ATLS EXAM WITH COMPLETE
SOLUTIONS RATED A+ 2025
LATEST UPDATE
field triage scheme step 1:
when to transport to level 1 trauma center?
GCS -
systolic BP -
RR - - answerGCS
<13 systolic BP <90
RR <10 or >29 [ <20 in infants <1 yr]
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ATLS Exam Questions and Answers: A Comprehensive Guide to Trauma Management, Exams of Nursing
A collection of questions and answers related to the advanced trauma life support (atls) exam. It covers key concepts in trauma management, including airway management, shock, and hemorrhage control. Useful for students preparing for the atls exam or those seeking to refresh their knowledge of trauma care.
Typology: Exams
2024/2025
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ATLS EXAM WITH COMPLETE
SOLUTIONS RATED A+ 2025
LATEST UPDATE
field triage scheme step 1: when to transport to level 1 trauma center? GCS - systolic BP - RR - - answerGCS <13 systolic BP < RR <10 or >29 [ <20 in infants <1 yr]
(OR need for ventilatory support) when adults fall > feet or meters (2 stories) you should transport to trauma center
- answer>20 feet or 6 meters (2 stories) when children fall > feet or meters you should transport to trauma center - answer>10 feet or 3 meters (2-3x height of child) high risk mvc qualities - answer- intrusion, including roof: >12 inches (30cm) occupants side
- intrusion >18 inches (45cm) on any side
- ejection
- death in same passenger compartment
- vehicle telemetry data consistent with high risk of injury
define multiple casualty incident - answermultiple casualty incidents are those in which the number of patients and the severity of their injuries do not exceed the capability of the facility to render care. In such cases, patients with life-threatening problems and those sustaining multiple-system injuries are treated first. define mass casualty incident - answerIn mass-casualty events, the number of patients and the severity of their injuries does exceed the capability of the facility and staff. In such cases, patients having the greatest chance of survival and requiring the least expenditure of time, equipment, supplies, and personnel are treated first Where can you assess a central pulse? - answerFemoral or carotid artery. Make sure you assess bilaterally for quality, rate and regularity. tourniquets are effective in - answermassive exsanguination from an extremity. However they carry a risk of ischemic injury.
stop the bleed - answer1. direct pressure to wound
When fluid warmers are not available, a microwave can be used to warm crystalloid fluids but it should never be used to warm blood products. When urethral injury is suspected, confirm urethral integrity by performing a before the catheter is inserted. - answerretrograde urethrogram How do you monitor the adequacy of a patient's respirations? - answerVentilatory rate, capnography, (end tidal carbon dioxide levels), ABG measurements. End tidal CO2 can be detected using? - answercolorimetry, capnometry, or capnography — a noninvasive monitoring technique that provides insight into the patient's ventilation, circulation, and metabolism. End tidal CO2 can also be used for tight control of ventilation to avoid hypoventilation and hyperventilation. It reflects and is used to predict -
answercardiac output and is used to predict return of spontaneous circulation (ROSC) during CPR. ex) >30 = ROSC likely ex) <10 = bad CPR AMPLE - answerAllergies Medications Past illnesses/pregnancy Last meal Events/Environment of injury ** part of 2ndary survey
hypercarbia - answerhypoventilation
- too much CO an agitated pt can suggest .. - answerhypoxia take away: abusive and belligerent pt may be hypoxic. do not assume intoxication! an obtunded pt can suggest - answerhypercarbia Cervical spinal cord injury can result in respiratory muscle paresis or paralysis. The more the injury, the more likely there will be respiratory impairment. - answerproximal
Injuries below the C3 level result in maintenance of the but loss of the intercostal and abdominal muscle contribution to respiration. - answerdiaphragmatic function Typically these patients display a seesaw pattern of breathing in which the abdomen is pushed out with inspiration, while the lower ribcage is pulled in. This presentation is referred to as "abdominal breathing" or "diaphragmatic breathing." This pattern of respiration is inefficient and results in rapid, shallow breaths that lead to atelectasis and ventilation perfusion mismatching and ultimately respiratory failure What nerves innervate the diaphragm? - answerC3,4,5 (phrenic nerve) When do you give O2 when managing an airway? - answerHigh-flow oxygen is required both before and immediately after instituting airway management measures. LEMON assessment for difficult intubation - answerL = Look Externally: Look for characteristics that are known to cause difficult intubation or ventilation (e.g., small mouth or jaw, large overbite, or facial trauma). E = Evaluate the 3-3-2 Rule: To allow for alignment of the pharyngeal, laryngeal, and oral axes and therefore simple intubation, observe the following
