PHTLS 2026 – 380 Trauma & Shock Questions with 100% Correct Answers

This document contains approximately 380 comprehensive exam-style questions with 100% verified correct answers for PHTLS 2026 (Prehospital Trauma Life Support). The material provides in-depth coverage of trauma pathophysiology, shock classifications, hemorrhage control, airway and ventilatory management, traumatic brain injury (TBI), spinal cord injury, thoracic trauma, burn management, fluid resuscitation, blast injuries, and trauma system triage criteria. Early sections (pages 1–7) review cavitation, tertiary blast injuries, internal hemorrhage as the leading cause of preventable trauma death, tourniquet use for uncontrolled bleeding, rib fracture patterns (ribs 4–8), hemothorax vs tension pneumothorax differentiation (dull percussion), cardiac tamponade (Beck’s triad), and flail chest management including pain control and ventilatory support. Advanced content thoroughly explores shock physiology including hypovolemic, distributive (neurogenic, septic, anaphylactic, psychogenic), and cardiogenic shock, with detailed hemorrhage classes I–IV and blood loss percentages (pages 12–13, 58–59). Fluid resuscitation strategies are emphasized, including permissive hypotension (SBP 80–90 mmHg in uncontrolled hemorrhage), 3:1 crystalloid replacement ratio, lactated Ringer’s as preferred isotonic solution, and MAP/CPP relationships in TBI management (pages 14–17, 60). Neurologic injury content includes epidural vs subdural hematoma distinctions, Cushing’s phenomenon (bradycardia, hypertension, abnormal respirations), uncal herniation with blown pupil, cerebral perfusion pressure (CPP = MAP − ICP), and hyperventilation effects on cerebral blood flow (pages 15–20). Thoracic trauma coverage includes pneumothorax (open and tension), needle thoracostomy indications (second or third intercostal space midclavicular line), hemothorax capacity (up to 3,000 mL per side), pulmonary contusion, traumatic aortic disruption, commotio cordis, diaphragmatic rupture, and cardiac tamponade (pages 49–53). Musculoskeletal and spinal injury sections detail vertebral anatomy (7 cervical, 12 thoracic, 5 lumbar), spinal cord syndromes (anterior cord, central cord, Brown-Séquard), axial loading mechanisms, compartment syndrome, crush syndrome (rhabdomyolysis), pelvic ring fractures, traction splint contraindications, and internal blood loss estimates by fracture site (pages 21–24, 36–38). Burn management includes burn depth classification (first through fourth degree), Rule of Palms, Parkland formula (4 mL/kg/%TBSA), airway priority in inhalation injury, escharotomy indications, circumferential burn complications, smoke inhalation pathophysiology (CO and cyanide exposure), and chemical burn mechanisms (coagulative vs liquefactive necrosis) (pages 41–47). The document also integrates trauma triage protocols (506 criteria), trauma center levels I–IV, mechanism-of-injury analysis (MVC impact types, kinetic energy formula KE = ½mv²), and injury prevention strategies. The structured question-and-answer format mirrors PHTLS certification examination standards and reinforces rapid trauma assessment, ABCDE prioritization, shock recognition, pathophysiology integration, critical thinking, and evidence-based prehospital management. This resource is especially relevant for: Paramedic students EMT and Advanced EMT programs PHTLS certification candidates Prehospital trauma providers Emergency Medical Services (EMS) professionals Firefighter/Rescue personnel preparing for trauma exams Keywords: PHTLS 2026 exam questions, prehospital trauma life support review, hypovolemic distributive cardiogenic shock, hemorrhage classes I II III IV, Beck triad cardiac tamponade, epidural vs subdural hematoma, Cushing phenomenon TBI, cerebral perfusion pressure CPP formula, permissive hypotension trauma, lactated ringers resuscitation, needle thoracostomy indications, hemothorax 3000 mL capacity, flail chest management, compartment syndrome crush syndrome, pelvic ring fracture types, Parkland formula 4 mL kg percent, burn depth classification, smoke inhalation carbon monoxide cyanide, spinal cord injury syndromes, trauma triage criteria 506