ITLS Patient Assessment and Management 2

Question 1

During scene size-up, you notice a car with severe intrusion into the driver's compartment and a spider-web pattern on the windshield.
The driver is ambulatory and denies injury.
How should this mechanism of injury influence your assessment?

Accepted Answer

High-energy mechanism warrants a full rapid trauma survey regardless of the patient's initial presentation, as occult injuries are likely

Answer

Since the patient is ambulatory, mechanism is irrelevant

Answer

Only perform a focused assessment on the area where the patient hit the windshield

Answer

Mechanism of injury is not used in clinical decision-making

Question 2

What is the difference between a rapid trauma survey and a focused assessment in ITLS, and when is each performed?

Accepted Answer

The rapid trauma survey is a systematic head-to-toe evaluation for unstable or significant-mechanism patients; the focused assessment targets specific injury sites in stable patients with isolated mechanisms

Answer

They are the same assessment performed at different speeds

Answer

The focused assessment is always more thorough than the rapid trauma survey

Answer

The rapid trauma survey is only for unresponsive patients

Question 3

During the circulation assessment of a primary survey, what four things should be evaluated?

Accepted Answer

Pulse (rate and quality), skin (color, temperature, moisture), capillary refill, and major external hemorrhage control

Answer

Blood type, clotting time, hemoglobin level, and platelet count

Answer

Heart sounds, lung sounds, blood pressure, and oxygen saturation

Answer

ECG rhythm, pulse oximetry, blood glucose, and temperature

Question 4

A multi-vehicle accident has 12 patients. As the first arriving unit, what ITLS triage system should you implement?

Accepted Answer

Implement START triage to rapidly categorize patients into immediate, delayed, minor, and expectant/deceased categories

Answer

Treat the most severely injured first

Answer

Transport all patients simultaneously

Answer

Wait for additional resources before beginning any assessment

Question 5

What mnemonic does ITLS use for the detailed secondary survey assessment of each body region, and what does each letter stand for?

Accepted Answer

DCAP-BTLS - Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling

Answer

ABCDE - Airway, Breathing, Circulation, Disability, Exposure

Answer

SAMPLE - Signs, Allergies, Medications, Past history, Last meal, Events

Answer

OPQRST - Onset, Provocation, Quality, Radiation, Severity, Time

Question 6

How often should reassessments be performed on unstable and stable trauma patients during transport according to ITLS guidelines?

Accepted Answer

Every 5 minutes for unstable patients and every 15 minutes for stable patients

Answer

Every 30 minutes for all patients

Answer

Only once during transport regardless of patient status

Answer

Continuously without pause for the entire transport