ADVANCED TRAUMA LIFE SUPPORT EXAM NEWEST 2024 ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)

Both tension pneumothorax and massive hemothorax are associated with decreased breath sounds on auscultation, so you can tell which it is by _______. - ANSWERS,Percussion - hyperresonant with pnuemo, dull with hemothorax. If a patient doesn't have JVD, does this mean they don't have a tension pneumo or tamponade? - ANSWERS,No, they might have a massive internal hemorrhage and be hypovolemic. By definition, how much blood is in the chest cavity to call it a "massive hemothorax"? - ANSWERS,1500 mL or 1/3 or more of the patient's total blood volume. (Some also define it as continued blood loss of 200 mL/hr for 2-4 hours- but ATLS does NOT use this rate for any mandatory treatment decisions). What size chest tube might you use to evacuate a massive hemothorax? - ANSWERS,#38 French - inserted at the 4th or 5th intercostal space, just anterior to the midaxillary line. What is Kussmaul's sign? - ANSWERS,A rise in venous pressure with inspiration while breathing spontaneously, and is a true paradoxical venous pressure abnormality associated with cardiac tamponade. How well do CPR compressions work on someone with a penetrating chest injury and hypovolemia? - ANSWERS,"Closed heart massage for cardiac arrest or PEA is INEFFECTIVE in patients with hypovolemia." Patients with PENETRATING thoracic injuries who arrive pulseless, but with myocardial electrial activity, may be candidates for an ED thoacotomy. Are patients with PEA who have sustained blunt thoracic injuries candidates for an ED thoracotomy? - ANSWERS,NO - Only PEA with PENETRATING thoracic injuries should get an ED thoracotomy. An ED thoracotomy can allow you to do what? - ANSWERS,Evacuate pericardial blood, directly control hemorrhage, cardiac massage, cross-clamp the descending aorta to slow blood loss below the diaphragm and increase perfusion to the heart and brain. For a patient with a traumatic simple pneumothorax, what should you do BEFORE you start positive pressure ventilation or take them to surgery for a GA? - ANSWERS,Chest tube - positive pressure ventilation can turn a sumple pneumo into a tension pneumo, so put in a chest tube first. Should you evacuate a simple hemothorax if it is not causing any respiratory problems? - ANSWERS,YES - A simple hemothorax, if not fully evacuated, may result in a retained, clotted hemothroax with lung entrapment or, if infected, develop into an empyema. A pneumothorax associated with a persistent large air leak after tube thoracos