PHTLS CHAPTER 6: PATIENT ASSESSMENT AND

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PHTLS CHAPTER 6: PATIENT ASSESSMENT AND

MANAGEMENT EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -34 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: eupnea

Answer:

normal breathing: 10-20 respirations/min

-can still use supplemental O2

Question 2: patients who need to go to trauma centers

Answer:

need blood products need intensive care unit require urgent surgery for their injuries require control of internal hemorrhage cannot be identified by prehospital care always

Question 3: definitive care

Answer:

intervention that completely corrects a particular condition -return of spontaneous rescucitation (ROSC) of Cardiac arrest patient much definitive care cannot be provided in pre hospital

Question 4: undertriage

Answer:

severe patients brought to non trauma centers

• not able to treat

Question 5: primary concerns for assessment and management of the trauma care patient

Answer:

• major hemorrhage control

• airway

• oxygenation

• ventilation

• perfusion
• neurologic function

Question 6: D-disability

Answer:

always consider altered mental status to be physiologically caused decreased LOC can be caused by

• decreased cerebral oxygenation

-CNS injury -drugs, alc

• metabolic derangement (caused by diabetes, seizure, cardiac arrest)

Question 7: analgesic of choice

Answer:

fentanyl: minimal effects on hemodynamics and is short acting

-ketamine, nitrous oxide, morphine sulfate, hydromorphone and nonopioids are also used

Question 8: field triage guidelines

Answer:

broken into 4 sections

- physiologic criteria: alteration in mental status

- anatomic criteria: things associated with severe injury

• mechanism of injury criteria

- special consideration: age, use of anticoagulants, etc

Question 9: analgesic

Answer:

painkiller

Question 10: when you can declare death

Answer:

• presence of an obviously fatal injury or when evidence of irreversibility exists )rigor mortis, dependent

lividity, decomposition)

• blunt trauma: patient is pulseless and apneic and without organized electrical activity

• penetrating trauma: pulseless, apneic, no other signs of life (no pupillary reflexes, no spontaneous

movement, no organized ecg)

Question 11: Secondary Survey

Answer:

more detailed, head to two evaluation -only after primary survey is completed -identify injuries and problems that were not identified during primary survey -look, listen, feel vital signs -reassess every 3-5 min for critical trauma patient sample history head to toe assessment actual calculation of GCS, evaluation of motor and sensory function

Question 12: extremely fast tachypnea

Answer:

over 30/min

• indicates hypoxia, anaerobic metabolism, can lead to acidosis
• supplemental O2, and ventilations if deemed necessary

Question 13: X controlling bleeding

Answer:

start with direct pressure, ideally with hemostatic agent

• directly on vein/artery
• pressure for 3 minutes minimum, 10 if normal gauze being used

tourniquets: when direct pressure is not working or sufficient personnel are not available to control bleeding

life threatening bleeding: tourniquet

Question 14: a verbal report to receiving hospital should include:

Answer:

• age, gender, mechanism of injury, time of events
• prehospital vitals, instance of systolic bp under 90
• injuries identified

-pre hospital interventions

• changes in patient status, especially neurological or hemodynamic
• patient medical history, allergies, and medications, especially blood thinner

20 to 30s

Question 15: Glasgow Coma Scale (GCS)

Answer:

• eye opening

-verbal response -motor response better than AVPU highest score is 15 lowest is 3 less than 8=serious injury 9-12=moderate injury

13-15: minor injury

accurately predicts motor progression, need for intubation, survival, hospital discharge

Question 16: sequence of primary survey

Answer:

follow XABCDE

Question 17: traumatic cardiac arrest

Answer:

caused by trauma, not medical -way lower survival rates with CPR -make best judgement on whether to initiate CPR, especially with external hemorrhaging

Question 18: proximal humerus

Answer:

best spot for intraosseous catheter insertion when normal IV not working