PRIMARY AND SECONDARY SURVEY OF A TRAUMA PATIENT

Question 1

TCCC Primary Survey is as follows:
M - __________
A – __________
R – __________
C – __________
H – __________

Answer 1

M - Massive Hemorrhage
A – Airway
R – Respirations
C – Circulation
H – Head Injury and Hypothermia

Question 2

Most casualties during combat are the result of __________ injuries, rather than the blunt trauma seen in the civilian setting.

Answer 2

penetrating

Question 3

_________ should be used as a primary adjunct for massive or arterial bleeding until controlled by dressing or hemostatic agents

Answer 3

tourniquets

Question 4

Internal Hemorrhage: If an operating room is not immediately available, abdominal or lower extremity hemorrhage can be reduced by what?

Answer 4

agents, wound packing, ligation, and clamping.

Question 5

What Class of hemorrhage?
loss of up to 15 percent (about 750 mL)
-is tolerated well in healthy patients

Answer 5

Class I

Question 6

What Class of hemorrhage?
15 to 30 percent (about 750 to 1500 mL)
-results in tachycardia and narrowed pulse pressure

Answer 6

Class II

Question 7

What Class of hemorrhage?
30 percent (1500 mL)
-worsening hypotension, tachycardia, peripheral hypo perfusion, and decline in mental status

Answer 7

Class III

Question 8

What Class of hemorrhage?
greater than 40 percent (2 Liters)
-the ability of the body to compensate has reached its limits and hemodynamic decompensation is imminent without effective resuscitation.

Answer 8

Class IV

Question 9

In virtually all trauma casualties requiring urgent intubation, a ________ intubation technique should be used.

Answer 9

rapid- sequence

Question 10

True/False
Attempts at intubation without optimal sedation and paralysis often result in failure

Answer 10

True

Question 11

True/ False
A formal blood pressure measurement should be performed at the C in the MARCH algorithm

Answer 11

False
SHOULD NOT be performed

Question 12

BP over palp
(1 Radial Pulse: pressure ≥ ___ mmHg
(2 Femoral Pulse: pressure ≥ ___ mmHg
(3 Carotid Pulse: pressure ≥ ___ mmHg

Answer 12

(1 Radial Pulse: pressure ≥ 80 mmHg
(2 Femoral Pulse: pressure ≥ 70 mmHg
(3 Carotid Pulse: pressure ≥ 60 mmHg

Question 13

The sign of white or ashen, grey skin depicts what?

Answer 13

hypovolemia

Question 14

When do you log roll the pt to check the back?

Answer 14

in the H of the MARCH
and when the pt is hemodynamically stable

Question 15

At what part of the MARCH is thorax and neck palpated and interventions such as needle D or chest tube completed?

Answer 15

R

Question 16

A GSC score of ≤ 8 indicates what?

Answer 16

severe head injury/coma

Question 17

What is the AMPLE history

Answer 17

(1) Allergies
(2) Medications and nutritional supplements
(3) Past medical illnesses and injuries
(4) Last meal
(5) Events associated to the injury

Question 18

_______ is a head-to-toe physical examination, to include a reassessment of vital signs

Answer 18

Secondary Survey

Question 19

Clear evidence of intra-abdominal injury (peritonitis or evisceration) will lead to what surgery?

Answer 19

laparotomy

Question 20

Basilar skull fractures are suggested by the presence of what signs?

Answer 20

bruising around the eyes(raccoon’s eyes) or behind the ears (Battle’s sign).

Question 21

A mid-face fracture is present when a gloved finger placed into the mouth can move the ____

Answer 21

central incisors and palate

Question 22

Any patient who is unconscious, has a neurologic deficit, or has an injury above the clavicles then you should treat them as if they have what kind of injury?

Answer 22

injury to the cervical spine until proven otherwise

Question 23

What organ?
1) Most commonly injured organ in blunt trauma
2) Often associated with other injuries
3) Left lower rib pain may be indicative
4) Often can be managed non-operatively

Answer 23

Spleen

Question 24

What organ?
1) Second most common solid organ injury
2 )Can be difficult to manage surgically
3 )Often associated with other abdominal injuries

Answer 24

Liver

Question 25

What issue?
1) Injury can involve stomach, bowel, or mesentery
2 )Symptoms are a result from a combination of blood loss and peritoneal contamination
3 )Small bowel and colon injuries result most often from penetrating trauma
4) Deceleration injuries can result in bucket-handle tears of mesentery

Answer 25

Hollow Viscous Injuries

Question 26

Free fluid without solid organ injury is a what until proven otherwise?

Answer 26

hollow viscous injury

Question 27

In a prehospital setting, early control of bleeding from fractures of the pelvic ring can sometimes be achieved by what?

Answer 27

binding the pelvis with a bed-sheet or commercial sling

Question 28

every patient with fractures or crush injuries to the extremities should be considered at risk for what?

Answer 28

compartment syndrome

Question 29

The Advance Trauma Life Support (ATLS) approach to casualty care is ………

Answer 29

to treat the greatest threat to life first