ATLS study cards Questions and Answers with complete solutions Graded A+
1. Glasgow
Coma
Scale:
2. Chance fracture: Transverse fracture through vertebra.
In children usually associated with enterc disruption. Seen in motor vehicle acci-
dents involving only lap belt.
May be associated with retroperitoneal and Abdominal visceral injuries.
3. Anterior hip dislocation: Flexed, abducted, externally rotated.
4. Burst fracture: Associated with vertebral-axial compression injuries
5. Posterior hip dislocation: Flexed, aDDucted, internally rotated
6. Anterior shoulder dislocation: Squared off appearance
7. Posterior shoulder dislocation: Lock in internal rotation.
8. Ankle dislocation: Most are Externally rotated, with a prominent medial malle-
olus.
9. FULL thickness (3rd degree) burn: Dark or white and leathery. Translucent
white as well. Painless and generally "dry" Does not blanch with pressure. Very
little swelling of burned tissue.
10. Principle Life saving measures for patients with burn injuries include: -
-Establishing airway control
-Stopping the burning. process
-Intravenous access
11. Factors that increase the risk for upper AIRWAY OBSTRUCTION in burns
include:: -Burns to the head and face
-Burn size and depth
-Burns inside the mouth
12. Partial thickness burn: Red remodeled appearance with associated swelling
and blister formation. May have weeping or wet appearance and is painfully
hypersensitive even to air current.
13. Signs and symptoms and history that suggest INHALATION INJURY
include:: These patients should be intubated. Inhalation injury is an indication for
transfer to a burn center.
14. Rule of nines - adult: The palm represents 1% of the body total surface area.
,ATLS study cards Questions and Answers with complete solutions Graded A+
15. Symptoms of carbon monoxide poisoning and respective levels: PaO2
does not reliably predict carbon monoxide poisoning because a CO partial pres-
sure of only 1 mmm Hg results in a hemoglobin CO level of 40% or greater.
16. Carbon monoxide has how many times greater affinity for hemoglobin
than oxygen: 240 times.
It displaces the oxyhemoglobin desaturated curve to the LEFT.
17. Two criteria required for the diagnosis of smoke inhalation injury: -Expo-
sure to a combustible agent
-Signs of exposure to smoke in the lower airway, below the vocal cords, by
bronchoscopy.
18. Performing this action will help reduce neck and chest wall edema in
patients with burn and inhalation injury.: Elevation of the head and chest by
30 degrees.
19. IV fluid administration formula for burn victims: Indicated in burns involving
over 20% of the body surface area.
*(2-4 mL/kg of LR/NS) (weight in kg) (% area of burn); give 1/2 of this volume in
first 8 hours. Remainder in over 16 hours.
Large caliber, at least 15 gauge intravenous line should be introduced.
20. Pitfalls for IV fluid requirements for burn victims.: These patients require
greater fluid requirements: ~immolation injury
~pediatric burn victims
~concomitant blunt or crush
injuries.
21. Basic rules regarding IV fluids administration in burn victims: IV fluid Rate
should not be based on the time of actual injury.
In very small children, less than 10 kilograms, it may be necessary to add glucose
to the IV fluids to avoid hypoglycemia.
Any adjustment in IV fluid rate should be based on urine output. In an adult, urine
output above 0.5 ml/ kilogram should result in reduction of IV fluid rate.
22. Initial treatment of frostbite/ cold injuries: Place injured part in circulating
water and a constant 40 degrees centigrade until pink color and perfusion return,
, ATLS study cards Questions and Answers with complete solutions Graded A+
usually within 20 to 30 minutes.
Antibiotics are not indicated empirically unless infection develops later.
23. Persisted ACIDEMIA in burn victims may reflect...: Cyanide poisoning.
(Cyanide is a naturally occurring toxin that may be inhaled in a confined space
fire).
24. Hypothermia
Severe hypothermia: Core temperature of 36 degrees centigrade
Temperature below 32 degrees centigrade
25. Definition of frostbite.: Freezing of tissue with intracellular ice crystal forma-
tion, microvascular occlusion, subsequent tissue anoxia.
26. First degree frostbite: Hyperemia and edema without skin necrosis
27. Second-degree frostbite: Large clear vesicle formation accompanies hyper-
emia and edema with partial thickness skin necrosis
28. 3rd degree frostbite: Full thickness and subcutaneous necrosis occurs, com-
monly with hemorrhage and vesicle formation.
29. Although a compartment pressure > systolic blood pressure is required
to lose a pulse distal to in extremity burn, a pressure of what was in the
compartment may lead to muscle necrosis: 30 mm Hg. If a pressure of greater
than 30 mm Hg in a burned extremity is present, eschatotomy is indicated.
30. Difference between fasciotomy and eschatotomy: Compartment syndrome
is also present with circumferential chest and abdominal burns, which lead to
increased peak inspiratory pressures.
31. Eschatotomy in circumferential chest and abdominal burns.: We are gen-
erally not needed before the first 6 hours after a burn.
32. Gastric tube placement in burn victims.: Place of burn involves more than
20% of total BSA.
33. Alkali burns to the eyes require how many hours of continuous irrigation-
: 8 hours.
34. Electrical burns.: Can cause thrombosis and entry to nerves, and digits are
especially prone to injury.
Patients with electrical injuries frequently require fasciotomies because of the
degree of deep tissue injury and should be transferred to a burn center.
