PHTLS FINAL Flashcards
A 42 year old female has been pulled from a smoke-filled apartment. Her mouth and nose are covered in soot. She has a weak, hoarse cry with inspiratory stridor. What should you do?
Prepare for a difficult intubation
A 28 year old female has suffered a head injury after falling from a horse. Her Glasgow Coma Scale score is 6 (E1, V1, M4) and she has snoring respirations at 8 per minute. What should you do first?
Place an oropharyngeal airway
A 50 year old male fell from a 6th story balcony. Intubation attempts have been unsuccessful. His
Glasgow Coma Scale score is 6 (E1, VI, M4). You note agonal respirations. What should you do first?
Insert a supraglottic airway device
What is a priority treatment for an internal hemorrhage due to a pelvic fracture?
Binder application
Which of the following presents the greatest risk of EMS provider fatalities?
Motor vehicle collision either an ems unit or on-scene
A 29 year old male falls 17 feet (5 m) to the ground from a tree. He complains of pain on the right side of his chest when he breathes. You note accessory muscle use, focal tenderness, bony crepitus, and absent breath sounds on his right side. What should you suspect?
Simple pneumothorax
A 26 year old male is supine on the ground. He was assaulted and has obvious head and facial trauma. He has snoring respirations at a rate of 8 per minute. What should you do?
Perform a modified jaw thrust
A 55 year old male has burns to both lower extremities from a car crash. He is awake and in severe pain. Assessment reveals dry, white, leathery appearance in both lower extremities. What is the burn classification?
Full thickness
An adult patient has partial thickness burns to his or her anterior abdomen, the entire right arm, and the palm of the left hand. What percent of the total body surface area is affected?
28%
A 44 year old male was involved in a motorcycle crash. He sustained severe blunt trauma to his chest and has a deformity to the right femur. Multiple IV attempts were unsuccessful. Vital signs are BP 70/40, P 126, R 28. What should you do?
Establish intraosseous access
An 8 year old female is being treated in the red treatment area after a housing complex fire. Vital signs are P 140, R 12 with noted stridor. Her eyebrows and hair are burnt. Suddenly, she becomes apneic. What should you do?
Insert an oropharyngeal airway and assist ventilations
Which type of shock includes neurogenic and anaphylactic shock?
Distributive
An 82 year old male fell in the shower 3 days ago and now only responds to painful stimuli. The nurse’s aide at the assisted living facility was unable to walk the patient for breakfast. Vitals signs are BP 170/72, R 26 and irregular, P 58, BGL 150 mg/dl. Glasgow Coma Scale score of 6 (E1, V1, M3). What should you do?
Check if the patient has advanced directives or a MOLST form
A 16 year old male complains of chest pain and difficulty taking a deep breath. He was assaulted with a metal pipe. He has unilateral chest rise and crepitus over the injured area. What should you do?
Apply high flow oxygen
An adult patient was involved in a motorcycle accident. Why should you remove his or her helmet?
To manage the airway
A 25 year old female has a gunshot wound to the abdomen. Vital signs are BP 80/40, P 122, R 18, with clear, equal lung sounds. What is the most appropriate IV fluid to administer?
Warmed lactated ringer’s
A 24 year old construction worker amputated his thumb. How should you manage the amputation?
Wrap in moistened gauze
A 47 year old female was stabbed with a knife in her upper right quadrant. Her Glasgow Coma Scale score is 9 (E2, V2, M5). Vital signs are BP 78/58, P 130, R 26. What should you do?
Immediately transport to a trauma center and establish an IV en route
A 26 year old female was the unrestrained driver of a head on collision. Her Glasgow Coma Scale score is 4 (E1, V1, M2). Vital signs are BP 156/78, P 66, R 12 and irregular, and her pupils are unequal. What should you do?
Assist ventilations at a rate of 20 breaths per minute
A 14 year old male suffered helmet-to-helmet contact during a football game followed by a 30 second period of unconsciousness. Initial exam shows that he is awake but slow to respond. He is nauseated and has a headache. He becomes unresponsive during transport. Examination of the pupils reveals a left pupil that is dilated and non-reactive. What type of hemorrhage should you expect?
Epidural
A 4 year old female fell down approximately 8 carpeted stairs. Her parents said she initially complained of neck pain and a tingling sensation in all 4 extremities, but the symptoms have since resolved. What should you do?
Initiate spinal motion restrictions and transport
A 29 year old male was injured in a high speed motor vehicle collision with lateral impact and intrusion into the side of a sedan. He has pale and diaphoretic skin, appears anxious, and is coughing up blood-tinged sputum. He complains of chest pain, has decreased breath sounds on the left lateral side, has crepitus on palpation of his ribs, and his jugular veins are flat. Vital signs are BP 88/56, P 120, R 24, SpO2 92%. What should you suspect?
Hemothorax
A 41 year old male was stabbed in the chest immediately below the sternum. He complains of shortness of breath and has engorged jugular veins. Vital signs are BP 108/84, P 130, R 26. What should you suspect?
Cardiac tamponade
Which is an early finding in compartment syndrome?
Pain
