ATLS

Question 1

what is more important- airway or cervical spine and why

Answer 1

airways

people die from hypoxia, rarely from spinal damage

Question 2

5 steps to control airway

Answer 2

• lift chin (dont tilt head, may damage cervical spine)
• jaw thrust
• oropharyngeal suctioning
• manually move tongue forward
• maintain cervical immobilisation but not at cost of airway

Question 3

options for intubation, considerations of each

Answer 3

• nasotracheal intubation: bad, nasocranial intubation/ nasal haemorrhage
• rapid sequence intubation:difficult
• awake intubation with benzodiazapine sedation (good)
• fibre-optic intubation if available
• percutaneous transtracheal ventilation
• retrograde intubation
• last resort: cricothyroidotomy

Question 4

where to insert for tracheostomy/ cricothyroidotomy

which is preferable?

Answer 4

cricothyroid membrane

tracheostomy preferable

Question 5

5 principles of trauma management

Answer 5

• primary survey: ABCDE + cervical spine
• secondary survey: examine whole body
• treat life-threatening conditions as they arise
• stabilise
• transfer

Question 6

what does ABCDE stand for

Answer 6

Airways
Breathing
Circulation
Disability
Exposure (of body to see wounds)

Question 7

what is flail mandible

Answer 7

tongue and associated structures fall down, blocking airways (lifting chin prevents this)

Question 8

where to insert chest drain

Answer 8

4th-5th intercostal spaces

Question 9

how to manage

a. airway obstruction
b. tension pneumothorax
c. open pneumothorax
d. massive haemothrorax
e. flail chest
f. cardiac tamponade

Answer 9

a. airway obstruction: intubation/ surgical airway
b. tension pneumothorax: needle thoracocentesis
c. open pneumothorax: 3 sided dressing/ chest tube
d. massive haemothrorax: IV fluids/ chest drain
e. flail chest: analgesia
f. cardiac tamponade: pericardiocentesis (needle in to pericardium to aspirate blood)

Question 10

what is cardiac tamponade

Answer 10

blood in pericardium –> heart cannot expand fully

Question 11

what is flail chest

Answer 11

broken ribs stop chest expanding –> lungs collapse

Question 12

5 common sites that blood goes following trauma

Answer 12

abdomen
pelvis
femur
chest cavity
floor

Question 13

what is the leading cause of disability in young adult males

Answer 13

trauma

Question 14

acute management of head injuries 5

Answer 14

• oxygen
• access glasgow coma scale GCS
• pupillary responsiveness
• posture
• glucose