ATLS Hemorrhage Control and Damage Control Surgery

Question 1

What is the maximum estimated blood loss in Class I hemorrhage according to ATLS classification?

Accepted Answer

Up to 750 mL (up to 15% blood volume)

Answer

Up to 1,500 mL (up to 30% blood volume)

Answer

Up to 2,000 mL (up to 40% blood volume)

Answer

Up to 500 mL (up to 10% blood volume)

Question 2

Which best defines damage control surgery (DCS) in the context of trauma care?

Accepted Answer

Abbreviated surgery to control hemorrhage and contamination, followed by ICU resuscitation and planned reoperation

Answer

Definitive repair of all injuries in a single prolonged operation

Answer

Surgery performed exclusively in the emergency department

Answer

Minimally invasive laparoscopic techniques for all trauma patients

Question 3

Which triad of physiologic derangements is known as the 'lethal triad' in trauma patients?

Accepted Answer

Hypothermia, acidosis, and coagulopathy

Answer

Hypertension, hyperkalemia, and alkalosis

Answer

Tachycardia, hypotension, and oliguria

Answer

Anemia, thrombocytosis, and hypoxia

Question 4

In penetrating torso trauma without suspected traumatic brain injury, permissive hypotension targets a systolic blood pressure of approximately:

Accepted Answer

90–100 mmHg until surgical hemorrhage control is achieved

Answer

120–130 mmHg maintained with aggressive crystalloid infusion

Answer

Below 70 mmHg in all trauma patients until OR arrival

Answer

Normal blood pressure using vasopressors if needed

Question 5

What blood product ratio is recommended during damage control resuscitation for massive hemorrhage?

Accepted Answer

1:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets

Answer

4:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets

Answer

2:4:1 ratio of packed red blood cells, fresh frozen plasma, and platelets

Answer

Packed red blood cells only until coagulopathy is confirmed by labs

Question 6

Resuscitative thoracotomy performed in the emergency department for blunt trauma is most appropriate when the patient:

Accepted Answer

Had signs of life on arrival and then loses vital signs in the ED

Answer

Arrives with no signs of life after more than 10 minutes of blunt traumatic arrest

Answer

Is hemodynamically stable with suspected cardiac tamponade

Answer

Has penetrating cardiac injury with pulseless electrical activity for more than 15 minutes

Question 7

The primary goal of the first stage of a damage control laparotomy is:

Accepted Answer

Control of life-threatening hemorrhage and gross contamination

Answer

Complete bowel anastomosis and reconstruction

Answer

Definitive vascular repair of all injured vessels

Answer

Fasciotomy closure and wound debridement