ATLS EXAM
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1. True or false? Although the mechanism of injury may be similar to those for
the younger population, data shows increased mortality with similar severity
of injury in older adults.: True
2. In the elderly population, what is decreased physiological reserve?: aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an increased susceptibility to the stress
of injury. Insults tolerated by the younger population can lead to devastating results in elderly patients.
3. Pre-existing conditions that affect morbidity and mortality include:: cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
4. What is the most common mechanism of injury in the elderly?: Fall. Nonfatal falls
are common in women and fractures are common in women who fall. Falls are the most common cause of TBI.
5. In the elderly population, what are risk factors for falls?: advanced age, physical
impairment, history of previous fall, medication use, dementia, unsteady gait, and visual, cognitive impairment
6. Most of elderly traffic fatalities occur in the daytime and on weekends and
typically involve other vehicles. Why?: Older people drive on more familiar roads and at lower speeds
and tend to drive during the day. Older people have slower reaction time, a larger blind spot, limited cervical mobility,
decreased hearing, and cognitive impairment.
7. True or False? Mortality associated with small to moderate sized burns in
older adults remains high: True
8. Spilled hot liquids on the leg, which in younger patients may re-epithelialize
due to an adequate number of hair follicles, will result in a full thickness burn
in older patients.: this is true
9. Airway-patients may have dentures that may loosen or obstruct the airway. If
dentures are not obstructing the airway, leave them in place for what?: bag mask
ventilation, as it improves mask fitting.
10. When preforming rapid sequence intubation, the dose of benzos, barbitu-
rates, and other sedatives should be reduced to what percentage to minimize
the risk of cardiovascular depression?: 20-40%
11. Functional changes in cardiac system include declining function, decreased
sensitivity to catecholamines, atherosclerosis of coronary vessels, increased
afterload, fixed heart rate (beta blockers): this results in lack of classic response to hypovolemia,
risk for cardiac ischemia, elevated BP at baseline, and increased risk of dysrythmias.
, ATLS EXAM
Study online at https://quizlet.com/_hqvloe
12. Functional changes in pulmonary system include decreased elastic recoil,
reduced residual capacity, decreased gas exchange and decreased cough re-
flex: thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
13. Functional changes in renal system include loss of renal mass, decreased
GFR, and decreased sensitivity to ADH and aldosterone: resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may be normal with
hypovolemia
14. Functional changes to MSK include loss of lean body mass, osteoporosis,
changes in joints and cartilage, c spine degenerative changes and loss of skin
elastin and subcutaneous fat: resulting in increased risk for fractures, decreased mobility, difficulty for
oral intubation, risk of skin injury, increased risk for hypothermia, challenges in rehabiliation
15. Functional changes in Endocrine system include decreased production and
response to thyroxin and decreased dehydroepiandrosterone (DHEA): resulting in
occult hypothyroidism, relative hypercortisone states and increased risk of infection
16. True or false: Arthritis can complicate the airway and cervical spine. Patients
can have multilevel degenerative changes affecting disk spaces and posterior
elements associated with severe central canal stenosis, cord compression, and
myelomalacia: true
17. In elderly population, due to their changes in pulmonary system, placing a
gauze between gums and cheek to achieve seal when using bag valve mask
ventilation is okay. In addition, because aging causes a suppressed heart rate
response to hypoxia......: respiratory failure may present insidiously in older adults.
18. Age related changes in the cardiovascular system place the elderly trauma
patient at significant risk for being inaccurately categorized as hemodynami-
cally stable.: Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older patients have HTN, an acceptable BP
may truly reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying hypotension
in patients 65 and older.
19. Do no equate blood pressure with shock in older patients: BP in older patients may
look normal due to the medications they are on. Use lactate and base deficit to evaluate for evidence of shock
, ATLS EXAM
Study online at https://quizlet.com/_hqvloe
20. what 2 factors place elderly patients at risk for intracranial hemorrhage?: ag-
ing causes dura to become more adherent to the skull increasing risk of injury and older patients are on anticoagulant
and antiplatelet medications.
21. Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions
place elderly patients as risk for hypothermia and complications for immo-
bility.: Rapid evaluation and when possible early liberation from spine boards and cervical collars will minimize
complications.
