ATLS Cheat Sheet 2026

The 30 highest-yield ATLS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. A trauma patient has HR 130, BP 70/50, RR 30, and altered mental status. What class of hemorrhagic shock? → Class IV
2. Which finding on fiberoptic bronchoscopy confirms inhalation injury? → Erythema, edema, and carbonaceous deposits in the airway
3. The mnemonic for trauma transfer communication is: → MIST
4. A patient presents with a deformed, swollen thigh after a motorcycle collision. Distal pulses are weak. What is the most important initial step? → Apply traction splinting and reassess neurovascular status
5. A patient has an unstable pelvis on manual compression. What is the correct immediate action? → Apply a pelvic binder and avoid further manipulation
6. A patient with a nasal fracture has complete obstruction of both nostrils after manipulation. What immediate concern must be addressed? → Septal hematoma requiring drainage to prevent avascular necrosis
7. When evaluating a patient for mandibular fracture after facial trauma, which clinical finding is most specific? → Malocclusion (abnormal bite alignment)
8. An 8-year-old child falls from playground equipment with brief loss of consciousness. GCS is 15 with no focal deficits. What is the most appropriate next step? → Observation for 4-6 hours with neurological checks
9. Under the START triage system, which respiratory rate threshold triggers a Red (Immediate) tag without further assessment? → Greater than 30 breaths per minute
10. Le Fort II fractures are characterized by which of the following? → Pyramidal fracture through the nasal bridge and orbital floors, separating the midface
11. A stab wound to the left lower chest at the 7th intercostal space should raise suspicion for injury to which abdominal organ? → Spleen
12. What is the appropriate initial antibiotic for a Grade III open tibial fracture? → IV cefazolin plus an aminoglycoside
13. During exposure in the primary survey, what is the most important environmental consideration? → Prevention of hypothermia
14. Which patient should be transferred to a Level I trauma center? → GCS 10, hemodynamically unstable, positive FAST
15. Perimortem cesarean delivery should be initiated within what time frame of maternal cardiac arrest? → 4 minutes of arrest, delivery by 5 minutes
16. A 5-year-old in an MVC has HR 150 but normal blood pressure. What does this suggest? → Compensated shock with up to 25-30% blood volume loss
17. Which is an absolute contraindication to transferring a trauma patient? → No absolute contraindication exists if transfer provides higher-level care
18. A trauma patient presents with a GCS of 7, copious oral bleeding, and suspected cervical spine injury. What is the most appropriate airway management approach? → Rapid sequence intubation with in-line cervical stabilization
19. In the SALT triage method, what does the acronym SALT stand for? → Sort, Assess, Lifesaving Interventions, Treatment/Transport
20. JumpSTART triage differs from START in that it is specifically designed for which patient population? → Pediatric patients under 8 years old or less than 45 kg
21. Which triad of physiologic derangements is known as the 'lethal triad' in trauma patients? → Hypothermia, acidosis, and coagulopathy
22. In massive transfusion protocol, what is the recommended PRBC:FFP:Platelets ratio? → 1:1:1
23. A hemodynamically stable patient with a Grade III splenic laceration on CT is best managed with which approach? → Nonoperative management with observation
24. What is the recommended head-of-bed elevation for a patient with severe TBI and elevated ICP? → 30 degrees
25. According to the 10th edition of ATLS, what is the recommended initial fluid bolus for an adult trauma patient in hemorrhagic shock? → 1 liter of warmed isotonic crystalloid
26. A T4 complete SCI patient is at risk for which respiratory complication? → Loss of intercostal and abdominal muscle function with preserved diaphragm
27. In blast injury classification, which category describes injury from the victim being thrown by the blast wind and striking a hard surface? → Tertiary blast injury
28. The ATLS 10th edition emphasizes that the MOST preventable cause of death in trauma is: → Hemorrhage
29. A patient with facial trauma has clear fluid leaking from the ear. What is the most likely diagnosis? → CSF otorrhea from a temporal bone or basilar skull fracture
30. Resuscitative thoracotomy performed in the emergency department for blunt trauma is most appropriate when the patient: → Had signs of life on arrival and then loses vital signs in the ED