ATLS Trauma in Special Populations 2

Question 1

In a pregnant trauma patient at 28 weeks, what is the most important initial intervention to improve hemodynamics?

Accepted Answer

Left lateral tilt of 15-30 degrees

Answer

Left lateral tilt relieves aortocaval compression by the gravid uterus, improving venous return and cardiac output by up to 30%.

Question 2

An 80-year-old on warfarin with GCS 15 after a ground-level fall hitting their head. Most appropriate management?

Accepted Answer

CT head scan regardless of GCS

Answer

Elderly patients on anticoagulants require CT after any head trauma regardless of GCS due to high risk of occult intracranial hemorrhage.

Question 3

A 5-year-old in an MVC has HR 150 but normal blood pressure. What does this suggest?

Accepted Answer

Compensated shock with up to 25-30% blood volume loss

Answer

Children maintain normal BP until 25-30% blood volume is lost, then decompensate rapidly. Tachycardia is the earliest sign.

Question 4

What modification to the primary survey is needed for pregnant patients beyond 20 weeks?

Accepted Answer

Add fetal heart tone assessment after maternal stabilization

Answer

After standard ABCDE and maternal stabilization, fetal assessment is added.

Question 5

Elderly trauma patients have increased mortality primarily because of which factor?

Accepted Answer

Decreased physiologic reserve and pre-existing conditions

Answer

Diminished physiologic reserve across all organ systems plus pre-existing conditions and medications impair compensation and recovery.

ATLS - Advanced Trauma Life Support Practice Test