SUMMARY ATLS EXAMINATION
ATLS Chapters 1-3
Question
Patients with a GSC of less than usually
require intubation. 8
Answer
The "A" in ABCD stands for
... [Show More] .
You should assume that any patient in a
multisystem trauma with an altered level of
consciousness or blunt injury above the clavicle
has what type of injury?
Flail chest is invariably accompanied by
which can interfere with blood oxygenation.
Hypotension is caused by until proven
otherwise.
When you don't have/can't get a blood pressure,
what are three things to look for when evaluating
perfusion.
Elderly patients have a limited ability to
to compensate for blood loss.
Resuscitation fluids should be warmed 39
degrees Celsius (102.2 F). Can you use a
microwave to do this?
Urinary catheters are good for assessing renal
perfusion and volume status. List 5 signs of
urethral injury that might prevent you from
inserting one.
Which arm should you NOT put a pulse-ox on?
Name two anatomical things that can interfere
with doing a FAST scan.
When should radiographs be obtained?
How do you get an ample patient history?
Why might you want a Bair Hugger for a patient
who smells of alcohol?
What things are you looking for when you do a
DRE in a trauma?
What should you do for every female patient?
Adult patients should maintain UOP of at least
mL/kg/hr. Kids should have at least
Airway maintenance with CERVICAL
SPINE PROTECTION
Cervical spine injury
pulmonary contusion - do NOT over fluid
resuscitate these patients!
hypovolemia
1. Level of consciousness (brain perfusion),
2. Skin color (ashen face/grey extremities)
3. Pulse (bilateral femoral - thready/tachy)
increase heart rate
YES - for CRYSTALLOID ONLY (but
NOT for blood products).
Blood at urethral meatus, perineal
ecchymosis, blood in scrotum, highriding/non-palpable prostate, pelvic fracture
The arm with a blood pressure cuff on it
Obesity & intraluminal bowel gas
During the SECONDARY survey.
A=Allergies, M=Medications,
P=PMH/Pregnancy, L=Last meal,
E=Events/Environment of injury
Vasodilation can lead to hypothermia
Blood, high-riding prostate (in males), and
sphincter tone
Pregnancy test (females of childbearing
age)
Adults 0.5 mL/kg/hr, Kids 1.0 ml/kg/hr
mL/kg/hr.
Preventing hypercarbia is critical in patients who
have sustained a injury. head
What two places would you LOOK at a patient if Lips and fingernail beds
you suspect hypoxemia?
Patients may be abusive and belligerent because
of , so don't just assume it's due to drugs,
alcohol, or the fact that they are just inherently a
jerk.
hypoxia
Yes, if the phrenic nerves (C3-C5) are
Can a patient breathe on their own after complete spared. This will result in "abdominal"
cervical cord transection?
Can you use an OPA (Guedel) in a conscious
patient?
Bougies are typically inserted blindly, how do
you know you are in the trachea and not the
esophagus?
breathing. The intercostal muscles will be
paralyzed though.
No, it could make them vomit. An NPA
(trumpet) would be okay.
You can feel the "clicks" as the distal tip
rubs against the cartilaginous tracheal rings,
or it will deviate right or left when entering
either bronchus (usually at 50 cm).
What do you NOT want to hear if you ascultate a Borborygmi - rumbling or gurgling noises
patient after placement of an ET tube?
What is the RSI dose for etomidate?
What is the RSI dose for sux?
How does etomidate affect blood pressure?
A RSI dose of sux usually lasts about
minutes.
What hypnotic/sedative/induction agent do you
NOT want to use for a severely burned patient?
Oxygen should flow at 15L for needle
cricothyroidotomy, and have a Y-connector for
insufflation if possible. What size needle do you
use for adults? Kids?
Cricoid cartilage is the only circumferential
support for the upper trachea in kids, therefore
surgical cricothyroidotomy is not recommended
in kids under the age of .
In a "normal" patient without significant chest
wall injury or lung disease, needle
cricothyroidotomy can provide adequate
oxygenation for approximately minutes.
For a patient with difficulty breathing, what
things might you try before you provide a
surgical airway?
suggesting esophageal insertion.
0.3 mg/kg (usually 20 mg)
1-2 mg/kg (usually 100 mg)
It doesn't - at least it SHOULDN'T have any
significant effect on BP. Ketamine will
increase BP, and propofol and thiopental
will both drop BP.
5
SUX - patients with severe burns, crush
injuries, hyperkalemia, or chronic
paralytic/neuromuscular diseases should
NOT get sux because of hyperkalemia risk.
Adults 12-14 gauge, kids 16-18 gauge
12
30-45
Chin-lift, jaw-thrust (NOT head-tilt while
maintaining c-spine prec [Show Less]