ITLS | Real Questions and Answers |
2026 Update | 100% Correct - A+
‣ What are the three separate events in an MVC? -✓✓Machine collision, body collision,
organ collision
‣ Five forms of MVCs? -✓✓Frontal, lateral, rear, rollover, rotational
‣ Common injuries for frontal collisions? -✓✓Windshield, whiplash, steering wheel,
compression, dashboard
‣ Common injuries for lateral collisions? -✓✓Lateral displacement, side impact
‣ Common injuries for rear collisions? -✓✓Whiplash, spinal, deceleration
‣ Common injuries for rollover collisions? -✓✓Axial-loading, ejections, impact, whiplash,
etc.
‣ Common injuries for rotational collisions? -✓✓frontal impact, lateral impact injuries
‣ Should you board someone with a penetrating injury if the injury is not near the spine?
-✓✓No
‣ What are the five different blast injuries? -✓✓Primary, secondary, tertiary, quaternary,
quinary
‣ Primary blast injuries? -✓✓initial air blast
‣ Secondary blast injuries? -✓✓shrapnel hits
‣ Tertiary blast injuries? -✓✓body being thrown into ground or other objects
‣ Quaternary blast injuries? -✓✓Thermal burns or respiratory injuries from inhalation of
fumes
‣ Quinary blast injuries? -✓✓contamination by chemical, biological, or radiological
material
‣ What is the highest cause of death in young people? -✓✓Trauma
‣ What are the three things that you're allowed to interrupt the primary survey? -
✓✓Scene becomes unsafe, treatment of airway obstruction, treatment of cardiac arrest
,‣ What's the goal to complete primary survey? -✓✓less than two minutes and on scene
time of 5 minutes or less
‣ What is the "fix-it" process? -✓✓Delegating to team interventions and continuing the
assessment
‣ What's the first thing to be done in a trauma? -✓✓Control bleeding then airway
‣ If the chest is moving but you don't feel air, is the pt breathing adequately? -✓✓No
‣ What is the general rule for all patients with multi-system trauma? -✓✓High-flow
supplemental oxygen, keeping the pulse oximeter reading around 95% rather than
100%
‣ What should be done with bleeding that is not controlled with pressure? -
✓✓Tourniquet, if a hemostatic agent and pressure fails.
‣ When should you obtain a SAMPLE history and why? -✓✓At the same time you are
performing the pt assessment (another EMT can be doing this) because you may be
obtaining info from bystanders who won't be transporting.
‣ What are the critical injuries and conditions in which you should transport
immediately? -✓✓AMS, abnormal breathing, abnormal circulation, injuries that could
lead to shock, significant mechanism of injury or general health
‣ What procedures should not be performed before rapid transport? -✓✓non-lifesaving
procedures such as splinting, bandaging, IV access, or elective endotracheal intubation
‣ Per ITLS, when should reassessment in the ongoing exam occur? -✓✓critical patients
every 5 minutes, stable patients every 15 minutes.
‣ During what occurrences, should the ongoing exam be performed? -✓✓each time the
pt is moved, each time an intervention is performed, any time the patient's condition
worsens.
‣ When should a secondary assessment be performed? -✓✓During transport rather
than on scene, unless primary survey does not reveal a critical condition
‣ What does TIC stand for? -✓✓Tenderness, instability, and crepitus
‣ When should a glucose check be obtained for AMS in a trauma? -✓✓Ongoing exam
‣ What is serum lactate a good marker for? -✓✓Tissue hypoxia, predictor of shock
, ‣ What is a FAST exam and what is it good for? -✓✓Focused Assessment with
Sonography in Trauma, good for assessing trauma in the abdomen
‣ What is the chest wall comprised of? -✓✓skin, subcutaneous tissue, muscle, ribs, and
the neurovascular bundle (which runs around the lower border of the rib)
‣ How much blood can the adult thoracic cavity contain? -✓✓Up to 3 liters on each side
‣ What does the mediastinum include? -✓✓heart, aorta, pulmonary artery, superior and
inferior vena cava, trachea, major bronchi, and esophagus
‣ Where is the diaphragm located? -✓✓lower six ribs and xyphoid process
‣ What nerve innervates the diaphragm and where does it originate in the cervical
spine? -✓✓Phrenic nerve, originating from C3-C5
‣ What injuries are responsible for most deaths on scene? -✓✓Chest injuries
‣ What life-threatening thoracic should be identified immediately during the ITLS primary
survey? -✓✓Airway obstruction, flail chest, open pnuemo, massive hemothorax, tension
pnuemo, cardiac tamponade
‣ What injuries should be identified during the ITLS secondary survey? -✓✓Myocaradial
contusion, traumatic aortic rupture, tracheal or bronchial tree injury, diaphragmatic
tears, pulmonary contusion, blast injuries
‣ Can flail segments be seen in the posterial wall? -✓✓Not typically due to the muscles
‣ How are large flail chests best treated? -✓✓ET ventilation, and assisted ventilation
with PEEP
‣ How are small flail chests best treated? -✓✓Oxygen and CPAP ventilation
‣ What effect does an open pneumothorax have on intrathoracic pressure? -✓✓It
equalizes the intrathoracic pressure and atmospheric pressures resulting in partial or
complete lung collapse
‣ What is a massive hemothorax? -✓✓hemothorax resulting in at least 1500 cc blood
loss in the pleural space
‣ Signs of a tension pneumothorax? -✓✓decreased LOC, rapid/shallow breathing,
weak/thready/absent radials, diaphoretic/cool/clammy/cyanotic, JVD, TD,
decreased/absent breath sound, hyper-resonant sound on one side
2026 Update | 100% Correct - A+
‣ What are the three separate events in an MVC? -✓✓Machine collision, body collision,
organ collision
‣ Five forms of MVCs? -✓✓Frontal, lateral, rear, rollover, rotational
‣ Common injuries for frontal collisions? -✓✓Windshield, whiplash, steering wheel,
compression, dashboard
‣ Common injuries for lateral collisions? -✓✓Lateral displacement, side impact
‣ Common injuries for rear collisions? -✓✓Whiplash, spinal, deceleration
‣ Common injuries for rollover collisions? -✓✓Axial-loading, ejections, impact, whiplash,
etc.