- The distance between the patient's incisor teeth should be at least 3 finger breadths (3)
- The distance between the hyoid bone and chin should be at least 3 finger breadths (3)
- The distance between the thyroid notch and floor of the mouth should be at least 2 finger breadths (2) M = Mallampati: Ensure that the hypopharynx is adequately visualized. This process has been done traditionally by assessing the Mallampati classification. In supine patients, the clinician can estimate Mallampati score by asking the patient to open the mouth fully and protrude the tongue; a laryngoscopy light is then shone into the hypopharynx from above to assess the extent of hypopharynx that is visible. O = Obstruction: Any condition that can cause obstruction of the airway will make laryngoscopy and ventilation difficult. N = Neck Mobility: This is a vital requirement for successful intubation. In a patient with non- traumatic injuries, clinicians can assess mobility easily by asking the patient to place his or her chin on the chest and then extend the neck so that he or she is looking toward the ceiling. Patients who require cervical spinal motion restriction obviously have no neck movement and are
therefore more difficult to intubate. Mallampati Score - answerI - soft palate, fauces, uvula, tonsillar pillars II - soft palate, fauces and uvula III - soft palate and base of uvula IV - soft palate not visible. hard palate only visible. The first priority of airway management is - answerto ensure continued oxygenation while restricting cervical spinal motion.
- Clinicians accomplish this task initially by positioning (i.e., chin-lift or jaw-thrust maneuver) and by using preliminary airway techniques (i.e., nasopharyngeal airway). If an endotracheal tube cannot be inserted and the patient's respiratory status is in jeopardy, clinicians may attempt ventilation via - answera laryngeal mask airway or other extraglottic airway device as a bridge to a definitive airway.
- If this measure fails, they should perform a cricothyroidotomy.
If clinicians decide to perform orotracheal intubation, what technique is preferred? - answerthe three-person technique with restriction of cervical spinal motion is recommended what is the preferred route taken to protect the airway? - answerorotracheal intubation What can reduce thee risk of aspiration during intubation? - answercricoid pressure.
- this maneuver may also reduce the view of the larynx What can aid in visualizing the vocal cords during intubation? - answerBURP! Laryngeal manipulation by backward, upward, and rightward pressure (BURP) on the thyroid cartilage can aid in visualizing the vocal cords.
- when the addition of cricoid pressure compromises the view of the larynx, this maneuver should be discontinued or readjusted. Additional hands are required for administering drugs and performing the BURP maneuver.
Problematic airway, what can you use to assist intubation? - answerEschmann tracheal tube introducer (aka gum elastic bougie ; GEB) When do clinicians use GEB? - answerwhen vocal cords cannot be visualized on direct laryngoscopy How do you confirm tracheal position with GEB placement? - answerby feeling clicks as the distal tip rubs along the cartilaginous tracheal rings. A GEB inserted into the esophagus will pass its full. length without resistance. After confirming position of GEB, pass a lubricated endotracheal tube over the bougie beyond the vocal cords. Proper placement of an endotracheal tube is suggested — but not confirmed — by - answer- hearing equal breath sounds bilaterally
Because of the potential for severe hyperkalemia, succinylcholine must be used cautiously in patients with: - answersevere crush injuries, major burns, and electrical injuries. **Extreme caution is warranted in patients with preexisting chronic renal failure, chronic paralysis, and chronic neuromuscular disease. Indications for Surgical Airway - answer- the presence of edema of the glottis
- fracture of the larynx
- severe oropharyngeal hemorrhage that obstructs the airway
- inability to place an endotracheal tube through the vocal cords. A surgical cricothyroidotomy is preferable to a tracheostomy for most patients who require an emergency surgical airway because - answerit is easier to perform, associated with less bleeding,
and requires less time to perform than an emergency tracheostomy. Oxygenated inspired air is best provided via .... - answera tight-fitting oxygen reservoir face mask with a flow rate of at least 10 L/min. PaO2 level of 90 corresponds with what O2 saturation? - answer100% PaO2 level of 60 corresponds with what O2 saturation? - answer90% PaO2 level of 30 corresponds with what O2 saturation? - answer60% PaO2 level of 27 corresponds with what O2 saturation? - answer50% Tachycardia is diagnosed when the heart rate is greater than 160 BPM in an - answerinfant