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Advanced Trauma Life Support Questions with Complete Solutions

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Advanced Trauma Life Support Questions with Complete Solutions Basic Outline of ATLS Protocol? -Answer- 1. Preparation 2. Triage 3. Primary survey (ABCDE) 4. Adjunct to Primary survey 5. Re-assess ABCDE and consider need for transfer 6. Transfer if needed 7. Secondary Survey (AMPLE + all physicals) 8. Adjuncts to second Survey 9. Pt. re-evaluation 10. Definitive Care. What is included in the Primary survey of a trauma patient? -Answer- -Airway and CSpine -Breathing and Ventilation -Circulation/bleeding control -Disability (Neuro Eval) -Exposure and Environmental control. What are adjuncts to Primary Survey and Resuscitation? -Answer- ECG monitoring Urinary/Gastric Catheters Other Monitoring (ABG, capnography) X-ray and Dx studies. What makes up the Secondary Survey? -Answer- AMPLE Hx and Detailed Physical Exam Mechanism of Injury Head and Maxillofacial C-spine Chest Abdomen Perineum/Rectum/Vagina Musculoskeletal Neurologic What is something you could do to get a quick assessment of ABCD? -Answer- Ask the pt. a question. If they can respond it can give you an idea about their airway and mental status. Failure to respond tells you there are abnormalities in ABCD. What assumption can safely be made in a pt. with blunt multisystem trauma above the clavicle or Altered mental status? -Answer- That the C-spine is compromised. 4 Steps to manage A? -Answer- Assess for patency Establish airway Maintain C-spine Reinstate Proper C-spine devices. 2 steps to Breathing? -Answer- 1.Expose Neck and chest to inspect and palpate. Percuss chest for presence of dullness or hyperresonance, auscultate chest bilaterally. All this checking for Tension Pneumo, Flail chest, Hemothorax, Open Pneumothorax. 2. Administer High concentration O2, ventilate with bag, alleviate Tension Pneumo, attach CO2 monitor to ET tube, Pulse ox. What is the predominant cause of preventable deaths after injury? -AnswerHemorrhage. 2 steps to managing C? -Answer- 1. Identify any sources of external/internal bleeding bleeding. The four big areas for massive bleeding include: Chest, Abdomen, Pelvis, Femur Fx. Assess Pulse quality, color of skin level of consciousness, BP. 2. Large bore IVs and obtain blood samples. Type and cross, ABG. Warm Fluids/blood. T or F: Aggressive and continued volume resuscitation is not a substitute for definitive control of hemorrhage. -Answer- True. best way to stop shock? -Answer- 1) ID and stop the bleed -> enhances VR 2) volume repletion - but will only help if the source of the bleed is identified - restores CO, end organ perfusion, tissue oxygenation

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