ABEM Trauma & Procedural Skills — Questions and Answers

Question 1: What is the first step in trauma assessment?

Check temperature
Primary survey (Correct answer)
Obtain history
Measure glucose

Correct answer: Primary survey

In trauma assessment, the primary survey is the crucial first step, focusing on identifying and immediately treating life-threatening injuries. It follows the ABCDE mnemonic (Airway, Breathing, Circulation, Disability, Exposure) to systematically assess and manage critical issues, ensuring the patient's immediate survival before proceeding to a more detailed secondary assessment.

Question 2: What is the purpose of cervical spine immobilization?

Monitor BP
Prevent spine injury (Correct answer)
Reduce pain
Lower stress

Correct answer: Prevent spine injury

Cervical spine immobilization is crucial in trauma to stabilize the neck and prevent movement of potentially fractured or damaged vertebrae. This stabilization minimizes the risk of further injury to the spinal cord, which could lead to permanent neurological deficits. It's a prophylactic measure to protect the delicate spinal cord from secondary damage.

Question 3: Which tool is used to stop external bleeding?

Bandage
Tourniquet (Correct answer)
Stethoscope
IV catheter

Correct answer: Tourniquet

A tourniquet is a life-saving device specifically designed to apply circumferential pressure to a limb, thereby occluding arterial blood flow. This extreme pressure is highly effective in stopping severe, life-threatening external bleeding that cannot be controlled by direct pressure alone. While bandages cover wounds, a tourniquet actively stops the hemorrhage.

Question 4: What is a FAST exam used for?

Head trauma
Infection
Internal bleeding (Correct answer)
Liver enzymes

Correct answer: Internal bleeding

A FAST (Focused Assessment with Sonography for Trauma) exam is a rapid ultrasound scan performed in emergency settings. Its primary purpose is to quickly identify free fluid, typically blood, in specific body cavities like the pericardium, perihepatic, perisplenic, and pelvic regions. This helps detect significant internal bleeding in trauma patients, guiding immediate management decisions.

Question 5: What needle size is typically used for trauma IV access?

22 gauge
30 gauge
14-16 gauge (Correct answer)
10 gauge

Correct answer: 14-16 gauge

In trauma, rapid fluid resuscitation and blood product administration are often critical. Larger bore IV catheters, specifically 14-16 gauge, are preferred because their wider lumen allows for a much faster flow rate of fluids and blood compared to smaller gauges. This enables efficient volume replacement to combat hypovolemic shock.

Question 6: What is the purpose of chest decompression?

Drain abscess
Relieve pneumothorax (Correct answer)
Remove clot
Control heart rate

Correct answer: Relieve pneumothorax

Chest decompression, often performed via needle decompression or chest tube insertion, is an emergency procedure to relieve a tension pneumothorax. In this life-threatening condition, air accumulates in the pleural space, collapsing the lung and putting pressure on the heart and great vessels. Decompression releases this trapped air, restoring lung function and cardiovascular stability.

Question 7: Which trauma score assesses severity?

BMI
GCS (Correct answer)
APGAR
ABG

Correct answer: GCS

The Glasgow Coma Scale (GCS) is a widely used neurological scale that provides an objective and reliable way to assess a patient's conscious state, particularly after a head injury or in other trauma. It evaluates eye opening, verbal response, and motor response, with a lower score indicating greater severity of brain injury and overall trauma.

Question 8: What is a sign of shock?

Hyperthermia
Bradycardia
Hypotension and tachycardia (Correct answer)
Rashes

Correct answer: Hypotension and tachycardia

Shock is a life-threatening condition characterized by inadequate tissue perfusion, meaning the body's cells aren't getting enough oxygen and nutrients. Hypotension (low blood pressure) occurs as the circulatory system fails to maintain adequate pressure, while tachycardia (rapid heart rate) is a compensatory mechanism as the heart tries to pump more blood to vital organs.

Question 9: Why reassess after interventions?

Avoid documentation
Monitor effectiveness (Correct answer)
Increase workload
Check policy

Correct answer: Monitor effectiveness

Reassessment after medical interventions is a fundamental principle of patient care. It allows healthcare providers to determine if the treatment administered is having the desired effect and if the patient's condition is improving, worsening, or remaining stable. This continuous monitoring guides further management decisions and ensures optimal patient outcomes.

ABEM Trauma & Procedural Skills

What is the first step in trauma assessment?