1. Glasgow
Coma
Scale:
2. Chance fracture: Transverse fracture through vertebra.
In children usually associated with enterc disruption. Seen in motor vehicle acci-
dents involving only lap belt.
May be associated with retroperitoneal and Abdominal visceral injuries.
3. Anterior hip dislocation: Flexed, abducted, externally rotated.
4. Burst fracture: Associated with vertebral-axial compression injuries
5. Posterior hip dislocation: Flexed, aDDucted, internally rotated
6. Anterior shoulder dislocation: Squared off appearance
7. Posterior shoulder dislocation: Lock in internal rotation.
8. Ankle dislocation: Most are Externally rotated, with a prominent medial malle-
olus.
9. FULL thickness (3rd degree) burn: Dark or white and leathery. Translucent
white as well. Painless and generally "dry" Does not blanch with pressure. Very
little swelling of burned tissue.
10. Principle Life saving measures for patients with burn injuries include: -
-Establishing airway control
-Stopping the burning. process
-Intravenous access
11. Factors that increase the risk for upper AIRWAY OBSTRUCTION in burns
include:: -Burns to the head and face
-Burn size and depth
-Burns inside the mouth
12. Partial thickness burn: Red remodeled appearance with associated swelling
and blister formation. May have weeping or wet appearance and is painfully
hypersensitive even to air current.
13. Signs and symptoms and history that suggest INHALATION INJURY
include:: These patients should be intubated. Inhalation injury is an indication for
transfer to a burn center.
14. Rule of nines - adult: The palm represents 1% of the body total surface area.
,ATLS study cards Questions and Answers with complete solutions Graded A+
15. Symptoms of carbon monoxide poisoning and respective levels: PaO2
does not reliably predict carbon monoxide poisoning because a CO partial pres-
sure of only 1 mmm Hg results in a hemoglobin CO level of 40% or greater.
16. Carbon monoxide has how many times greater affinity for hemoglobin
than oxygen: 240 times.
It displaces the oxyhemoglobin desaturated curve to the LEFT.
17. Two criteria required for the diagnosis of smoke inhalation injury: -Expo-
sure to a combustible agent
-Signs of exposure to smoke in the lower airway, below the vocal cords, by
bronchoscopy.
18. Performing this action will help reduce neck and chest wall edema in
patients with burn and inhalation injury.: Elevation of the head and chest by
30 degrees.
19. IV fluid administration formula for burn victims: Indicated in burns involving
over 20% of the body surface area.
*(2-4 mL/kg of LR/NS) (weight in kg) (% area of burn); give 1/2 of this volume in
first 8 hours. Remainder in over 16 hours.
Large caliber, at least 15 gauge intravenous line should be introduced.
20. Pitfalls for IV fluid requirements for burn victims.: These patients require
greater fluid requirements: ~immolation injury
~pediatric burn victims
~concomitant blunt or crush
injuries.
21. Basic rules regarding IV fluids administration in burn victims: IV fluid Rate
should not be based on the time of actual injury.
In very small children, less than 10 kilograms, it may be necessary to add glucose
to the IV fluids to avoid hypoglycemia.
Any adjustment in IV fluid rate should be based on urine output. In an adult, urine
output above 0.5 ml/ kilogram should result in reduction of IV fluid rate.
22. Initial treatment of frostbite/ cold injuries: Place injured part in circulating
water and a constant 40 degrees centigrade until pink color and perfusion return,
, ATLS study cards Questions and Answers with complete solutions Graded A+
usually within 20 to 30 minutes.
Antibiotics are not indicated empirically unless infection develops later.
23. Persisted ACIDEMIA in burn victims may reflect...: Cyanide poisoning.
(Cyanide is a naturally occurring toxin that may be inhaled in a confined space
fire).
24. Hypothermia
Severe hypothermia: Core temperature of 36 degrees centigrade
Temperature below 32 degrees centigrade
25. Definition of frostbite.: Freezing of tissue with intracellular ice crystal forma-
tion, microvascular occlusion, subsequent tissue anoxia.
26. First degree frostbite: Hyperemia and edema without skin necrosis
27. Second-degree frostbite: Large clear vesicle formation accompanies hyper-
emia and edema with partial thickness skin necrosis
28. 3rd degree frostbite: Full thickness and subcutaneous necrosis occurs, com-
monly with hemorrhage and vesicle formation.
29. Although a compartment pressure > systolic blood pressure is required
to lose a pulse distal to in extremity burn, a pressure of what was in the
compartment may lead to muscle necrosis: 30 mm Hg. If a pressure of greater
than 30 mm Hg in a burned extremity is present, eschatotomy is indicated.
30. Difference between fasciotomy and eschatotomy: Compartment syndrome
is also present with circumferential chest and abdominal burns, which lead to
increased peak inspiratory pressures.
31. Eschatotomy in circumferential chest and abdominal burns.: We are gen-
erally not needed before the first 6 hours after a burn.
32. Gastric tube placement in burn victims.: Place of burn involves more than
20% of total BSA.
33. Alkali burns to the eyes require how many hours of continuous irrigation-
: 8 hours.
34. Electrical burns.: Can cause thrombosis and entry to nerves, and digits are
especially prone to injury.
Patients with electrical injuries frequently require fasciotomies because of the
degree of deep tissue injury and should be transferred to a burn center.
