ATLS FULL STUDY GUIDE 2026 QUESTIONS
WITH ANSWERS GRADED A+
⩥ In the elderly population, what is decreased physiological reserve?
Answer: aging is characterized by impaired adaptive and homeostatic
mechanisms that caused an increased susceptibility to the stress of
injury. Insults tolerated by the younger population can lead to
devastating results in elderly patients.
⩥ Pre-existing conditions that affect morbidity and mortality include:
Answer: cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
⩥ What is the most common mechanism of injury in the elderly?
Answer: Fall. Nonfatal falls are common in women and fractures are
common in women who fall. Falls are the most common cause of TBI.
⩥ In the elderly population, what are risk factors for falls? Answer:
advanced age, physical impairment, history of previous fall, medication
use, dementia, unsteady gait, and visual, cognitive impairment
⩥ Most of elderly traffic fatalities occur in the daytime and on weekends
and typically involve other vehicles. Why? Answer: Older people drive
on more familiar roads and at lower speeds and tend to drive during the
day. Older people have slower reaction time, a larger blind spot, limited
cervical mobility, decreased hearing, and cognitive impairment.
,⩥ True or False? Mortality associated with small to moderate sized
burns in older adults remains high Answer: True
⩥ Spilled hot liquids on the leg, which in younger patients may re-
epithelialize due to an adequate number of hair follicles, will result in a
full thickness burn in older patients. Answer: this is true
⩥ Airway-patients may have dentures that may loosen or obstruct the
airway. If dentures are not obstructing the airway, leave them in place for
what? Answer: bag mask ventilation, as it improves mask fitting.
⩥ When preforming rapid sequence intubation, the dose of benzos,
barbiturates, and other sedatives should be reduced to what percentage to
minimize the risk of cardiovascular depression? Answer: 20-40%
⩥ Functional changes in cardiac system include declining function,
decreased sensitivity to catecholamines, atherosclerosis of coronary
vessels, increased afterload, fixed heart rate (beta blockers) Answer: this
results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
⩥ Functional changes in pulmonary system include decreased elastic
recoil, reduced residual capacity, decreased gas exchange and decreased
cough reflex Answer: thus they are at increased risk for respiratory
failure, increased risk for pneumonia, and poor tolerance to rib fractures
,⩥ Functional changes in renal system include loss of renal mass,
decreased GFR, and decreased sensitivity to ADH and aldosterone
Answer: resulting in drug dosing for renal insufficiency, decreased
ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
⩥ Functional changes to MSK include loss of lean body mass,
osteoporosis, changes in joints and cartilage, c spine degenerative
changes and loss of skin elastin and subcutaneous fat Answer: resulting
in increased risk for fractures, decreased mobility, difficulty for oral
intubation, risk of skin injury, increased risk for hypothermia, challenges
in rehabiliation
⩥ Functional changes in Endocrine system include decreased production
and response to thyroxin and decreased dehydroepiandrosterone
(DHEA) Answer: resulting in occult hypothyroidism, relative
hypercortisone states and increased risk of infection
⩥ True or false: Arthritis can complicate the airway and cervical spine.
Patients can have multilevel degenerative changes affecting disk spaces
and posterior elements associated with severe central canal stenosis,
cord compression, and myelomalacia Answer: true
⩥ In elderly population, due to their changes in pulmonary system,
placing a gauze between gums and cheek to achieve seal when using bag
valve mask ventilation is okay. In addition, because aging causes a
, suppressed heart rate response to hypoxia...... Answer: respiratory failure
may present insidiously in older adults.
⩥ Age related changes in the cardiovascular system place the elderly
trauma patient at significant risk for being inaccurately categorized as
hemodynamically stable. Answer: Elderly patients have a fixed heart
rate and fixed cardiac output, thus, their response to hypovolemia will
involve increasing their systemic vascular resistance. Furthermore, since
older patients have HTN, an acceptable BP may truly reflect a
hypotensive state. A systolic BP of 110 is to be utilized as the threshold
for identifying hypotension in patients 65 and older.
⩥ Do no equate blood pressure with shock in older patients Answer: BP
in older patients may look normal due to the medications they are on.
Use lactate and base deficit to evaluate for evidence of shock
⩥ what 2 factors place elderly patients at risk for intracranial
hemorrhage? Answer: aging causes dura to become more adherent to the
skull increasing risk of injury and older patients are on anticoagulant and
antiplatelet medications.
⩥ Loss of subcutaneous fat, nutritional deficiencies, chronic medical
conditions place elderly patients as risk for hypothermia and
complications for immobility. Answer: Rapid evaluation and when
possible early liberation from spine boards and cervical collars will
minimize complications.
WITH ANSWERS GRADED A+
⩥ In the elderly population, what is decreased physiological reserve?
