ATLS

Question 1

What must be asked in ems handover?

Answer 1

Mist
Mechanism and time injury
Injuries found and suspected
Symptoms and signs
Treatment initiated

Question 2

Name 6 immediately life threatening injuries in trauma (“lethal” 6)

Answer 2

Atomic
• Airway obstruction or disruption
• tension pneumothorax
• open pneumothorax
• massive haemothorax
• intercostal disruption: flail chest
• cardiac tamponade

Question 3

Name the hidden 6 thoracic traumas that are potentially life threatening

Answer 3

1 tracheobronchial disruption
2.0esophageal disruption
3. Thoracic aortic disruption
4- pulmonary contusion
5. Myocardial contusion
6. Traumatic diaphragm tear
Assess in secondary survey

Question 4

What is the lethal triad?

Answer 4

• Acidosis
• coagulopathy
• hypothermia

Question 5

What is occult shock?

Answer 5

Persistent metabolic acidosis with near - normal/ normal vitals

Question 6

Normal urinary output?

Answer 6

> 0,5 ml /kg/h

Question 7

How do secondary survey?

Answer 7

• history:
Sample- signs and symptoms, allergies, medication, past pertinent history, last oral intake, events leading to injury
DEATH
Injury patterns
• Clin exam head to toe including log roll
• adjuncts inducing e fast, xray etc

Question 8

Name the sequence of the 8 steps of managing a p1 trauma patient

Answer 8

1. Preparation:prehospital and hospital phase, mist
2. Triage
3. Primary survey abcde and resuscitation
4. Adjuncts to primary survey
5. Secondary survey: head to toe, history
6. Adjuncts to secondary survey
7. Reevaluation - end points resuscitation, repeat examination, vitals etc
8. Definitive care including transport

Question 9

How is ems handover done?

Answer 9

MIST
Mechanism and time of injury
Injuries found and suspected
Symptoms and signs
Treatment initiated

Question 10

Name the 6 P’s of a major incident response

Answer 10

1. preparation
2. Planning
3. Pre-hospital
4. Procedures for hospital management
5. Patterns of Injury
6. Pitfalls

Question 11

When a major incident is declared, what report should ems give as part of pre-hospital response?

Answer 11

Methane
Major incident declared!
Exact location
Type incident
Hazards
Access-routes safe to use
Number, type, severity of casualties
Emergency services present and required

Question 12

Name the 3 procedures for hospital management when major incident has been declared

Answer 12

1. Reception phase
2. Definitive care
3. Recovery phase

Question 13

Define surge capacity

Answer 13

Expansion of space and resources beyond normal to handle mass casualties. Expressed as number of additional critically injured casualties per hour that can be managed

Question 14

Define surge capability

Answer 14

Mobilizing key personnel to take care of the complicated problems that will arise. Capability to manage injuries and medical problems with which patients are afflicted eg burns, Paeds, critical care, elderly with comorbids, physical trauma, psycho-emotional issues, chemical and radiological exposure.

Question 15

Which principles should be followed in each stage of major incidents management?

Answer 15

Ccscattt
Command
Control
Safety
Communication
Assessment
Triage
Treatment
Transport

Question 16

When and why should triage sieve be used?

Answer 16

At scene of incident or where large numbers of patients are delivered to hospital all at once.
Rely on basic clinical characteristics like walking, breathing, rr, cap refill, hr

Question 17

When and why should triage sort be used?

Answer 17

After initial triage scene or when resources allow for more accurate triage

Question 18

How is triage sort done and priority assigned?

Answer 18

Use gcs, rr, SBP. Each score out of 4
12 = priority 3
≤ 10= priority 1

Question 19

Name 3 purposes of triage

Answer 19

• Triage severity of injury
• facilitate rotational transport to definitive care
• assign priorities of treatment
. Allow appropriate allocation of resources
• improve qualify of care