‣ Common injuries for rotational collisions? -✓✓frontal impact, lateral impact injuries
‣ Should you board someone with a penetrating injury if the injury is not near the spine?
-✓✓No
‣ What are the five different blast injuries? -✓✓Primary, secondary, tertiary, quaternary,
quinary
‣ Primary blast injuries? -✓✓initial air blast
‣ Secondary blast injuries? -✓✓shrapnel hits
‣ Tertiary blast injuries? -✓✓body being thrown into ground or other objects
‣ Quaternary blast injuries? -✓✓Thermal burns or respiratory injuries from inhalation of
fumes
‣ Quinary blast injuries? -✓✓contamination by chemical, biological, or radiological
material
‣ What is the highest cause of death in young people? -✓✓Trauma
‣ What are the three things that you're allowed to interrupt the primary survey? -
✓✓Scene becomes unsafe, treatment of airway obstruction, treatment of cardiac arrest
,‣ What's the goal to complete primary survey? -✓✓less than two minutes and on scene
time of 5 minutes or less
‣ What is the "fix-it" process? -✓✓Delegating to team interventions and continuing the
assessment
‣ What's the first thing to be done in a trauma? -✓✓Control bleeding then airway
‣ If the chest is moving but you don't feel air, is the pt breathing adequately? -✓✓No
‣ What is the general rule for all patients with multi-system trauma? -✓✓High-flow
supplemental oxygen, keeping the pulse oximeter reading around 95% rather than
100%
‣ What should be done with bleeding that is not controlled with pressure? -
✓✓Tourniquet, if a hemostatic agent and pressure fails.
‣ When should you obtain a SAMPLE history and why? -✓✓At the same time you are
performing the pt assessment (another EMT can be doing this) because you may be
obtaining info from bystanders who won't be transporting.
‣ What are the critical injuries and conditions in which you should transport
immediately? -✓✓AMS, abnormal breathing, abnormal circulation, injuries that could
lead to shock, significant mechanism of injury or general health
‣ What procedures should not be performed before rapid transport? -✓✓non-lifesaving
procedures such as splinting, bandaging, IV access, or elective endotracheal intubation
‣ Per ITLS, when should reassessment in the ongoing exam occur? -✓✓critical patients
every 5 minutes, stable patients every 15 minutes.
‣ During what occurrences, should the ongoing exam be performed? -✓✓each time the
pt is moved, each time an intervention is performed, any time the patient's condition
worsens.
‣ When should a secondary assessment be performed? -✓✓During transport rather
than on scene, unless primary survey does not reveal a critical condition
‣ What does TIC stand for? -✓✓Tenderness, instability, and crepitus
‣ When should a glucose check be obtained for AMS in a trauma? -✓✓Ongoing exam
‣ What is serum lactate a good marker for? -✓✓Tissue hypoxia, predictor of shock
, ‣ What is a FAST exam and what is it good for? -✓✓Focused Assessment with
Sonography in Trauma, good for assessing trauma in the abdomen
‣ What is the chest wall comprised of? -✓✓skin, subcutaneous tissue, muscle, ribs, and
the neurovascular bundle (which runs around the lower border of the rib)
‣ How much blood can the adult thoracic cavity contain? -✓✓Up to 3 liters on each side
‣ What does the mediastinum include? -✓✓heart, aorta, pulmonary artery, superior and
inferior vena cava, trachea, major bronchi, and esophagus
‣ Where is the diaphragm located? -✓✓lower six ribs and xyphoid process
‣ What nerve innervates the diaphragm and where does it originate in the cervical
spine? -✓✓Phrenic nerve, originating from C3-C5
‣ What injuries are responsible for most deaths on scene? -✓✓Chest injuries
‣ What life-threatening thoracic should be identified immediately during the ITLS primary
survey? -✓✓Airway obstruction, flail chest, open pnuemo, massive hemothorax, tension
pnuemo, cardiac tamponade
‣ What injuries should be identified during the ITLS secondary survey? -✓✓Myocaradial
contusion, traumatic aortic rupture, tracheal or bronchial tree injury, diaphragmatic
tears, pulmonary contusion, blast injuries
‣ Can flail segments be seen in the posterial wall? -✓✓Not typically due to the muscles
‣ How are large flail chests best treated? -✓✓ET ventilation, and assisted ventilation
with PEEP
‣ How are small flail chests best treated? -✓✓Oxygen and CPAP ventilation
‣ What effect does an open pneumothorax have on intrathoracic pressure? -✓✓It
equalizes the intrathoracic pressure and atmospheric pressures resulting in partial or
complete lung collapse
‣ What is a massive hemothorax? -✓✓hemothorax resulting in at least 1500 cc blood
loss in the pleural space
‣ Signs of a tension pneumothorax? -✓✓decreased LOC, rapid/shallow breathing,
weak/thready/absent radials, diaphoretic/cool/clammy/cyanotic, JVD, TD,
decreased/absent breath sound, hyper-resonant sound on one side
