SUMMARY ATLS EXAMINATION ATLS Chapters 1-3

Question Answer Patients with a GSC of less than ___ usually require intubation. 8 The "A" in ABCD stands for _______. Airway maintenance with CERVICAL SPINE PROTECTION You should assume that any patient in a multisystem trauma with an altered level of consciousness or blunt injury above the clavicle has what type of injury? Cervical spine injury Flail chest is invariably accompanied by ______ which can interfere with blood oxygenation. pulmonary contusion - do NOT over fluid resuscitate these patients! Hypotension is caused by _____ until proven otherwise. hypovolemia When you don't have/can't get a blood pressure, what are three things to look for when evaluating perfusion. 1. Level of consciousness (brain perfusion), 2. Skin color (ashen face/grey extremities) 3. Pulse (bilateral femoral - thready/tachy) Elderly patients have a limited ability to ______ to compensate for blood loss. increase heart rate Resuscitation fluids should be warmed 39 degrees Celsius (102.2 F). Can you use a microwave to do this? YES - for CRYSTALLOID ONLY (but NOT for blood products). Urinary catheters are good for assessing renal perfusion and volume status. List 5 signs of urethral injury that might prevent you from inserting one. Blood at urethral meatus, perineal ecchymosis, blood in scrotum, highriding/non-palpable prostate, pelvic fracture Which arm should you NOT put a pulse-ox on? The arm with a blood pressure cuff on it Name two anatomical things that can interfere with doing a FAST scan. Obesity & intraluminal bowel gas When should radiographs be obtained? During the SECONDARY survey. How do you get an ample patient history? A=Allergies, M=Medications, P=PMH/Pregnancy, L=Last meal, E=Events/Environment of injury Why might you want a Bair Hugger for a patient who smells of alcohol? Vasodilation can lead to hypothermia What things are you looking for when you do a DRE in a trauma? Blood, high-riding prostate (in males), and sphincter tone What should you do for every female patient? Pregnancy test (females of childbearing age) Adult patients should maintain UOP of at least Adults 0.5 mL/kg/hr, Kids 1.0 ml/kg/hr