ATLS

Question 1

<div>What are the three intervals of death following trauma?</div>

Answer 1

<ul> <li>Immediate</li> <ul> <li>Severe brain, high spinal cord injury, rupture of heart or large vessels</li> <li>Only prevention interventions can stop these deaths</li> </ul> <li>Minutes to Hours</li> <ul> <li>The Golden hour: shock, hypoxia, head injury</li> <ul> <li>Examples, hemo/pneumothorax, ruptured spleen, liver lacs, pelvic fractures</li> <li>Deaths in this time period can often be prevented by expedient care</li> </ul> </ul> <li>Days to weeks</li> <ul> <li>Sepsis and multiorgan failure</li> </ul></ul>

Question 2

<div>What are five contraindications to foley catheter insertion?</div>

Answer 2

<ul> <li>Blood at the meatus</li> <li>Perineal ecchymosis</li> <li>Blood in the scrotum</li> <li>High riding or non palpable prostate</li> <li>Pelvic fracture</li> </ul>

<div>Not necessarily contraindications just indications to do a retrograde urethrogram before you place one</div>

Question 3

<div>What are three signs of laryngeal trauma/fracture?</div>

Answer 3

<ul> <li>Hoarseness</li> <li>Subcutaneous emphysema</li> <li>Palpable fracture</li></ul>

Question 4

<div>List six indications to place a definitive airway</div>

Answer 4

<ul> <li>Apnea</li> <li>Inability to maintain airway by other means</li> <li>Protect airway from aspiration</li> <li>Impeding loss of airway</li> <li>Closed head injury requiring ventilation</li> <li>Inability to bag mask</li></ul>

Question 5

<div>List 4 contraindications to nasopharyngeal intubation</div>

Answer 5

<ul> <li>Nasal polyps (obstruction)</li> <li>TBI</li> <li>Coagulopathy (could create bleeding that will then obstruct the airway)</li> <li>CSF leaks indicating basillar skull fractures</li></ul>

Question 6

<div>List 9 complications of orotracheal or nasotracheal intubation</div>

Answer 6

<ul> <li>Cervical cord injury in presence of C-spine fracture</li> <li>Broken teeth</li> <li>Nose bleed</li> <li>Esophageal intubation</li> <li>Intubation of right mainstem bronchus (too deep)</li> <li>Inability to obtain airway</li> <li>Overinflate the cuff (tracheal endothelium necrosis)</li> <li>Gagging/vomiting/aspiration</li></ul>

Question 7

<div>What conditions shift the oxygen dissociation curve to the left (4) or right (4)?</div>

Answer 7

“<ul> <li>Right shift</li> <ul> <li>Increase H+ (Decreased ph)</li> <li>Increased temp</li> <li>Increased CO2</li> <li>Increased 2,3 diphosphoglycerates</li> </ul><li>A right shift indicates decreased oxygen affinity of haemoglobin allowing more oxygen to be available to the tissues.</li><li>A left shift indicates increased oxygen affinity of haemoglobin allowing less oxygen to be available to the tissues.<br></br></li><li><img></img><br></br></li></ul>”