1. Q: What does the ABCDE approach stand for in trauma
management? ANSWER Airway with cervical spine protection,
Breathing and ventilation, Circulation with hemorrhage control,
Disability (neurologic status), Exposure/Environmental control.
2. Q: What is the most common cause of airway obstruction in an
unconscious trauma patient? ANSWER The tongue falling back
against the posterior pharyngeal wall.
3. Q: What maneuver should be used first to open the airway in a
trauma patient? ANSWER Chin lift or jaw thrust maneuver while
maintaining cervical spine protection.
4. Q: When should a definitive airway be established? ANSWER When
the patient cannot maintain a patent airway, requires prolonged
ventilation, has severe head injury (GCS ≤8), or has inadequate
oxygenation despite supplemental oxygen.
5. Q: What are the three types of definitive airways? ANSWER
Orotracheal tube, nasotracheal tube, and surgical airway
(cricothyroidotomy or tracheostomy).
6. Q: What is the preferred method for emergency surgical airway in
adults? ANSWER Cricothyroidotomy.
7. Q: At what age is surgical cricothyroidotomy contraindicated?
ANSWER Children under 12 years old (needle cricothyroidotomy
preferred).
8. Q: What oxygen delivery device can provide near 100% oxygen
concentration? ANSWER Non-rebreather mask with reservoir bag at
10-15 L/min.
,9. Q: What are the five immediately life-threatening chest injuries
identified during primary survey? ANSWER Airway obstruction,
tension pneumothorax, open pneumothorax, massive hemothorax, and
flail chest.
10.Q: How is tension pneumothorax diagnosed? ANSWER Clinically -
by respiratory distress, hypotension, distended neck veins, tracheal
deviation, absent breath sounds, and hyperresonance on the affected side.
11.Q: What is the immediate treatment for tension pneumothorax?
ANSWER Needle decompression in the 2nd intercostal space,
midclavicular line, followed by chest tube insertion.
12.Q: Where should a chest tube be inserted for hemothorax or
pneumothorax? ANSWER 5th intercostal space, anterior to the
midaxillary line.
13.Q: What volume of blood loss indicates massive hemothorax?
ANSWER More than 1,500 mL initially or ongoing blood loss of 200
mL/hr for 2-4 hours.
14.Q: What is the most common cause of shock in trauma patients?
ANSWER Hemorrhage (hypovolemic shock).
15.Q: What are the four classes of hemorrhagic shock? ANSWER Class
I (<15% blood loss), Class II (15-30%), Class III (30-40%), Class IV
(>40%).
16.Q: What are the signs of Class II hemorrhagic shock? ANSWER
Tachycardia (>100 bpm), tachypnea, decreased pulse pressure, anxiety,
delayed capillary refill.
17.Q: What is the preferred initial fluid for resuscitation in hemorrhagic
shock? ANSWER Warmed isotonic crystalloid solution (lactated
Ringer's or normal saline).
18.Q: What is the ratio for balanced resuscitation in massive transfusion
protocol? ANSWER 1:1:1 ratio of packed red blood cells, fresh frozen
plasma, and platelets.
19.Q: What is permissive hypotension in trauma resuscitation?
ANSWER Accepting lower than normal blood pressure (target SBP 80-
90 mmHg) until hemorrhage is controlled to prevent dilutional
coagulopathy and clot disruption.
, 20.Q: What is the preferred IV access in trauma patients? ANSWER
Two large-bore (14-16 gauge) peripheral IV lines in the upper
extremities.
21.Q: When should intraosseous access be considered? ANSWER When
peripheral venous access cannot be obtained rapidly, especially in
children or during cardiac arrest.
22.Q: What is the normal adult urine output target? ANSWER 0.5
mL/kg/hr (approximately 30-50 mL/hr for adults).
23.Q: How is the Glasgow Coma Scale (GCS) calculated? ANSWER
Sum of Eye opening (1-4), Verbal response (1-5), and Motor response (1-
6), total 3-15.
24.Q: What GCS score indicates severe traumatic brain injury?
ANSWER GCS ≤8.
25.Q: What are signs of herniation syndrome? ANSWER Deteriorating
level of consciousness, dilated or asymmetric pupils, decerebrate
posturing, bradycardia, and hypertension.
26.Q: What should be done if herniation is suspected? ANSWER Brief
hyperventilation to PCO2 30-35 mmHg, elevate head of bed 30 degrees,
administer mannitol or hypertonic saline, emergent neurosurgical
consultation.
27.Q: Why should patients be completely undressed during trauma
evaluation? ANSWER To identify all injuries during complete physical
examination.
28.Q: What is the target temperature to prevent hypothermia in trauma
patients? ANSWER Core temperature >36°C (96.8°F).
29.Q: What is the trauma triad of death? ANSWER Hypothermia,
acidosis, and coagulopathy.
30.Q: When should a trauma patient be log-rolled? ANSWER During
secondary survey to examine the back, while maintaining spinal
precautions with at least 4 people.
31.Q: What baseline laboratory studies should be obtained in major
trauma? ANSWER Type and crossmatch, complete blood count,
metabolic panel, coagulation studies, arterial blood gas, lactate,
pregnancy test (in females of childbearing age).
management? ANSWER Airway with cervical spine protection,
Breathing and ventilation, Circulation with hemorrhage control,
Disability (neurologic status), Exposure/Environmental control.
