ATLS CERTIFIED EXAM QUESTIONS
WITH 100% CORRECT ANSWERS
An 8 month old infant, being held in her mother's arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 64 kph (40 mph). On
arrival to the Emergency Department, the infant presents with multiple facial injuries, is
lethargic, and is in severe respiratory distress. Respiratory support is not effective using
a bag mask device, and her oxygen saturation is falling. Repeated attempts at
orotracheal intubation are unsuccessful. The most appropriate procedure to perform
next is:
Administer heliox and racemic epinephrine.
Perform nasotracheal intubation.
Perform surgical cricothyroidotomy.
Repeat orotracheal intubation.
Perform needle cricothyroidotomy with jet insufflation. - Answer-Perform needle
cricothyroidotomy with jet insufflation.
A 32 year - old gentleman is brought to the Emergency Department after being
assaulted. His chest shows multiple severe bruises. His airway is clear, respiratory rate
is 22, HR is 126, and systolic blood pressure is 90 mm Hg. Which of the following
should be performed during the primary survey?
A Glasgow Coma Score.
B Tetanus toxoid administration.
C Cervical spine xray.
D Blood alcohol level.
E Rectal exam. - Answer-A Glasgow Coma Score.
A 29 year - old mountaineer is rescued by a medical helicopter and brought to a Trauma
Centre due to severe injuries: a forearm fracture, a mid - thigh amputation, and open
fracture with bleeding, an unstable pelvic fracture and bilateral femur fractures with
obvious deformity. Which one of these injuries should be addressed in the secondary
survey?:
Forearm fracture.
Mid-thight amputation.
Open fracture with bleeding.
, Unstable pelvic fracture.
Bilateral femur fractures with obvious deformity. - Answer-Forearm fracture.
An 18 year - old boy is stabbed in the right chest during a gang fight. On arrival to the
ED, he is very short of breath. His heart rate is 122 and his blood pressure is 78/47 mm
Hg. His neck veins are flat. On auscultation of the chest, there is diminished air entry on
the right side, and there is dullness posteriorly on percussion, These findings are most
consistent with:
Tension pneumothorax.
Pericardial tamponade.
Hypovolemia from liver injury.
Hemothorax.
Spinal cord injury. - Answer-Hemothorax.
(Not a tension pneumothorax because during the auscultation there is no
hyperresonance.)
Regarding thermal injuries, which of the following is CORRECT?:
Chemical burns require the immediate removal of clothing.
Patients who sustain thermal injury are at lower risk for hypothermia.
Patients with circumferential truncal burns need promptfasciotomies.
Electrical burns are associated with extensive skin necrosis.
The Parkland formula should be used to determine adequacy of resuscitation. - Answer-
Chemical burns require the immediate removal of clothing.
An 18 year - old man is brought to the ED after being involved in a car crash. He is
unconscious and was intubated at the scene by emergency medical personnel. Upon
arrival at the ED, the patient's oxygen saturation is 92%, heart rate is 96, and blood
pressure is 150/85 mm Hg. Breath sounds are decreased on the left side of the thorax.
The next step is:
Immediate needle cricothyroidotomy.
Immediate needle thoracentesis.
Chest tube insertion.
Reassess the position of the endotracheal tube.
WITH 100% CORRECT ANSWERS
An 8 month old infant, being held in her mother's arms, is ejected on impact from a
vehicle that is struck head on by an oncoming car traveling at 64 kph (40 mph). On
arrival to the Emergency Department, the infant presents with multiple facial injuries, is
lethargic, and is in severe respiratory distress. Respiratory support is not effective using
a bag mask device, and her oxygen saturation is falling. Repeated attempts at
orotracheal intubation are unsuccessful. The most appropriate procedure to perform
next is:
Administer heliox and racemic epinephrine.
Perform nasotracheal intubation.
Perform surgical cricothyroidotomy.
Repeat orotracheal intubation.
Perform needle cricothyroidotomy with jet insufflation. - Answer-Perform needle
cricothyroidotomy with jet insufflation.
A 32 year - old gentleman is brought to the Emergency Department after being
assaulted. His chest shows multiple severe bruises. His airway is clear, respiratory rate
is 22, HR is 126, and systolic blood pressure is 90 mm Hg. Which of the following
should be performed during the primary survey?
A Glasgow Coma Score.
B Tetanus toxoid administration.
C Cervical spine xray.
D Blood alcohol level.
E Rectal exam. - Answer-A Glasgow Coma Score.
A 29 year - old mountaineer is rescued by a medical helicopter and brought to a Trauma
Centre due to severe injuries: a forearm fracture, a mid - thigh amputation, and open
fracture with bleeding, an unstable pelvic fracture and bilateral femur fractures with
obvious deformity. Which one of these injuries should be addressed in the secondary
survey?:
Forearm fracture.
Mid-thight amputation.
Open fracture with bleeding.
, Unstable pelvic fracture.
Bilateral femur fractures with obvious deformity. - Answer-Forearm fracture.
An 18 year - old boy is stabbed in the right chest during a gang fight. On arrival to the
ED, he is very short of breath. His heart rate is 122 and his blood pressure is 78/47 mm
Hg. His neck veins are flat. On auscultation of the chest, there is diminished air entry on
the right side, and there is dullness posteriorly on percussion, These findings are most
consistent with:
Tension pneumothorax.
Pericardial tamponade.
Hypovolemia from liver injury.
Hemothorax.
Spinal cord injury. - Answer-Hemothorax.
(Not a tension pneumothorax because during the auscultation there is no
hyperresonance.)
Regarding thermal injuries, which of the following is CORRECT?:
Chemical burns require the immediate removal of clothing.
Patients who sustain thermal injury are at lower risk for hypothermia.
Patients with circumferential truncal burns need promptfasciotomies.
Electrical burns are associated with extensive skin necrosis.
The Parkland formula should be used to determine adequacy of resuscitation. - Answer-
Chemical burns require the immediate removal of clothing.
An 18 year - old man is brought to the ED after being involved in a car crash. He is
unconscious and was intubated at the scene by emergency medical personnel. Upon
arrival at the ED, the patient's oxygen saturation is 92%, heart rate is 96, and blood
pressure is 150/85 mm Hg. Breath sounds are decreased on the left side of the thorax.
The next step is:
Immediate needle cricothyroidotomy.
Immediate needle thoracentesis.
Chest tube insertion.
Reassess the position of the endotracheal tube.
