CST Trauma & Emergency Surgery 2 — Questions and Answers
Question 1: During a damage control laparotomy, the scrub tech should anticipate packing the abdomen with which material to control hemorrhage temporarily?
- Gelfoam sheets
- Lap sponges (laparotomy pads) (Correct answer)
- Collagen fleece
- Oxidized cellulose strips
Correct answer: Lap sponges (laparotomy pads)
Laparotomy pads (lap sponges) are used for abdominal packing in damage control surgery to tamponade bleeding until the patient is stabilized for definitive repair.
Question 2: A trauma patient arrives with a suspected tension pneumothorax. The FIRST intervention before chest tube insertion is:
- Thoracotomy tray setup
- Needle decompression at the 2nd intercostal space midclavicular line (Correct answer)
- Pericardiocentesis
- Chest X-ray confirmation
Correct answer: Needle decompression at the 2nd intercostal space midclavicular line
Needle decompression immediately relieves the life-threatening pressure of a tension pneumothorax before a formal chest tube can be placed.
Question 3: Which retractor is most commonly used to provide exposure during an emergency exploratory laparotomy?
- Balfour self-retaining retractor (Correct answer)
- Weitlaner retractor
- Gelpi retractor
- Army-Navy retractor
Correct answer: Balfour self-retaining retractor
The Balfour self-retaining retractor provides broad, stable abdominal wall retraction needed for rapid exploration during emergency laparotomy.
Question 4: In a trauma case involving a Grade IV liver laceration, the scrub tech should have immediately available:
- Only argon beam coagulator tips
- Pringle maneuver clamp, suction, and hemostatic agents (Correct answer)
- Harmonic scalpel only
- LigaSure device only
Correct answer: Pringle maneuver clamp, suction, and hemostatic agents
Grade IV liver lacerations require hemorrhage control via Pringle maneuver (vascular clamping of the porta hepatis), aggressive suction, and hemostatic adjuncts.
Question 5: When a patient sustains a traumatic amputation in the field, the amputated part should be transported by:
- Placing directly in ice water
- Wrapping in moist saline gauze, placing in a sealed bag on ice (Correct answer)
- Dry packing in sterile towels without cooling
- Submerging in Lactated Ringer's solution
Correct answer: Wrapping in moist saline gauze, placing in a sealed bag on ice
The amputated part is wrapped in moist saline gauze, sealed in a bag, and placed on ice — never in direct contact with ice — to preserve viability for replantation.
Question 6: During an emergency cricothyrotomy, the incision is made through which membrane?
- Thyrohyoid membrane
- Cricotracheal membrane
- Cricothyroid membrane (Correct answer)
- Tracheal ring 1–2 interspace
Correct answer: Cricothyroid membrane
The cricothyroid membrane, located between the thyroid and cricoid cartilages, is the site of incision for emergent cricothyrotomy to establish an airway.
Question 7: The scrub technician's PRIMARY role during a massive hemorrhage requiring emergency thoracotomy is:
- Documenting blood loss independently
- Anticipating instrument needs and maintaining a sterile field while passing instruments efficiently (Correct answer)
- Calling for blood products from the blood bank
- Positioning the patient on the OR table
Correct answer: Anticipating instrument needs and maintaining a sterile field while passing instruments efficiently
The scrub tech's primary role is sterile field maintenance and rapid, accurate instrument passing to support the surgical team during emergency thoracotomy.
CST Trauma & Emergency Surgery 2
During a damage control laparotomy, the scrub tech should anticipate packing the abdomen with which material to control hemorrhage temporarily?