PHTLS EXAM EVALUATION QUESTIONS WITH ANSWERS
GRADED A+ 2025/2026
The potential for death or serious injury is greatest in what kind of MVC's? - Ejection
from vehicles
Bilateral femur fractures are most often associated with which type of motorcycle crash?
- Head On impact
What is the preferred fluid for resuscitation of hemorrhagic shock in prehospital setting?
- Lactated Ringers
What is the most common cause of upper airway obstruction in the trauma patient? -
Tongue
What is the preferred adjunct device for verifying placement of an endotracheal tube in
a patient with a perfusing rhythm? - End-tidal CO2 (capnography)
What is the most important reason to maintain an open airway in the trauma patient? -
Preventing hypoxemia and hypercarbia
What is the essential airway skill that includes manual clearing of the airway, manual
maneuvers, suctioning and... - OPA
What is the definition of shock? - Inadequate tissue perfusion
What is the most appropriate initial action for a bleed? - Direct pressure
Hypotension of unknown etiology in a trauma patient should be assumed to result from
what? - Blood loss
Which assessment is most beneficial in differentiating hemorrhagic shock from
neurogenic shock in the prehospital setting? - Skin signs
The body initially compensates for blood loss through activation of what? - Sympathetic
nervous system
Medication used by trauma patients for pre-existing conditions may cause what? - Beta
blockers may prevent tachycardia with blood loss
The target blood pressure for a trauma patient with suspected intra-abdominal
hemorrhage is what? - 80-90 mmHg
What best explains the mechanism by which gas exchange is impaired in pulmonary
contusion? - Blood in alveoli
,What is a key finding that differentiates cardiac tamponade from tension pneumothorax?
- Tachycardia
What is the preferred prehospital wound management for a patient with 36% body
surface area flame burn? - Dry sterile dressings
The most immediate life threatening condition resulting from injury to solid abdominal
organs is what? - Hemorrhage
If direct pressure doesn't work, what is the next step? - Apply tourniquet and tighten it
until bleeding stops
What makes up the GCS? - Max: 15 Min: 3
Eyes (4) Voice (5) Motion (6)
14-15 = mild dysfunction
11-13 = moderate to severe dysfunction
10 or less = severe dysfunction
GCS: Eyes - 4 = spontaneous opening
3 = verbal stimulus
2 = painful stimulus
1 = no response
GCS: Voice - 5 = oriented (person, place, time)
4 = confused
3 = inappropriate words
2 = grunts or moans
1 = no response
GCS: Motion - 6 = follows commands
5 = localizes pain
4 = withdraws from pain
3 = decorticate flexion
2 = decerebrate extension
1 = no response
What are the phases/classes of shock? - Early (class 1)
Compensated (class 2)
Decompensated (class 3)
Irreversible (class 4)
Shock: Class 1 Parameters - < 750 mL (15%)
Normal HR
Normal RR
, Normal SBP
Normal urine output
Shock: Class 2 Parameters - 750-1,500 mL (15-30%)
HR > 100
RR 20-30
SBP Normal
Urine output 20-30 mL/hr
Shock: Class 3 Parameters - 1,500-2,000 mL (30-40%)
HR > 120
RR 30-40
SBP is decreased
Urine output 5-15 mL/hr
Shock: Class 4 Parameters - > 2,000 mL (40%)
HR > 140
RR > 35
SBP is GREATLY decreased
Urine output is minimal
What is the purpose of a primary assessment? - Find and correct any life threats
What is done during an initial assessment? - - ABC's
- C-Spine
- Disability (GCS & pupils)
- Expose the patient
Who is considered a critical patient? - Anyone who has an insult to airway, breathing,
circulation, and disability (GCS & pupils)
If traumatic patient is in critical condition, what is your primary concern? - Getting them
to the hospital
Vitals, splinting, IV's all done en route
If traumatic patient is stable, what is your concern? - Vitals, secondary assessment,
pain management, splinting done on scene
***FRACTURES MUST BE SPLINTED BEFORE MOVING PT TO SPINE
BOARD/STRETCHER***
How should traumatic patients be transported to the hospital? - Flat whenever possible
What does a two-toned skin indicate? - Neurogenic Shock
Flushed below sight of injury
Pale above the sight of injury
GRADED A+ 2025/2026
The potential for death or serious injury is greatest in what kind of MVC's? - Ejection
from vehicles
Bilateral femur fractures are most often associated with which type of motorcycle crash?
