Hemorrhage Control and Shock Flashcards
6 cards from real ITLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Hemorrhage Control and Shock flashcards as text
A patient has a gunshot wound to the groin crease with arterial bleeding. A tourniquet cannot be applied at this junctional location. What is the most appropriate hemorrhage control technique?
Answer: Pack the wound with hemostatic gauze and apply direct pressure
Junctional hemorrhage (groin, axilla, neck) cannot be controlled by tourniquet. Wound packing with hemostatic gauze (such as Combat Gauze or Celox) followed by sustained direct pressure is the recommended technique.
What is the lethal triad of trauma, and why does it create a vicious cycle?
Answer: Hypothermia, acidosis, and coagulopathy—each worsens the other two, creating a self-reinforcing downward spiral toward death
The lethal triad (hypothermia, acidosis, coagulopathy) creates a self-perpetuating cycle: hemorrhage causes hypothermia and acidosis, both impair clotting, worsened coagulopathy increases hemorrhage, which deepens hypothermia and acidosis.
When is it appropriate to apply a tourniquet in the prehospital setting according to current ITLS guidelines?
Answer: For life-threatening extremity hemorrhage that cannot be controlled by direct pressure, applied as early as needed
Current ITLS guidelines support early tourniquet application for life-threatening extremity hemorrhage when direct pressure is ineffective or impractical, reflecting evidence from military and civilian trauma that early tourniquet use saves lives.
A trauma patient presents with cool, mottled extremities, delayed capillary refill, and thready radial pulses but has a blood pressure of 118/90. What stage of shock is this patient in?
Answer: Compensated shock—the body is maintaining blood pressure through vasoconstriction despite significant volume loss
This patient is in compensated shock. Despite maintaining a near-normal systolic pressure through intense vasoconstriction, the clinical signs (cool skin, mottling, delayed capillary refill, narrowed pulse pressure) reveal inadequate tissue perfusion.
What is the role of tranexamic acid (TXA) in trauma hemorrhage management?
Answer: It is an antifibrinolytic that prevents clot breakdown and improves survival when given within 3 hours of injury
Tranexamic acid (TXA) inhibits fibrinolysis (the breakdown of blood clots), helping the body maintain clots that have formed at injury sites. The CRASH-2 trial showed significant mortality reduction when administered within 3 hours of injury.
How do you differentiate obstructive shock from hypovolemic shock in a trauma patient?
Answer: Obstructive shock (tension pneumothorax, cardiac tamponade) presents with JVD and often unilateral breath sounds changes, while hypovolemic shock presents with flat neck veins and clear lungs
Obstructive shock causes mechanical obstruction to cardiac output (distended neck veins from impaired venous return) while hypovolemic shock depletes circulating volume (flat neck veins). The physical exam findings help distinguish them and guide treatment.