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ITLS Exam Preparation/260 Questions with Answers
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ITLS Exam Preparation/260Questions with Answers
What is a Scene Size-Up? - -Observations made and actions taken at a
trauma scene before actually approaching the patient. It is the initial step in
the ITLS Primary Survey
-What does "OPIM" stand for? - -Other Potentially Infectious Material
-What equipment should you always take with you for trauma patients? - --
PPE (Personal Protection Equipment)
-Patient transport device (stretcher, long spine board, and so on) with
effective strapping and head motion-restriction device
-Rigid cervical extrication collar of an appropriate size
-Oxygen and airway equipment, which should include suction equipment and
a BVM (Bag-Valve Mask)
-Trauma box (bandage material, hemostatic agent, tourniquet, blood
pressure cuff, stethoscope)
-What are some of the potential injury patterns for a mechanism of Injury of
frontal impact? (Name 8) - --Cervical-spine fracture
-Flail chest
-Myocardial contusion
-Pneumothorax
-Aortic disruption
-Spleen or liver laceration
-Posterior hip dislocation
-Knee dislocation
-What are some of the potential injury patterns for a mechanism of lateral
impact (T-bone)? (Name 8) - --Contralateral neck sprain
-Cervical-spine fracture
-Lateral flail chest
-Pneumothorax
-Aortic disruption
-Diaphragmatic rupture
-Laceration of liver, kidney or spleen
-Pelvic fracture
-What are potential injury patterns for a mechanism of ejection? - -Exposure
to all mechanisms (and mortality increased)
-What are some of the potential injury patterns for a mechanism of Injury of
pedestrian vs. car? (Name 4) - --Head injury
,-Aortic disruption
-Abdominal visceral injuries
-Fracture pelvis and lower extremities
-What is "index of suspicion"? - -The medical provider's estimate of a
disease or injury being present in a patient. A high index of suspicion means
there is a high probability the injury is present. A low index of suspicion
means there is a low risk of the injury.
-List the two basic mechanisms of motion injury - -Blunt and penetrating
-Identify the three collisions associated with a motor-vehicle collision (MVC) -
-1. Machine collision
2. Body collision
3. Organ collision resulting in rupture, shearing, or bruising
-Name the five common forms of MVCs - -1. Frontal-impact (head-on
collision)
2. Lateral-impact (T-bone collision)
3. Rear-impact collision
4. Rollover collision
5. Rotational collision
-Using the three collisions associated with a MVC, relate at least three
frontal-impact collisions to potential patient injuries to deformity of the
vehicle, interior structures and body structures. - -Machine collision =
Deformed front end
Body collision = Spider-web pattern of windshield
Organ collision = Coup/contracoup brain, soft-tissue injury (scalp, face,
neck), hyperextension/flexion of the cervical spine
Machine collision = Deformed front end
Body collision = Steering wheel ring fracture, deformity and column
displacement
Organ collision = Traumatic tattooing of patient's skin
Machine collision = Deformity of vehicle
Body collision = Dashboard fracture and deformity
Organ collision = Facial trauma, coup/contracoup brain,
hyperextension/flexion of the cervical spine, pelvis, hip and knee trauma
-Using the three collisions associated with a MVC, relate at least three
lateral-impact collisions to potential patient injuries to deformity of the
vehicle, interior structures and body structures. - -Machine collision =
Deformed driver or passenger side
,Body collision = Degree of door deformity (ex: armrest bent, outward or
inward bowing of door)
Organ collision = This cannot be predicted by external exam alone. Instead,
consider organs beneath areas of external injury:
-Head = Coup/contracoup
-Neck = Ranging from cervical-muscle strain to fracture or subluxation with
neurologic deficit
-Upper arm and shoulder = Injuries appear on the side of the impact and are
common, as are injuries to the lower extremities
-Thorax/abdomen = Injuries from soft-tissue injuries to flail chest, lung
contusion, pneumothorax, hemothorax, or possible traumatic aortic
dissection. Injuries include those to solid and hollow organs
-Pelvis/legs = Pelvic, hip or femur fractures. Pelvic injuries may also include
dislocation, bladder rupture and urethral injuries
-Describe potential injuries associated with proper and improper use of seat
restraints, headrest and air bags in a head-on collision - -Proper use of seat
restraint = Facial, head or neck injuries such as fractures, dislocations or
spinal-cord injuries; Clavicle fractures (at the point where the chest strap
crosses) and chest-wall injuries; Internal organ damage
Improper use of seat restraint = Abdominal or lumbar spine injury; No
restraint could possibly lead to ejection of vehicle
Improper use of headrest = (second impact) Hyperextension of the cervical
spine
Proper use of air bags = Injuries from a second impact after deflation can
lead to striking the steering wheel leading to internal injuries (thus, check
under the deflated air bag for mechanical deformity; Leg, pelvis or
abdominal injuries; Abrasions from the nylon bag, corneal abrasions and
superficial burns on arms in the vicinity of the airbag vents
-Describe at least two potential injuries from rear-end collisions - --
Hyperextension of the cervical spine (if headrest too low)
-lumbar-spine injury (if the seat breaks and falls backwards)
*Rapid forward deceleration can occur from striking something in front after
being struck from behind, thus leading to front impact injuries.
-How many more times is a person likely to die if they are ejected from a
vehicle during an accident? - -25
-What four questions are used as a checklist in scene stabilization for a
tractor accident? - -1. Is the engine off?
2. Are the rear wheels locked?
, 3. Has the fuel situation and fire hazards been addressed?
4. Are there hydraulic fluid leaks or radiator leaks?
-Describe the three assessment criteria for falls - -1. Distance of fall
2. Anatomic area impacted
3. Surface struck
-What are at least six anticipated injuries from a fall? - --Fractures of the
feet or legs
-Hip and/or pelvic injuries
-Axial loading to the lumbar and cervical spine
-Vertebrae compression fracture
-Vertical deceleration forces to the organs
-Colles fractures of the wrists
-Identify the two most common forms of penetrating injuries - -Knife and
gun
-Discuss associated mechanisms of the two most common forms of
penetrating injuries and extent of these injuries - -Knife depends on the
anatomic area penetrated, length of the blade, and angle of penetration.
Low-energy injury and tissue damage confined to the direct path of the
blade.
Guns depends on the anatomic area penetrated, on type of weapon, caliber
(size of bullet), and distance from which the weapon was fired. High-energy
injury and tissue damage usually not confined to the direct path of the bullet.
-What are the four injury mechanisms involved in blast injuries - -1. Primary
= Air blast
2. Secondary = Material (shrapnel) propelled by the blast force
3. Tertiary = Body impact with ground or object
4. Quinary = (Delayed type of injury) Hyperinflammatory state from
exposure to contaminants (ex: burns, chemical, biological, radiological)
-Relate how the four injury mechanisms involved in blast injuries relate to
patient assessment - -1. Primary = Air containing organs injuries (ex: Ears,
lungs, gastrointestinal tract) can lead to ruptured tympanic membranes,
pneumothorax, parenchymal hemorrhage, aveolar rupture
2. Secondary = May be penetrating or blunt, as well at higher velocities than
high powered rifles
3. Tertiary = injuries similar to being ejected from a vehicle or fallen from a
height. Injuries depend on what the person impacts
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