ATLS Thoracic Trauma 2

Question 1

A patient with blunt chest trauma has paradoxical chest wall movement. What is the primary cause of hypoxia?

Accepted Answer

Underlying pulmonary contusion

Answer

The underlying pulmonary contusion, not the mechanical wall defect, is the primary driver of respiratory failure.

Question 2

A chest tube initially drains 1,800 mL of blood. According to ATLS, next step?

Accepted Answer

Prepare for emergent thoracotomy

Answer

Initial drainage >1,500 mL indicates massive hemothorax requiring emergent thoracotomy.

Question 3

An open pneumothorax (sucking chest wound) is initially managed with which intervention?

Accepted Answer

Three-sided occlusive dressing

Answer

Three-sided dressing creates a flutter-valve: sealed during inspiration, open during expiration to prevent tension.

Question 4

Widened mediastinum on CXR after high-speed deceleration suggests which injury?

Accepted Answer

Traumatic aortic injury

Answer

Widened mediastinum (>8 cm) after deceleration is the most common finding suggesting traumatic aortic injury at the isthmus.

Question 5

A chest tube is in place but there is continuous air leak with the lung not re-expanding. Diagnosis?

Accepted Answer

Tracheobronchial disruption

Answer

Persistent large air leak with failure to re-expand suggests tracheobronchial disruption.

ATLS - Advanced Trauma Life Support Practice Test