PHTLS Review (2026) – 360 Questions on Trauma Assessment, Shock, Airway & Critical Care

This document contains approximately 360 comprehensive exam-style questions with verified answers for PHTLS Review 2026. The material provides extensive coverage of trauma epidemiology, scene management, primary and secondary survey principles, airway management, shock classification, thoracic trauma, traumatic brain injury (TBI), spinal cord injuries, burn management, hemorrhage control, and trauma systems. Early sections (pages 1–3) review global trauma statistics, including over 5 million trauma deaths annually, motor vehicle accidents as the leading cause of trauma deaths, and the PHTLS philosophy of delivering the right patient to the right facility at the right time. Scene assessment priorities, MOI analysis, ABCDE primary survey components, and structured radio reports are emphasized. Airway and breathing management are detailed thoroughly (pages 4–7, 24–25), including trauma jaw thrust as the first maneuver, OPA/NPA use, supraglottic airways, indications for endotracheal intubation (GCS 8), capnography confirmation, and surgical airway as a last resort. Thoracic trauma topics include rib fractures (ribs 4–8), hemothorax capacity (3000–4000 mL per side), needle decompression at the 2nd intercostal space midclavicular line, sucking chest wound management with occlusive dressings, pulmonary contusion, tracheobronchial detachment, commotio cordis, and Beck’s triad in cardiac tamponade (pages 6, 28–29). Shock and resuscitation principles are extensively reviewed (pages 7–10, 25–27), including hypovolemic shock as the most common type in trauma, hemorrhage classes I–IV with percentage blood loss, permissive hypotension targets (SBP 80–90 mmHg; TBI 90–100 mmHg), 3:1 crystalloid-to-blood replacement ratio, fluid warming to 102°F, and ischemic tolerance of organs. Detailed neurologic content includes ICP management (normal 10–15 mmHg), Cushing’s triad, epidural vs subdural hematomas, GCS scoring after correcting reversible causes, cerebral perfusion pressure, and signs of impending herniation (pages 12–13, 30–31). Additional high-yield trauma topics include kinetic energy formula (½mv²), phases of blast injuries (primary through quinary), fall severity (≥15 feet or 3x patient height), auto vs pedestrian injury patterns, spinal anatomy (C1 atlas, C2 axis, dermatomes), anterior and central cord syndromes, compartment syndrome and crush syndrome, burn classifications (second through fourth degree), Parkland formula (4 mL/kg/%TBSA), radiation exposure factors (distance, shielding, time), and trauma center levels I–IV (pages 18–36). The structured Q&A format mirrors official PHTLS certification standards and reinforces rapid trauma prioritization, ABCDE management, pathophysiology integration, mechanism-of-injury analysis, shock recognition, airway decision-making, and evidence-based prehospital care. 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 Review 2026 exam questions, prehospital trauma life support review, ABCDE primary survey trauma, hypovolemic hemorrhagic shock classes I II III IV, permissive hypotension trauma 80 90 systolic, needle decompression 2nd intercostal space MCL, Beck triad cardiac tamponade, rib fractures 4 8 most common, epidural vs subdural hematoma, Cushing triad signs, GCS scoring trauma, 3 to 1 fluid replacement ratio, Parkland formula burn management, blast injury phases primary secondary tertiary quaternary quinary, kinetic energy formula half mass velocity squared, spinal cord injury syndromes anterior central Brown Sequard, compartment syndrome crush syndrome, trauma center levels I II III IV, capnography ET tube confirmation, abdominal hemorrhage until proven otherwise