22. True or False: Fall prevention is the mainstay of reducing the mortality
associated with pelvic fractures.: true
23. poor hygiene, dehydration, oral injury, contusions affecting the inner arms,
inner thighs, palms, soles, scalp, ear, nasal bridge and temple injury from being
struck while wearing glasses, contact burns and scalds. These are all signs
of.......?: Elder maltreatment. The presence of physical findings of maltreatment should prompt a detailed history.
if history conflicts with findings, immediately report findings to authorities.
24. True of false: early activation of the trauma team may be required for elderly
patients who do not meet traditional criteria for activation: True. A simple injury such as
an open tibia fracture in a frail elderly patient may become life threatening.
25. Common mechanisms of injury include falls, MVC, burns, and penetrating
injuries: common injuries in the elderly include rib fractures, TBI, pelvic fractures
26. The best initial treatment for the fetus is to provide optimal resuscitation
of the mother. True or False?: True. Also if xray examination is indicated during the pregnant patient's
treatment, it should not be withheld because of the pregnancy.
27. What happens as the uterus enlarged and the bowel is pushed cephalad.: -
When the uterus enlarges it pushes the bowel cephalad and the uterus lies in the upper abdomen. As a result, the
bowel is somewhat protected from blunt abdominal trauma, whereas the uterus and its contents (fetus and placenta)
become more vulnerable. Uterus remains intrapelvic until 12 weeks and then at 20 weeks it is at the umbilicus, and at
34-36 weeks it reaches the costal margin.
28. Amniotic fluid can cause amniotic fluid embolism and disseminated intravas-
cular coagulation following trauma if fluid enters maternal intravascular space.
True or False: True
29. By the third trimester, what is the complication of trauma to the pelvis of the
mother?: by the third trimester, the uterus is large and thin walled. In vertex presentation, fetal head is usually in
Study online at https://quizlet.com/_hqvloe
1. True or false? Although the mechanism of injury may be similar to those for
the younger population, data shows increased mortality with similar severity
of injury in older adults.: True
2. In the elderly population, what is decreased physiological reserve?: aging is
characterized by impaired adaptive and homeostatic mechanisms that caused an increased susceptibility to the stress
of injury. Insults tolerated by the younger population can lead to devastating results in elderly patients.
3. Pre-existing conditions that affect morbidity and mortality include:: cirrhosis,
coagulopathy, COPD, ischemic heart disease, DM
4. What is the most common mechanism of injury in the elderly?: Fall. Nonfatal falls
are common in women and fractures are common in women who fall. Falls are the most common cause of TBI.
5. In the elderly population, what are risk factors for falls?: advanced age, physical
impairment, history of previous fall, medication use, dementia, unsteady gait, and visual, cognitive impairment
6. Most of elderly traffic fatalities occur in the daytime and on weekends and
typically involve other vehicles. Why?: Older people drive on more familiar roads and at lower speeds
and tend to drive during the day. Older people have slower reaction time, a larger blind spot, limited cervical mobility,
decreased hearing, and cognitive impairment.
7. True or False? Mortality associated with small to moderate sized burns in
older adults remains high: True
8. Spilled hot liquids on the leg, which in younger patients may re-epithelialize
due to an adequate number of hair follicles, will result in a full thickness burn
in older patients.: this is true
9. Airway-patients may have dentures that may loosen or obstruct the airway. If
dentures are not obstructing the airway, leave them in place for what?: bag mask
ventilation, as it improves mask fitting.
10. When preforming rapid sequence intubation, the dose of benzos, barbitu-
rates, and other sedatives should be reduced to what percentage to minimize
the risk of cardiovascular depression?: 20-40%
11. Functional changes in cardiac system include declining function, decreased
sensitivity to catecholamines, atherosclerosis of coronary vessels, increased
afterload, fixed heart rate (beta blockers): this results in lack of classic response to hypovolemia,
risk for cardiac ischemia, elevated BP at baseline, and increased risk of dysrythmias.