- Head On impact
What is the preferred fluid for resuscitation of hemorrhagic shock in prehospital setting?
- Lactated Ringers
What is the most common cause of upper airway obstruction in the trauma patient? -
Tongue
What is the preferred adjunct device for verifying placement of an endotracheal tube in
a patient with a perfusing rhythm? - End-tidal CO2 (capnography)
What is the most important reason to maintain an open airway in the trauma patient? -
Preventing hypoxemia and hypercarbia
What is the essential airway skill that includes manual clearing of the airway, manual
maneuvers, suctioning and... - OPA
What is the definition of shock? - Inadequate tissue perfusion
What is the most appropriate initial action for a bleed? - Direct pressure
Hypotension of unknown etiology in a trauma patient should be assumed to result from
what? - Blood loss
Which assessment is most beneficial in differentiating hemorrhagic shock from
neurogenic shock in the prehospital setting? - Skin signs
The body initially compensates for blood loss through activation of what? - Sympathetic
nervous system
Medication used by trauma patients for pre-existing conditions may cause what? - Beta
blockers may prevent tachycardia with blood loss
The target blood pressure for a trauma patient with suspected intra-abdominal
hemorrhage is what? - 80-90 mmHg
What best explains the mechanism by which gas exchange is impaired in pulmonary
contusion? - Blood in alveoli
,What is a key finding that differentiates cardiac tamponade from tension pneumothorax?
- Tachycardia
What is the preferred prehospital wound management for a patient with 36% body
surface area flame burn? - Dry sterile dressings
The most immediate life threatening condition resulting from injury to solid abdominal
organs is what? - Hemorrhage
If direct pressure doesn't work, what is the next step? - Apply tourniquet and tighten it
until bleeding stops
What makes up the GCS? - Max: 15 Min: 3
Eyes (4) Voice (5) Motion (6)
14-15 = mild dysfunction
11-13 = moderate to severe dysfunction
10 or less = severe dysfunction
GCS: Eyes - 4 = spontaneous opening
3 = verbal stimulus
2 = painful stimulus
1 = no response
GCS: Voice - 5 = oriented (person, place, time)
4 = confused
3 = inappropriate words
2 = grunts or moans
1 = no response
GCS: Motion - 6 = follows commands
5 = localizes pain
4 = withdraws from pain
3 = decorticate flexion
2 = decerebrate extension
1 = no response
What are the phases/classes of shock? - Early (class 1)
Compensated (class 2)
Decompensated (class 3)
Irreversible (class 4)
Shock: Class 1 Parameters - < 750 mL (15%)
Normal HR
Normal RR
, Normal SBP
Normal urine output
Shock: Class 2 Parameters - 750-1,500 mL (15-30%)
HR > 100
RR 20-30
SBP Normal
Urine output 20-30 mL/hr
Shock: Class 3 Parameters - 1,500-2,000 mL (30-40%)
HR > 120
RR 30-40
SBP is decreased
Urine output 5-15 mL/hr
Shock: Class 4 Parameters - > 2,000 mL (40%)
HR > 140
RR > 35
SBP is GREATLY decreased
Urine output is minimal
What is the purpose of a primary assessment? - Find and correct any life threats
What is done during an initial assessment? - - ABC's
- C-Spine
- Disability (GCS & pupils)
- Expose the patient
Who is considered a critical patient? - Anyone who has an insult to airway, breathing,
circulation, and disability (GCS & pupils)
If traumatic patient is in critical condition, what is your primary concern? - Getting them
to the hospital
Vitals, splinting, IV's all done en route
If traumatic patient is stable, what is your concern? - Vitals, secondary assessment,
pain management, splinting done on scene
***FRACTURES MUST BE SPLINTED BEFORE MOVING PT TO SPINE
BOARD/STRETCHER***
How should traumatic patients be transported to the hospital? - Flat whenever possible
What does a two-toned skin indicate? - Neurogenic Shock
Flushed below sight of injury
Pale above the sight of injury
