PHTLS 2023 with verified questions and answers

when does the assessment begin before arrival at the scene what are the steps in an assessment scene survey, general impression, intial assessment, priority decision, rapid trauma assessment or focused assessment clothes should come off when intial primary assessment what are considerations for priority of transport age, confounding factors such as health, age, meds how long do you wait to terminate a trauma resuscitation witnessed arrest after 15 minutes of interventions and unsuccessful efforts what should you apply on a burn dry sterile dressings mci if pt is not breathing open airway after you open the airway in an mci if patient can maintain own airway tag critical if pt cannot tage black for dead if pelvis is showing signs of instability you should not palpate or assess again for patients with multi system trauma and multiple fractures you should splint by placing on a backboard when immpobilizing pediatric plations where should you pad, and for adults? pedi pad under torso adults pad under the head airway maneuver for a trauma patient should be jaw thrust confirm placement of et tube with etco2, edd what is the highest priority in critically injured patients airway what is the most sensitive organs with decreasd levels of o2 Brain, heart, lungs early sign of respiratory failure is increased respiratory rate sucking chest wound use occlusive dressing if needing to loosen the dressing if respiratory distress occurs flail chest is instability of rib cage with asymmetrical movement most common airway obstruction patients tongue if blood in the airway open, clear with log roll and suction burns to the airway with swelling you should go to which hospital nearest Traumatic asphyxia has a history of crush or compression patient may be blue or purple hyperventilation in patients without a need can produce hypocapnia and vasoconstriction simple vs tension pneumo tension will produce signs and symptoms of shock and poor perfusion definition of shock inadequate energy production in cells secondary to poor volume, failing pump or vasodilation reducing available blood flow hypoperfusino is due to pump failure, volume loss, vasodilation most common shock with trauma hypovolemic due to hemorrhage not enough rbc for oxygen carrying shock is progressive intial body response is hemodynamic instability then metabolic changes then microvascular changes compensatory mechanisms are temporary and short term patients with beta blockers have no what during trauma compensatory responses no obvious external cause for signs of shock you should suspect abdominal or chest as location of bleed pregnant should be positioned on their left side fluid replacement regimen 20ml/kg titrate to 80mm hg with uncompressible bleed and 90mmhg with compressible bleed transport considerations trauma center, burn center, weather estimated head injuries per year 4 million estimated spinal injuries per year 20,000 usual age groups for head and spinal injuries 16-35 year old mostly males causes of head and spinal injuries in young adults mvc injury type that mostly affects elderly falls primary injury occurs upon impact secondary injury swelling and hypoxia TBI traumatic brain injury first clue of TBI AMS, motor or sensory deficit, loss of coordination and reflexes Subdural hematoma slow to develop may take days Epidural hematoma rapidly developing temporal bone fracture usually injures the middle meningeal artery causing rapid bleeding signs of increased icp change in loc, unequal pupils, cushings triad cushings triad increased bp, decreased hr, irregular respirations petco2 should be what during icp 30-35mm hg ventilation rate for ICP 25bpm or 1 breath every 4-5 seconds pediactrics head injury first sign AMS bleeding from ear you should cover with a loose dresing heat stroke signs and symptoms of head injury not sweating