Answer: aging is characterized by impaired adaptive and homeostatic
mechanisms that caused an increased susceptibility to the stress of
injury. Insults tolerated by the younger population can lead to
devastating results in elderly patients.
⩥ Pre-existing conditions that affect morbidity and mortality include:
Answer: cirrhosis, coagulopathy, COPD, ischemic heart disease, DM
⩥ What is the most common mechanism of injury in the elderly?
Answer: Fall. Nonfatal falls are common in women and fractures are
common in women who fall. Falls are the most common cause of TBI.
⩥ In the elderly population, what are risk factors for falls? Answer:
advanced age, physical impairment, history of previous fall, medication
use, dementia, unsteady gait, and visual, cognitive impairment
⩥ Most of elderly traffic fatalities occur in the daytime and on weekends
and typically involve other vehicles. Why? Answer: Older people drive
on more familiar roads and at lower speeds and tend to drive during the
day. Older people have slower reaction time, a larger blind spot, limited
cervical mobility, decreased hearing, and cognitive impairment.
,⩥ True or False? Mortality associated with small to moderate sized
burns in older adults remains high Answer: True
⩥ Spilled hot liquids on the leg, which in younger patients may re-
epithelialize due to an adequate number of hair follicles, will result in a
full thickness burn in older patients. Answer: this is true
⩥ Airway-patients may have dentures that may loosen or obstruct the
airway. If dentures are not obstructing the airway, leave them in place for
what? Answer: bag mask ventilation, as it improves mask fitting.
⩥ When preforming rapid sequence intubation, the dose of benzos,
barbiturates, and other sedatives should be reduced to what percentage to
minimize the risk of cardiovascular depression? Answer: 20-40%
⩥ Functional changes in cardiac system include declining function,
decreased sensitivity to catecholamines, atherosclerosis of coronary
vessels, increased afterload, fixed heart rate (beta blockers) Answer: this
results in lack of classic response to hypovolemia, risk for cardiac
ischemia, elevated BP at baseline, and increased risk of dysrythmias.
⩥ Functional changes in pulmonary system include decreased elastic
recoil, reduced residual capacity, decreased gas exchange and decreased
cough reflex Answer: thus they are at increased risk for respiratory
failure, increased risk for pneumonia, and poor tolerance to rib fractures
,⩥ Functional changes in renal system include loss of renal mass,
decreased GFR, and decreased sensitivity to ADH and aldosterone
Answer: resulting in drug dosing for renal insufficiency, decreased
ability to concentrate urine, increased risk for AKI and urine flow may
be normal with hypovolemia
⩥ Functional changes to MSK include loss of lean body mass,
osteoporosis, changes in joints and cartilage, c spine degenerative
changes and loss of skin elastin and subcutaneous fat Answer: resulting
in increased risk for fractures, decreased mobility, difficulty for oral
intubation, risk of skin injury, increased risk for hypothermia, challenges
in rehabiliation
⩥ Functional changes in Endocrine system include decreased production
and response to thyroxin and decreased dehydroepiandrosterone
(DHEA) Answer: resulting in occult hypothyroidism, relative
hypercortisone states and increased risk of infection
⩥ True or false: Arthritis can complicate the airway and cervical spine.
Patients can have multilevel degenerative changes affecting disk spaces
and posterior elements associated with severe central canal stenosis,
cord compression, and myelomalacia Answer: true
⩥ In elderly population, due to their changes in pulmonary system,
placing a gauze between gums and cheek to achieve seal when using bag
valve mask ventilation is okay. In addition, because aging causes a
, suppressed heart rate response to hypoxia...... Answer: respiratory failure
may present insidiously in older adults.
⩥ Age related changes in the cardiovascular system place the elderly
trauma patient at significant risk for being inaccurately categorized as
hemodynamically stable. Answer: Elderly patients have a fixed heart
rate and fixed cardiac output, thus, their response to hypovolemia will
involve increasing their systemic vascular resistance. Furthermore, since
older patients have HTN, an acceptable BP may truly reflect a
hypotensive state. A systolic BP of 110 is to be utilized as the threshold
for identifying hypotension in patients 65 and older.
⩥ Do no equate blood pressure with shock in older patients Answer: BP
in older patients may look normal due to the medications they are on.
Use lactate and base deficit to evaluate for evidence of shock
⩥ what 2 factors place elderly patients at risk for intracranial
hemorrhage? Answer: aging causes dura to become more adherent to the
skull increasing risk of injury and older patients are on anticoagulant and
antiplatelet medications.
⩥ Loss of subcutaneous fat, nutritional deficiencies, chronic medical
conditions place elderly patients as risk for hypothermia and
complications for immobility. Answer: Rapid evaluation and when
possible early liberation from spine boards and cervical collars will
minimize complications.
