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