ITLS In Pregnancy 5

Question 1

A 34-week pregnant patient in shock has an obvious open femur fracture. After controlling hemorrhage and managing the airway, what transport decision is most appropriate?

Accepted Answer

Trauma center with obstetric capability

Answer

Pregnant trauma patients in shock should be transported to a facility that can provide simultaneous trauma and obstetric care.

Question 2

Which pregnant patient is at HIGHEST risk for significant injury from seemingly minor blunt abdominal trauma?

Accepted Answer

A patient at 36 weeks who was assaulted with a punch to the abdomen

Answer

Intimate partner violence (assault) is associated with directed blows to the gravid uterus and carries high risk of placental abruption regardless of gestational age.

Question 3

What change in normal vital sign ranges for a pregnant patient might lead a provider to UNDERESTIMATE shock severity?

Accepted Answer

Heart rate is normally higher and BP normally lower in pregnancy

Answer

Pregnancy normally causes a baseline HR increase of 10–20 bpm and BP decrease of 10–15 mmHg, so typical shock thresholds may not apply.

Question 4

Which intervention for a pregnant patient in traumatic cardiac arrest should be performed SIMULTANEOUSLY with standard ACLS measures?

Accepted Answer

Manual left uterine displacement and preparation for perimortem cesarean

Answer

Manual uterine displacement to relieve aortocaval compression should begin immediately alongside CPR, and PMCD should be prepared if arrest persists beyond 4 minutes.

Question 5

A pregnant trauma patient at 26 weeks is given IV fluids. What is a potential complication of aggressive crystalloid resuscitation in this population?

Accepted Answer

Pulmonary edema due to reduced oncotic pressure

Answer

Pregnancy lowers serum albumin and oncotic pressure, making pregnant patients more susceptible to pulmonary edema with aggressive crystalloid administration.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS In Pregnancy 5