, ATLS EXAM
Study online at https://quizlet.com/_hqvloe
12. Functional changes in pulmonary system include decreased elastic recoil,
reduced residual capacity, decreased gas exchange and decreased cough re-
flex: thus they are at increased risk for respiratory failure, increased risk for pneumonia, and poor tolerance to rib
fractures
13. Functional changes in renal system include loss of renal mass, decreased
GFR, and decreased sensitivity to ADH and aldosterone: resulting in drug dosing for
renal insufficiency, decreased ability to concentrate urine, increased risk for AKI and urine flow may be normal with
hypovolemia
14. Functional changes to MSK include loss of lean body mass, osteoporosis,
changes in joints and cartilage, c spine degenerative changes and loss of skin
elastin and subcutaneous fat: resulting in increased risk for fractures, decreased mobility, difficulty for
oral intubation, risk of skin injury, increased risk for hypothermia, challenges in rehabiliation
15. Functional changes in Endocrine system include decreased production and
response to thyroxin and decreased dehydroepiandrosterone (DHEA): resulting in
occult hypothyroidism, relative hypercortisone states and increased risk of infection
16. True or false: Arthritis can complicate the airway and cervical spine. Patients
can have multilevel degenerative changes affecting disk spaces and posterior
elements associated with severe central canal stenosis, cord compression, and
myelomalacia: true
17. In elderly population, due to their changes in pulmonary system, placing a
gauze between gums and cheek to achieve seal when using bag valve mask
ventilation is okay. In addition, because aging causes a suppressed heart rate
response to hypoxia......: respiratory failure may present insidiously in older adults.
18. Age related changes in the cardiovascular system place the elderly trauma
patient at significant risk for being inaccurately categorized as hemodynami-
cally stable.: Elderly patients have a fixed heart rate and fixed cardiac output, thus, their response to hypovolemia
will involve increasing their systemic vascular resistance. Furthermore, since older patients have HTN, an acceptable BP
may truly reflect a hypotensive state. A systolic BP of 110 is to be utilized as the threshold for identifying hypotension
in patients 65 and older.
19. Do no equate blood pressure with shock in older patients: BP in older patients may
look normal due to the medications they are on. Use lactate and base deficit to evaluate for evidence of shock
, ATLS EXAM
Study online at https://quizlet.com/_hqvloe
20. what 2 factors place elderly patients at risk for intracranial hemorrhage?: ag-
ing causes dura to become more adherent to the skull increasing risk of injury and older patients are on anticoagulant
and antiplatelet medications.
21. Loss of subcutaneous fat, nutritional deficiencies, chronic medical conditions
place elderly patients as risk for hypothermia and complications for immo-
bility.: Rapid evaluation and when possible early liberation from spine boards and cervical collars will minimize
complications.
22. True or False: Fall prevention is the mainstay of reducing the mortality
associated with pelvic fractures.: true
23. poor hygiene, dehydration, oral injury, contusions affecting the inner arms,
inner thighs, palms, soles, scalp, ear, nasal bridge and temple injury from being
struck while wearing glasses, contact burns and scalds. These are all signs
of.......?: Elder maltreatment. The presence of physical findings of maltreatment should prompt a detailed history.
if history conflicts with findings, immediately report findings to authorities.
24. True of false: early activation of the trauma team may be required for elderly
patients who do not meet traditional criteria for activation: True. A simple injury such as
an open tibia fracture in a frail elderly patient may become life threatening.
25. Common mechanisms of injury include falls, MVC, burns, and penetrating
injuries: common injuries in the elderly include rib fractures, TBI, pelvic fractures
26. The best initial treatment for the fetus is to provide optimal resuscitation
of the mother. True or False?: True. Also if xray examination is indicated during the pregnant patient's
treatment, it should not be withheld because of the pregnancy.
27. What happens as the uterus enlarged and the bowel is pushed cephalad.: -
When the uterus enlarges it pushes the bowel cephalad and the uterus lies in the upper abdomen. As a result, the
bowel is somewhat protected from blunt abdominal trauma, whereas the uterus and its contents (fetus and placenta)
become more vulnerable. Uterus remains intrapelvic until 12 weeks and then at 20 weeks it is at the umbilicus, and at
34-36 weeks it reaches the costal margin.
28. Amniotic fluid can cause amniotic fluid embolism and disseminated intravas-
cular coagulation following trauma if fluid enters maternal intravascular space.
True or False: True
29. By the third trimester, what is the complication of trauma to the pelvis of the
mother?: by the third trimester, the uterus is large and thin walled. In vertex presentation, fetal head is usually in