2. Q: What is the most common cause of airway obstruction in an
unconscious trauma patient? ANSWER The tongue falling back
against the posterior pharyngeal wall.
3. Q: What maneuver should be used first to open the airway in a
trauma patient? ANSWER Chin lift or jaw thrust maneuver while
maintaining cervical spine protection.
4. Q: When should a definitive airway be established? ANSWER When
the patient cannot maintain a patent airway, requires prolonged
ventilation, has severe head injury (GCS ≤8), or has inadequate
oxygenation despite supplemental oxygen.
5. Q: What are the three types of definitive airways? ANSWER
Orotracheal tube, nasotracheal tube, and surgical airway
(cricothyroidotomy or tracheostomy).
6. Q: What is the preferred method for emergency surgical airway in
adults? ANSWER Cricothyroidotomy.
7. Q: At what age is surgical cricothyroidotomy contraindicated?
ANSWER Children under 12 years old (needle cricothyroidotomy
preferred).
8. Q: What oxygen delivery device can provide near 100% oxygen
concentration? ANSWER Non-rebreather mask with reservoir bag at
10-15 L/min.
,9. Q: What are the five immediately life-threatening chest injuries
identified during primary survey? ANSWER Airway obstruction,
tension pneumothorax, open pneumothorax, massive hemothorax, and
flail chest.
10.Q: How is tension pneumothorax diagnosed? ANSWER Clinically -
by respiratory distress, hypotension, distended neck veins, tracheal
deviation, absent breath sounds, and hyperresonance on the affected side.
11.Q: What is the immediate treatment for tension pneumothorax?
ANSWER Needle decompression in the 2nd intercostal space,
midclavicular line, followed by chest tube insertion.
12.Q: Where should a chest tube be inserted for hemothorax or
pneumothorax? ANSWER 5th intercostal space, anterior to the
midaxillary line.
13.Q: What volume of blood loss indicates massive hemothorax?
ANSWER More than 1,500 mL initially or ongoing blood loss of 200
mL/hr for 2-4 hours.
14.Q: What is the most common cause of shock in trauma patients?
ANSWER Hemorrhage (hypovolemic shock).
15.Q: What are the four classes of hemorrhagic shock? ANSWER Class
I (<15% blood loss), Class II (15-30%), Class III (30-40%), Class IV
(>40%).
16.Q: What are the signs of Class II hemorrhagic shock? ANSWER
Tachycardia (>100 bpm), tachypnea, decreased pulse pressure, anxiety,
delayed capillary refill.
17.Q: What is the preferred initial fluid for resuscitation in hemorrhagic
shock? ANSWER Warmed isotonic crystalloid solution (lactated
Ringer's or normal saline).
18.Q: What is the ratio for balanced resuscitation in massive transfusion
protocol? ANSWER 1:1:1 ratio of packed red blood cells, fresh frozen
plasma, and platelets.
19.Q: What is permissive hypotension in trauma resuscitation?
ANSWER Accepting lower than normal blood pressure (target SBP 80-
90 mmHg) until hemorrhage is controlled to prevent dilutional
coagulopathy and clot disruption.
, 20.Q: What is the preferred IV access in trauma patients? ANSWER
Two large-bore (14-16 gauge) peripheral IV lines in the upper
extremities.
21.Q: When should intraosseous access be considered? ANSWER When
peripheral venous access cannot be obtained rapidly, especially in
children or during cardiac arrest.
22.Q: What is the normal adult urine output target? ANSWER 0.5
mL/kg/hr (approximately 30-50 mL/hr for adults).
23.Q: How is the Glasgow Coma Scale (GCS) calculated? ANSWER
Sum of Eye opening (1-4), Verbal response (1-5), and Motor response (1-
6), total 3-15.
24.Q: What GCS score indicates severe traumatic brain injury?
ANSWER GCS ≤8.
25.Q: What are signs of herniation syndrome? ANSWER Deteriorating
level of consciousness, dilated or asymmetric pupils, decerebrate
posturing, bradycardia, and hypertension.
26.Q: What should be done if herniation is suspected? ANSWER Brief
hyperventilation to PCO2 30-35 mmHg, elevate head of bed 30 degrees,
administer mannitol or hypertonic saline, emergent neurosurgical
consultation.
27.Q: Why should patients be completely undressed during trauma
evaluation? ANSWER To identify all injuries during complete physical
examination.
28.Q: What is the target temperature to prevent hypothermia in trauma
patients? ANSWER Core temperature >36°C (96.8°F).
29.Q: What is the trauma triad of death? ANSWER Hypothermia,
acidosis, and coagulopathy.
30.Q: When should a trauma patient be log-rolled? ANSWER During
secondary survey to examine the back, while maintaining spinal
precautions with at least 4 people.
31.Q: What baseline laboratory studies should be obtained in major
trauma? ANSWER Type and crossmatch, complete blood count,
metabolic panel, coagulation studies, arterial blood gas, lactate,
pregnancy test (in females of childbearing age).
