Adults

Question 1

What are the components of the primary survey?

Answer 1

Airway
Breathing
Circulation
Disability (pupil sizes, limb strength, glasgow)
Exposure

Question 2

What is involved with the secondary survey?

Answer 2

Thorough head-to-toe exam

Question 3

What airway should not be utilized if you suspect a basilar skull fracture?

Answer 3

Nasal

Question 4

If a trauma patient vomits, what should be done?

Answer 4

Log Roll them and suction

Question 5

What are the components of the nexus criteria? (5)

Answer 5

• No midline cervical spinal tenderness
• No evidence of intoxication
• Alert
• No focal neuro deficits
• No painful distracting injuries

Question 6

What should be done regarding the breathing component of the ABCs? (2)

Answer 6

Auscultate

Palpate trachea and chest wall

Question 7

What are the following for class I shock:

• Blood loss (mL, and %)
• Pulse rate
• BP
• Pulse pressure

Answer 7

• Blood loss (mL, and %) = 750 mL or 15%
• Pulse rate = Less than 100
• BP = Normal
• Pulse pressure = normal or increased

Question 8

What are the following for class II shock:

• Blood loss (mL, and %)
• Pulse rate
• BP
• Pulse pressure

Answer 8

• Blood loss (mL, and %) = 750-1500 (15%-30%)
• Pulse rate = 100-120
• BP = Normal
• Pulse pressure = Decreased

Question 9

What are the following for class III shock:

• Blood loss (mL, and %)
• Pulse rate
• BP
• Pulse pressure

Answer 9

• Blood loss (mL, and %) = 1500-2000 mL or 30-40%
• Pulse rate = 120-140
• BP = Decreased
• Pulse pressure = Decreased

Question 10

What are the following for class IV shock:

• Blood loss (mL, and %)
• Pulse rate
• BP
• Pulse pressure

Answer 10

• Blood loss (mL, and %) = over 2000 or 40%
• Pulse rate = over 140
• BP = Decreased
• Pulse pressure = Decreased

Question 11

If there is no improvement in mentation or circulation after a 2L bolus of fluids in a patient without an obvious indication for surgery, what should be done?

Answer 11

Give blood

Question 12

What is the correct ratio of pRBCs to FFP in trauma patients requiring massive transfusions?

Answer 12

1:1

Question 13

How do you give TXA in a trauma patient (2 parts)

Answer 13

1 g bolus over 10 minutes followed by 1 g over 8 hours

Question 14

What are the components of the disability part of the primary survey? (4)

Answer 14

• Glasgow coma scale
• Pupillary sizes
• Motor function
• Intoxicants

Question 15

True or false: Prophylactic hyperventilation is indicated for potential traumatic brain injuries

Answer 15

False

Question 16

Why should you defer the treatment of any immediately life threatening intervention on a trauma patient until after the head CT is obtained?

Answer 16

Need to quickly identify the need for neurosurgical intervention

Question 17

True or false; it is appropriate to remove and then replaced the C-collar on a trauma patient to allow for intubation

Answer 17

True

Question 18

What are the indications that a patient has an abdominal organ injury and requires OR intervention immediately?

Answer 18

Tenderness
Hypotension
Distention

Question 19

In whom should a ED thoracotomy be attempted?

Answer 19

Penetrating chest trauma with witnessed signs of life during transport to the ED, and at least electrical heart activity

Question 20

If a trauma patient has blood at the urethral meatus, what needs to be done?

Answer 20

Retrograde urethrography prior to inserting a foley

Question 21

Any young woman with trauma should get what test performed?

Answer 21

Pregnancy

Question 22

Any trauma patient with AMS should get what bedside test done?

Answer 22

Fingerstick glucose