ATLS - Advanced Trauma Life Support Thermal and Electrical Injuries Questions and Answers

Question 1

A 45-year-old male is rescued from a house fire.
He has full-thickness burns to his face, singed nasal hairs, a hoarse voice, and carbonaceous sputum.
His initial oxygen saturation is 98% on a non-rebreather mask.
What is the most appropriate next step in management?

Accepted Answer

Perform immediate endotracheal intubation.

Answer

Obtain a chest X-ray to rule out pulmonary injury.

Answer

Administer a 2 L bolus of lactated Ringer's solution.

Answer

Request an urgent bronchoscopy to assess airway damage.

Question 2

A 70 kg adult has sustained full-thickness burns to his entire right arm and the entire anterior trunk. According to the Parkland formula, what is the total volume of lactated Ringer's solution that should be administered in the first 8 hours after the injury occurred?

Accepted Answer

3780 mL

Answer

7560 mL

Answer

5040 mL

Answer

1890 mL

Question 3

A patient presents with a circumferential, full-thickness burn to the right lower leg. The limb is tense and swollen. Which of the following is the most definitive indication for an immediate escharotomy?

Accepted Answer

Loss of a previously audible distal pulse signal on Doppler ultrasound.

Answer

Severe pain reported by the patient in the affected limb.

Answer

A capillary refill time of 4 seconds in the toes.

Answer

The presence of a third-degree burn around the entire limb.

Question 4

A 30-year-old lineman sustains a high-voltage electrical injury with entry and exit wounds on his hand and foot. He is alert and hemodynamically stable. Besides cardiac monitoring, which of the following is a critical management priority to prevent a common, severe complication?

Accepted Answer

Aggressive fluid resuscitation to maintain urine output at 75-100 mL/hr.

Answer

Administration of prophylactic intravenous antibiotics.

Answer

Immediate surgical debridement of the visible entry and exit wounds.

Answer

Application of topical silver sulfadiazine to all burn areas.

Question 5

A patient is brought to the emergency department after being found confused in a garage with a running car. The patient complains of a headache and nausea. A standard pulse oximeter shows an oxygen saturation of 99%. Which of the following is the most appropriate and immediate action?

Accepted Answer

Administer 100% high-flow oxygen via a non-rebreather mask.

Answer

Reassure the patient, as the normal pulse oximetry reading rules out significant hypoxia.

Answer

Obtain an arterial blood gas (ABG) with co-oximetry before initiating any treatment.

Answer

Perform a head CT scan to evaluate for other causes of confusion.

Question 6

Which of the following patients with thermal burns requires initiation of formal intravenous fluid resuscitation according to ATLS guidelines?

Accepted Answer

An 8-year-old with partial-thickness burns covering the entire back.

Answer

A 40-year-old with partial-thickness burns to the entire anterior aspect of both arms.

Answer

A 30-year-old with superficial (first-degree) burns covering 30% TBSA.

Answer

A 50-year-old with full-thickness burns on the back of the left hand and fingers.