ATLS principles

Question 1

ABCDE means

Answer 1

airways and cervical spine protection
breathing and ventilation
circulation with haemorrhage control
disability (glucose)
exposure and environmental control

Question 2

what to do for A 5 steps

Answer 2

assess airway
stabilise neck
open airway with jaw thrust
clear obstructions (suction)
give 100% oxygen

Question 3

what to do for B 5 steps

Answer 3

Inspection 
palpate: central trachea, expansion
percussion dull for blood, resonant for air
auscultation
obs-spo2, pulse, bp

Question 4

signs of obstructed airways

Answer 4

hoarseness
stridor
snoring
no noise

Question 5

breathing management for ATLS

Answer 5

high flow o2 trauma mask-50L

Question 6

what is a insufficient respiratory rate

Answer 6

<10 breaths per minute

Question 7

specific breathing injuries to be aware of for breathing 2

Answer 7

c2 fracture- common in hyperflexion injuries- can cause a pneumothorax
pneumothorax

Question 8

3 types of pneumothorax

Answer 8

tension
open
closed

Question 9

what is a tension pneumothorax

Answer 9

internal one way valve so air flowing in builds up in pleural space

Question 10

signs of a tension pneumothroax 6

Answer 10

mediastinum shift
engorged neck veins
reduced lung expansion
deviation trachea
increased percussion 
decreased breath sounds

Question 11

management of a tension pneumothorax and location

Answer 11

needle decompression in 2nd intercostal space mid clavicular
definitive chest drain

Question 12

what is a open pneumothorax

Answer 12

sucking chest wound
external one way valve with air coming in
air pressure same as outside-tear doesnt act as a valve

Question 13

management open pneumothorax

Answer 13

three sided occlusive dressing

Question 14

what is a closed pneumothorax

Answer 14

air has got in and then closed

so pressure is < then the atmosphric pressure

Question 15

what is flail chest

Answer 15

when 2 or more ribs are fractured in 2 or more places- ie complete separated
cant contribute to lung expansion

Question 16

signs of flail chest

Answer 16

indrawing on inspiration

moving out on expiration

Question 17

circulation assessment steps 3

Answer 17

circulatory compromise signs: pale, hr, bp, pulses
obvious sources
IV access establish x2

Question 18

fluid resus components 3 and how much

Answer 18

fluid bolus (10-20ml/kg)-1l crystalloid
Blood products
Tranexamic acid 1gIV

Question 19

3 blood products and their ratio

Answer 19

red blood cells
fresh frozen plasma
platelets
1;1;1

Question 20

responses to fluids 3

Answer 20

responsive
transient: goes up/down
non-responsive

Question 21

what is permissive hypotension and what bp aiming for

Answer 21

restrictive fluid therapy so that don’t quite reach normal BP
only to achieve radial pulse/ bp of 80-90 systolic

Question 22

pelvic fracture management

Answer 22

pelvic binder as can lose all of circulating volume

Question 23

normal blood volume l

Answer 23

5l

Question 24

what is the definition of a massive haemothorax and the signs

Answer 24

> 1500ml of blood in pleural cavity
dull on percussion
respiratory compromise
large volume loss

Question 25

management of a massive haemothorax

Answer 25

chest drain and surgery

Question 26

what is cardiac tamponade

Answer 26

fluid in the pericardium sac

Question 27

what is Beck's triad of cardiac tamponade

Answer 27

hypotension: decrease SV jugular venous distension: increase heart pressure muffled heart sounds

Question 28

management of cardiac tamponade

Answer 28

pericardiocentesis under ultrasound guidance

Question 29

what is shock

Answer 29

end organ dysfunction low blood pressure inadequate o2 available

Question 30

what organs are prone to shock 4

Answer 30

brain renal cardiac GI

Question 31

lethal triad of shock measurements

Answer 31

1. acidosis pH <7.25, base excess <5 and lactate >2.5 2. hypothermia <35 3. coagulopathy platelets <120 inr >1.5

Question 32

2 types of shock

Answer 32

haemorrhagic and non-haemorrhagic

Question 33

types of haemorrhagic shock 5

Answer 33

``` intrathoracic intraperitoneal retroperitoneal thigh compartment floor ```

Question 34

types of non-haemorrhagic shock 5

Answer 34

``` cardiogenic tension pneumothorax neurogenic- spinal cord injury and BP septic: vasodilatory anaphylaxis ```

Question 35

class I shock measurements and management

Answer 35

``` blood loss <15% pulse <100 BP N urine <30 crystalloid replace ```

Question 36

class II shock

Answer 36

``` blood loss 15-30% pulse 100-120 BP N urine 20-30 crystalloid replace ```

Question 37

class III shock

Answer 37

``` blood loss 30-40% pulse 120-140 BP low urine 5-15 crystalloid and blood ```

Question 38

class IV shock

Answer 38

``` >40 blood loss pulse >140 bp low negative urine crystalloid and blood ```

Question 39

normal circulating volume

Answer 39

70mlx kg

Question 40

3 GCS components

Answer 40

eye opening verbal response motor response

Question 41

what is the AVPU scale

Answer 41

alert, verbal, pain or unresponsive

Question 42

disability components

Answer 42

GCS or AVPU pupils constriction blood glucose

Question 43

2 steps after abc

Answer 43

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