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ADVANCED TRAUMA LIFE SUPPORT EXAM AND
PRACTICE EXAM NEWEST 2024 ACTUAL EXAM
COMPREHENSIVE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
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What is included in the Primary survey of a trauma patient? -Answer-- -Airway and C-Spine
-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
X-ray and Dx studies.
What makes up the Secondary Survey? -Answer-- History and Physical Exam
Mechanism of Injury
Head and Maxillofacial
C-spine
Chest
Abdomen
Perineum/Rectum/Vagina
Musculoskeletal
Neurologic
Basic Outline of ATLS Protocol? -Answer-- 1. Preparation
- Triage
- Primary survey
- Adjunct to Primary survey
- Re-assess ABCDE and consider need for transfer
- Transfer if needed
- Secondary Survey
- Adjuncts to second Survey
- Pt. re-evaluation
- Definitive Care.
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.
- Large bore IVs and obtain blood samples. Type and cross,
ABG.
Warm Fluids/blood.
- Perineal Assessment for contusions, lacerations or bleeding.
- Rectal assessment
Bleeding, sphincter tone, bowell wall integrity, bony fragments, prostate position.
- Vaginal Assessment in select pts. Presence of blood. Pregnancy. Exploratory surgery.
- Musculoskeletal Assessment:
Inspect extremities for blunt or penetrating trauma, deformities, lacerations, sensation, Pulses, fractures, control any bleeding if not done yet. Inspect and palpate throacic and lumbar spines for injury, deformity. X rays for suspected fracture sites.
- Musculoskeletal management:
Immobilization of thoracic spine, splinting, wrap sheet around pelvis for compression binder to help control pelvic bleeding. CONSIDER COMPARTMENT SYNDROME!!!!!!
- Neurologic:
Determine GCS ag
What comes after the Secondary survey? -Answer-- Continued monitoring for any changes in pts. responsiveness and vital signs, urine output.
Transfer to definitive care. Direct communication provider to provider.
Blood loss Classifications? -Answer-- Class 1: 750mL Loss= 15%
Class 2: 750-1500mL Loss=15-30%
Class 3: 1500-2000mL Loss= 30-40%
Class 4: >2000mL Loss= >40%
Urine output will be less. HR will increase. BP decreases, Respiratory Rate Increases.
At what class Should you start Blood transfusing? -Answer-- Class 3 or higher.
3 Steps to D? -Answer-- Establish Level of consciousness, Pupillary size and reaction, Lateralizing signs and spinal cord injury level.
- Glascow score.
- Pupil size and reaction
Blown and dilated pupils indicate intracranial hemorrhage or swelling with increased ICP
- Lateralizing signs. If they are moving, are they moving both sides equally, are there any signs of spinal cord injury.
What is assessed in glasgow? -Answer-- eyes response= 4
Verbal response=
Motor Response=
At what Glasgow score should you intubate? -Answer-- 8
How can you control Exposure/Environment? -Answer-- Undress pt. Prevent Hypothermia
Warmed IV fluids. Room temp maintained appropriately.
9- Abdomen: Rigidness, AAA, Tenderness, Ultrasound, muscle guarding, bowel sounds, percussion, palpation, signs of blunt or penetrating trauma.
Pelvic Xray, CT of abdomen.
