ATLS

Question 1

Airway and C-spine control

Answer 1

• Cervical collar
• Examine airway obstruction
• Support airway initially (eg: lifting chin, jaw thrust)
• Secretion and blood are sucked
• Place oropharyngeal/ nasopharyngeal airways to hold tongue forward
• If unsuccessful, tracheal intubation

Question 2

Breathing

Answer 2

• Check for breath sound
• Palpate trachea for deviation
• Percuss chest for hyperresonance or dullness
• Tension pneumothorax decompressed immediately
• Followed by chest drain placement
• High flow oxygen

Question 3

Circulation and bleeding control

Answer 3

• Look for external bleeding
• Sign of shock
• Auscultate heart for muffled heart sound
• 2 large bore IV cannula

Question 4

Disability

Answer 4

• GSC score

- Examine pupil size - raised ICP

Question 5

Exposure and environment

Answer 5

• Remove clothing for exposure
• Log roll check for back
• Covered with blanket + Kept warm close to 37 degree

Question 6

Life threatening condition to rule out in primary survey

Answer 6

ATOM-FC

• Airway obstruction
• Tension pneumothorax
• Open pneumothorax
• Massive hemothorax
• Flail chest
• Cardiac tamponade

Question 7

Sign and symptoms of shock

Answer 7

• Pulse
• Skin pale and cool
• Delayed capillary refill
• Tachycardia
• Altered mental status
• Reduce pulse pressure, blood pressure

Question 8

GSC scale

Answer 8

> Eye opening
4 - spontaneous
3 - to sound
2 - to pressure
1 - none

> Verbal response
5 - orientated
4 - confused
3 - words
2 - sounds
1 - none

> Motor response
6 - obey commands
5 - localising
4 - normal flexion
3 - abnormal flexion
2 - extension
1 - none

15-13 mild
12-9 moderate
3-8 severe

Question 9

AVPU component

Answer 9

• Alert
• response to Verbal stimuli
• response to Painful stimuli
• Unresponsive

Question 10

Initial X-ray view to be taken

Answer 10

• Lateral Cervical
• AP Chest
• AP Pelvis

Question 11

Secondary survey history

Answer 11

• Symptoms and signs
• Allergies
• Medication currently taking
• Past illness
• Last meal
• Event of injury - How? When? Where?

Question 12

Component of high quality CPR

Answer 12

• Adequate rate and depth
• Allowing complete chest recoil between compression
• Minimizing interruptions in compression
• Avoiding excessive ventilation

Question 13

Severe airway obstruction sign

Answer 13

• Increase respiratory difficulty
• Possible cyanosis
• Unable to speak
• Clutching the neck with thumb and finger making the universal sign
• Unable to move air

Question 14

Criteria for ROSC

Answer 14

• Pulse and BP
• Abrupt sustained increased in PET CO2 (typically >=44mmHg)
• Spontaneous arterial pressure waves with intra-arterial monitoring