Intro to Advanced Trauma Life Support
(ATLS) Q&As 2024
What is the trimodal death distribution and what are the mortality rates? - ANS-Timing of
death resulting from trauma
First peak = Immediately = 50% within minutes
Fatal disruption of big vessels, heart, lungs
Massive blood loss or neuro injury
2nd peak = Early = 30% within first few hours
Mostly neuro injury
3rd peak = Later = 20% within days-weeks after initial injury
Multiple system organ failure and sepsis
What's the biggest risk to EMS? - ANS-Accidents
-usually while responding emergently to other accidents
How is evidence based medicine implemented in trauma? - ANS-American college of
surgeons requires that every level 1 trauma center has to have National trauma registry
that collects information and basic data points on their patients
National trauma registry assesses data to see whats the best care, treatment and who's
at risk and then studies are created to help better perform care on our patients
When do most trauma patients die? How do you prevent trauma deaths? - ANS-Most
die immediately within first 10 minutes d/t primary injury to major organs, massive blood
loss, etc
Prevention with education w/anticipatory guidance
What is trauma care versus critical care?
What is the golden hour? - ANS-Trauma care = saves patients from early trauma
mortality
, Critical care = avert later trauma mortality
Golden hour:
The time the patient gets injured until definitive care at the trauma center (1st hour of
trauma)
-most commonly die from neurologic injury
In trauma, treat the [...] before [...] if the patient is unstable. What is not your friend?
What is the process of death on a cellular level? - ANS-Treat the PATIENT before the
DIAGNOSIS
TIME IS NOT YOUR FRIEND
Cells die -> tissue dies -> organs die -> patient becomes septic (hemorrhage or
hypovolemic) and develops multi organ dysfunction syndrome (MODS) ->organ failure
(kidney, liver, respiratory)
How are morbidity and mortality prevented during the second peak? - ANS-By
avoidance of secondary injury d/t hypoxia, hemorrhage or inadequate tissue perfusion
Is most trauma an accident? How can we view as preventable vs non-preventable?
How can we prevent? - ANS-NO
Preventable = MVC (motor vehicle crash)
Non-preventable = MVA (motor vehicle accident) aka it implies that car crashes are
not-preventable
We prevent by educating patients on trauma prevention
WEAR YOUR SEATBELTS->seatbelts are not as confining as wheel chairs
Who oversees EMS and hand off to trauma team? What is the pneumonic to
remember? - ANS-Trauma leader
MIST:
M=mechanism of injury - EMS shows you picture to demonstrate the extent of trauma
I= injuries found and suspected - by EMS during primary and secondary survey. Other
than time theres not a lot EMS can do for trauma victim
S= signs and symptoms
T = treatment
What is the platinum half hour? - ANS-Time you are left "half hour" once the patient gets
(ATLS) Q&As 2024
What is the trimodal death distribution and what are the mortality rates? - ANS-Timing of
death resulting from trauma
First peak = Immediately = 50% within minutes
Fatal disruption of big vessels, heart, lungs
Massive blood loss or neuro injury
2nd peak = Early = 30% within first few hours
Mostly neuro injury
3rd peak = Later = 20% within days-weeks after initial injury
Multiple system organ failure and sepsis
What's the biggest risk to EMS? - ANS-Accidents
-usually while responding emergently to other accidents
How is evidence based medicine implemented in trauma? - ANS-American college of
surgeons requires that every level 1 trauma center has to have National trauma registry
that collects information and basic data points on their patients
National trauma registry assesses data to see whats the best care, treatment and who's
at risk and then studies are created to help better perform care on our patients
When do most trauma patients die? How do you prevent trauma deaths? - ANS-Most
die immediately within first 10 minutes d/t primary injury to major organs, massive blood
loss, etc
Prevention with education w/anticipatory guidance
What is trauma care versus critical care?
What is the golden hour? - ANS-Trauma care = saves patients from early trauma
mortality
, Critical care = avert later trauma mortality
Golden hour:
The time the patient gets injured until definitive care at the trauma center (1st hour of
trauma)
-most commonly die from neurologic injury
In trauma, treat the [...] before [...] if the patient is unstable. What is not your friend?
What is the process of death on a cellular level? - ANS-Treat the PATIENT before the
DIAGNOSIS
TIME IS NOT YOUR FRIEND
Cells die -> tissue dies -> organs die -> patient becomes septic (hemorrhage or
hypovolemic) and develops multi organ dysfunction syndrome (MODS) ->organ failure
(kidney, liver, respiratory)
How are morbidity and mortality prevented during the second peak? - ANS-By
avoidance of secondary injury d/t hypoxia, hemorrhage or inadequate tissue perfusion
Is most trauma an accident? How can we view as preventable vs non-preventable?
How can we prevent? - ANS-NO
Preventable = MVC (motor vehicle crash)
Non-preventable = MVA (motor vehicle accident) aka it implies that car crashes are
not-preventable
We prevent by educating patients on trauma prevention
WEAR YOUR SEATBELTS->seatbelts are not as confining as wheel chairs
Who oversees EMS and hand off to trauma team? What is the pneumonic to
remember? - ANS-Trauma leader
MIST:
M=mechanism of injury - EMS shows you picture to demonstrate the extent of trauma
I= injuries found and suspected - by EMS during primary and secondary survey. Other
than time theres not a lot EMS can do for trauma victim
S= signs and symptoms
T = treatment
What is the platinum half hour? - ANS-Time you are left "half hour" once the patient gets
