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PHTLS fully solved 2023 updated
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In general, what is the leading cause of death in the United States? - correct answer Unintentional injury Actions taken during the event phase of trauma care are designed to: - correct answer Minimize the injury Which of the following does PHTLS not provide? - correct answer Specific care protocols for different classes of trauma patients Which of the following is a key change in the PHTLS recommendation for the assessment and treatment of trauma patients? - correct answer XABCDE You are called to the scene of a possible domestic violence situation and are the first to arrive on scene. As you arrive, you hear a man and woman arguing loudly and a child crying in the background. You hear a loud crash, and the women cries out. What is your first priority? - correct answer Call for law enforcement Upon entering the house, you note that the female has obvious multiple bruises on her face and a laceration over one cheek. She is holding her right arm, and you note a significant amount of blood flowing from a long gash. This is an example of what type of hemorrhage? - correct answer Venous bleeding What is the best way to control the bleeding? - correct answer direct pressure As your partner begins to control the bleeding, what should you do? - correct answer Observe the scene for potential danger The patient is wearing long sleeves, and you have trouble visualizing the wound. What should you do? - correct answer Cut the cloth away from the site, avoiding cutting through the slashed area. You are called to the scene of an explosion and fire at a chemical plant where you find multiple casualties. Triage has begun. Your first patient is a 40-year-old man who was near the source of the explosion. He is unconscious and has extensive injuries. You note gurgling respiration's. Why should you use the trauma jaw thrust maneuver first when dealing with a trauma patient? - correct answer It allows you to open the airway with little or no movement of the head and cervical spine. The patient becomes apneic. You suspect he has a cervical injury. Which type of airway should you use? - correct answer Supraglottic airway
You have determined that you are going to need to perform orotracheal intubation on this patient. What do you need to do first? - correct answer Preoxygenate to maximize oxygen saturation You next patient is a fire fighter who was overcome by smoke inhalation during the fire. His trachea is swelling rapidly. What type of airway treatment will he most likely need? - correct answer Endotracheal intubation Why is it important to ensure that the ET tube has been properly placed in the trachea?
At what point should you do a neurologic evaluation on the patient? - correct answer As the finial step of the secondary survey You are responding to a call for a 25 year old fit and healthy female who fell off of a mountain bike. Upon arrival, you find the patient walking around. She is alert but complaining of pain in her clavicle and on her right side when she inhales. You notice that her helmet is split in two. What's the first thing you need to do? - correct answer Perform manual in-line stabilization Which of the following signs would be most concerning at this point? - correct answer A drop in systolic blood pressure to 88 mm Hg Why is it important to find out when a patient last ate when taking a sample history - correct answer Many trauma patient will require surgery, and recent food intake increases the risk of aspiration during induction of anesthesia Based on what you know, what is the patient's GCS? - correct answer 15 You're called out an assisted living facility for a 72 year old woman complaining of a severe headache and experiencing increased confusion. Staff reports she fell out of her wheelchair earlier in the week but didn't appear to be hurt. However, she's become increasingly disoriented over the last day or so. Vital signs show: BP 110/90; heart rate 118 and irregularly regular; ventilation rate 20 and slightly labored; SPO2 93% on room air. She is taking Coumadin for a clotting issue. Which of the following should you suspect? - correct answer Subdural hematoma According to the Monro-Kellie doctrine, what happens to the brain when it is still in a compensated state after a TBI - correct answer CSD and blood volume decrease, while heart and blood pressure are still within normal range The patient is in a lot of pain and is getting increasingly restless. What should you do? - correct answer Administer an analgesic You arrive on the scene of a vehicle-pedestrian accident. The primary assessment reveals no immediate life-threatening injuries although the patient has an obvious deformity of her lower leg. What should you do? - correct answer Conduct a detailed secondary survey How should you take a patient's blood pressure reading initially? - correct answer Manually When you examine the patient's pupils, you notice the right one is dilated significantly and her motor response on the left is delayed. What does this suggest? - correct answer Uncal herniation During primary survey, you find the following:
LOC: alert and oriented, speaking in full sentences GCS: 15 Airway: good air entry to bases Breathing: bilateral Circulation: skin warm, pink, dry Pulse Rate: 112 strong and regular BP: 90/ Pain: Patient complains of severe pain at clavicle site and pain on inspiration at site of possible fractured ribs. No other injuries detected What's your next step? - correct answer Apply cervical collar and in-line immobilization device Which body part should you secure first? - correct answer Torso How should you immobilize the patient's torso? - correct answer Place backpack-type loops around each shoulder through the armpit and fasten the ends of each loop in the same handhold What type of padding should you provide for this patient as you immobilize her - correct answer Use firm padding between the back of the head and the backboard to prevent hyperextension While attempting to lay the the patient supine for spinal immobilization she becomes increasingly distressed and complains of shortness of breath and difficulty breathing. The fractured clavicle appears to move distally and increases the difficulty of breathing as the patient lays back. What should you do? - correct answer Raise the back of the stretcher You are responding to a two-car accident on the highway. One of the vehicle's occupants is a 2-year-old boy who was improperly restrained in a booster seat. When you arrive, he is sitting in the booster seat, which is slightly turned at an angle; there is blood on the back of the headrest of the seat in front of him. Despite numerous abrasions and minor bleeding from the head, face, and neck, the child seems calm. Survey reveal the following: The child weakly repeats ma-ma, ma-ma His pulse rate is 180 beats/minute, with the radial pulses weaker than the carotid His blood pressure is 50 mm Hg by palpation His ventilatory rate is 22 breaths/minute, slightly irregular, but without abnormal sounds What do these signs indicate? - correct answer Multi system trauma What mnemonic should you use to assess the child's general appearance? - correct answer TICLS What are the stabilization priorities for this patient? - correct answer Perform manual cervical spine control, and provide supplemental oxygen with bag-mask device