PHTLS

Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age?

1 to 2 years of age

a 23 year old male construction worker fell approximately 30 feet from the roof. The patient is unresponsive to all stimuli; his R pupil is 7mm and non-reactive and his L pupil is 3mm. He has irregular respirations at 8 breaths per min. You do not have waveform capnography, so what is the most appropriate rate of ventilations?

20 BPM

Which of the following patients will compensate for blood loss the longest?

6 year old male

Prehospital providers respond to a 17 year old male who fell through a sliding glass door and sustained a large laceration to his arm that is bleeding heavily. He is restless and diaphoretic, with a weak, thready pulse. What is the most approbate first action?

Apply direct pressure

A 30 year old male is injured in a terror bombing. He experiences traumatic amputation of his left leg at knee level. An improvised tourniquet was put in place by bystanders The victim is conscious and in severe pain. Your first action should be to do which of the following?

Confirm the tourniquet was properly applied

EMS responds to an adult barista with partial thickness burns to the abdomen and right leg, sustained from a cooking accident. Initial treatment of this injury would include:

Cover burned area with dry sterile dressings

you are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does not recalled the incident, and is vomiting which a headache. Which of the following inures is most likely?

concussion

A patent presents with a blunt trauma injury to the chest. On exam, he has absent sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumothorax?

distended neck veins

a 38-year old male sustains a large wound to his right thigh while at work. Which of the following actions is the most important initial step?

hemorrhage control

the most common type if shock resulting from trauma is?

hemorrhaging

when of the following best guides the decision to provide spinal immobilization?

history and complaint

Hemostatic agents should be used for excessive bleeding when direct pressure alone does not work. The proper way to use the most hemostatic agents is which of the following?

placing the agent property into the wound and holding direct pressure

Which best describes the goal of airway management in a trauma patient?

provide or adequate exchange of oxygen and CO2

when caring for a trauma patient, a principle is what is necessary for patient improvement or survival. A preference is how the principle is achieved and depends upon four factors. The factor used to establish the preference in treating the patient include all except:

research information

________ is the earliest sign of deterioration in a patient with a flail chest.

respiratory rate increases

when approaching a trauma patient, what is the first assessment that must be made?

scene safety

you response to a patient who has sustained a stab wound to the left upper thorax. she is barley responsive, pale and diaphoretic. Which of the following is the most appropriate for transport?

scoop stretcher

You respond to a local bar for an unconscious person. On arrival, you are met by a police officer who reports that one of their "regular alcoholics" was found in the ally behind their. On exam, you note the smell of an alcoholic beverage as well as the following: Patient flexes his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths per minute and a BP of 210/100. What condition do you suspect?

subdural hematoma

of the following, which is preventable cause of secondary brain injury addressable during the transport phase?

systemic hypoxia

The most appropriate airway maneuver in the initial management of a trauma patient is which of the following?

trauma jaw thrust

When managing a pediatric patient, prehospital providers should do all of the following except:

Use half the adult dose of medication administration

In a blast-related multiple patient situation, which of the following patients should be treated first?

a 33 year old female with altered level of consciousness and decreased capillary refill

when using a selective spinal immobilization protocol, which of the following findings indicate the need for imbolization?

an associated femoral shaft fracture with severe pain

Falls are most common cause of death in trauma patients over ____ years of age.

75

When energy proceeded by the cells occurs during a state of adequate oxygenation, it is referred to as which of the following conditions?

Aerobic Metabolism

In a patient with a suspected traumatic brain injury, what is the most concerning physical finding?

Altered level of consciousness

Hypoperfusion will affect which of the following organs first?

Brain

Which of the following is the best indicator of shock in a trauma patient?

Depressed level of cognition

Which of the following is a golden principle of trauma care?

Ensure adequate airway and ventilation

What is the most likely source of bleeding in a patient with signs of shock and no obvious injury?

Intra-abdominal injury

You respond to a reported assault at a local bar. On arrival, you find a 46 year old male in the bathroom floor with snoring respirations at 4 times per minute and obvious facial injuries. Pupils reveal the R pupil is 4mm and the L pupil is 7mm and non-reactive. What is the most appropriate first step?

Jaw thrust maneuver

Hypotension due to a spinal cord injury is a result of what physiological mechanisms?

Loss of sympathetic tone causing vasodilation

EMS arrivals on a scene and finds that emergency medical responders have attempted,pted to immobilize a pediatric patient onto a long backboard. They note that the patients head is in a flexed position. Which of the following actions is the most appropriate?

Place padding under the patients torso

EMS is treating a 24 year old soccer player who was kicked in the chest. Prehospital providers note paradoxical moment of portion of the patients chest wall. The patients respiratory rate is 16 and oxygen saturation is 94%. What is the appropriate action?

Provide supplemental oxygen and transport to a trauma center

Prehospital providers have treated a sucking chest wound with an occlusive dressing. During transport to the hospital, the patient developed increasing respiratory distress with increased respirations and absent lung sounds are noted on repeat auscultation. What is the most appropriate next intervention?

Release and reapply the occlusive dressing

You have a patient who is 35 weeks pregnant who was assaulted by her boyfriend. Patient is having severe abdominal pain described as "tearing" and on exam toy not her abdomen is asymmetrical and believe you can feel the fetus through the abdominal wall. What condition do you suspect?

Ruptured Uterus

while caring for a patient who was involved in an altercation, the patient vomits, causing his airway to become totally obstructed with vomitus and blood. What is the most important action?

Suctioning the airway

A 30 year old males thrown from his horse, landing on the top rail of a pipe fence and now has loss of sensation from the nipples down. What level of the spine do you suspect he injured?

T4

What is the most common cause of airway obstruction in the unresponsive trauma patient?

Tongue

Patients with a suspected traumatic brain injury (TBI) are susceptible to secondary injuries which are typically preventable. In addition to hypoxia and hypotension which of the following can also decrease cerebral perfusion?

inadvertent of excess hyperventilation

the pre-hospital assessment of the trauma patient beings with which of the following?

information provided by the dispatcher

EMS responds for a patient involved in a motorcycle vs. motor vehicle collision. The patient is poorly responsive with no movement of lower extremities and loss of temperature sensation (hot vs cold) below the T10. Which of the following types of shock is the patient most likely experiencing?

neurogenic

In addition to glucose, what is required to maintain the metabolic processes of life and energy production?

oxygen

Which of the following information is assessed during the secondary surgery?

vital signs

In a multi-system trauma patient what s considered the best method for confirming proper placement of an endotracheal tube?

wave form capnography

When verifying ET Tube placement on a perfusing patient, the "Gold standard" of monitoring is considered to be?

waveform capnography

Units responding to a motor vehicle accident on the highway should consider which of the following as part of their pre-arrival assessment?

weather conditions

Hyperventlation of a patient with suspected traumatic brain injury should occur when?

when signs of impending brain herniation are present

the secondary survey should be accomplished:

when time and situation allow

Excessive fluid resuscitation of the trauma patient can result in which of the following?

worsening coagulopathy