operating room, while initiating fluid therapy A 22 year old male present following a motorcycle crash. He complains of the inability to move his legs. His BP is 80/50, HR 70, RR 18 and GCS 15. Oxygen saturation is 99% on 21 nasal prongs. Chest x-ray, pelvic x-ray and FAST are normal. Extremities are normal. His management should be: A: 1L of iv . crystalloid and two units 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 crystalloid and vasopressors if blood pressure does not respond - ANSWER - E. 1 L of crystalloid and vasopressors if blood pressure does not respond Which of the following is MOST RELIABLE to confirm endotracheal intubation? a. presence of breath sounds bilaterally b. absence of borborygmi in the epigastrium on auscultation c. presence of CO2 in exhaled air via capnography d. appearance of fog in the endotracheal tube e. chest x-ray with endotracheal tube tip appearing above the carina - ANSWER - e. chest x-ray with endotracheal tube tip appearing above the carina A 6 month old infant, being held in her mothers arms, is ejected on impact from a vehicle that is struck head on by an oncoming car traveling at 64kph. The infant arrives in the ED with multiple facial injuries, is lethargic, and is in severe respiratory distress. Respiratory support is not effective using a bag mask device, and her oxygen saturation is falling. Repeated attempts at orotracheal intubation are unsuccessful. the most appropriate procedure to perform next is: A.Administer heliox and racemic epinephrine B. Perform nasotracheal intubation Perform surgical cricothyroidotomy Repeat orotracheal intubation E. Perform needle cricothyroidotomy with jet insufflation - ANSWER - E. Perform needle cricothyroidotomy with jet insufflation A 28 year old male is brought to the ED. He was involved in a fight, during which he was beaten with a wooden stick. His chest shows multiple severe bruises. His airway is clear, resp rate is 22, hear rate 126, and systolic blood pressure is 90 mmHG. Which of the following should be performed during the primary survey a. Glasgow coma b. tetanus status c. cervical spine x-ray d. blood alcohol level e. rectal exam - ANSWER - a. Glasgow coma an 18yo male is brought to the emergency department after being dumped by a large wave while surfing. He landed head first on the firm beach sand. His vital signs are blood pressure 85/60 mmHg, heart rate 60, and respiratory rate 18; he is unable to move his lower extremities. He appears calm and asks if he will ever walk again. The most appropriate next step is to: a. reassure patient that he will walk again b. proceed to a more detailed neuro exam c. obtain c spin x-rays d. begin infusion of vasopressors