AIRWAY BREATHING CIRCULATION AND
TRAUMA MANAGEMENT
◉ Which one of the following statements is FALSE concerning Rh
isoimmunization in pregnant trauma patients?
A. It occurs in blunt or penetrating abdominal trauma
B. It is produced by minor degrees of fetomaternal hemorrhage
C. Rh immunoglobulin therapy should be administered to pregnant
females who have sustained a gunshot wound to the leg
D. This is not a problem in traumatized, Rh-positive pregnant
patients
E. Initiation of Rh immunoglobulin therapy does not require proof of
fetomaternal hemorrhage.
Answer: C. Rh immunoglobulin therapy should be administered to
pregnant females who have sustained a gunshot wound to the leg
◉ Which of the following statements is TRUE regarding access in
pediatric resuscitation?
A. Intraosseous access should be only be considered after 5
percutaneous attempts
B. Cut down at the ankle is a preferred initial access technique
C. Blood transfusion can be delivered through intraosseous access
,D. Internal jugular cannulation is the next preferred option when
percutaneous venous access fails
E. Intraosseous cannulation should be first choice for access.
Answer: C. Blood transfusion can be delivered through intraosseous
access
(anything can be delievered IO)
◉ A 23 year old male is stabbed below the right nipple. He is alert,
and his oxygen saturation is 98%. Chest tube was placed for
treatment of hemopneumothorax. BP is 90/60 mmHg after
administration of 1 L of crystalloid solution. What is the next step in
treatment?
A. Re-examine the chest
B. Place a left-sided chest tube
C. Insert central venous catheter
D. Perform CT Abd/Pelvis
E. Prepare for urgent thoractomy.
Answer: A. Re-examine the chest
◉ You are treating a trauma patient and attempt a definitive airway
by intubation. However, the vocal cords are not visible. What tool
would be most valuable for achieving successful intubation?
A. Gum elastic bougie
B. Lateral cervical spine XR
,C. Nasopharyngeal airway
D. Oxygen
E. Laryngeal mask airway.
Answer: A. Gum elastic bougie
When glottis is not visualized, it is passed blindly behind the
epiglottis
◉ A 79 year old female is involved in a motor vehicle crash and
presents to the ED. She is on Coumadin and a beta blocker. Which of
the folowing statements is true concerning her management?
A. The risk of subdural hemorrhage is decreased
B. Absence of tachycardia indicates that the patient is
hemodynamically normal
C. Non-operative management of abdominal injuries is more likely to
be successful in older adults than in younger patients
D. Vigorous fluid resuscitation may be assocaited with
cardiorespiratory failure
E. Epinephrine should be infused immediately for hypotension.
Answer: D. Vigorous fluid resuscitation may be assocaited with
cardiorespiratory failure
◉ The primary indication for transferring a patient to a higher level
trauma center is:.
, Answer: Resource limitations as determined by the transferring
doctor
-> DO NOT obtain things unless they are necessary at current
hospital!
◉ A teenaged bicycle rider is hit by a truck traveling at high speed.
In the emergency department, she is actively bleeding from open
fractures of her legs, and has abrasions on her chest and abdominal
wall. Her blood pressure is 80/50 mm Hg, heart rate is 140 beats per
minute, respiratory rate is 8 breaths per minute, and GCS score is 6.
The first step in managing this patient is to:
a) obtain a lateral cervical spine xray.
b) administer 2 liters of crystalloid solution.
c) insert a central venous pressure line.
d) perform endotracheal intubation and ventilation..
Answer: D. Perform endotracheal intubation and ventilation
GCS 8 or less -> intubate
◉ Contraindication to nasogastric intubation is the presence of a:.
Answer: Fracture of the cribiform plate
◉ Which of the following statements regarding patients with
thoracic spine injuries is true?.