PHTLS - Prehospital Trauma Life Support Prehospital Trauma Life Support Shock and Hemorrhage Control 1

Question 1

In PHTLS, which physiologic mechanism is the PRIMARY cause of death in hemorrhagic shock when the body's compensatory mechanisms fail?

Accepted Answer

Inadequate cellular oxygen delivery leading to anaerobic metabolism and organ failure

Answer

Severe metabolic alkalosis from bicarbonate loss

Answer

Systemic inflammatory response overwhelming the immune system

Answer

Neurogenic depression of the cardiac conduction system

Question 2

According to PHTLS hemorrhagic shock classification, a patient presenting with heart rate of 118 bpm, mildly anxious affect, and normal blood pressure most likely falls into which class?

Accepted Answer

Class II

Answer

Class I

Answer

Class III

Answer

Class IV

Question 3

When applying a wound packing technique for hemorrhage control in a non-compressible truncal wound, PHTLS recommends packing the wound with hemostatic gauze and then:

Accepted Answer

Holding firm, direct manual pressure for a minimum of 3 minutes

Answer

Applying a tourniquet proximal to the wound site

Answer

Loosely filling the cavity and covering with a pressure dressing

Answer

Applying a chest seal before wound packing

Question 4

The 'lethal triad' in trauma, which PHTLS providers are taught to recognize and prevent, consists of:

Accepted Answer

Hypothermia, acidosis, and coagulopathy

Answer

Hypovolemia, tachycardia, and coagulopathy

Answer

Hypoxia, hypotension, and hyperkalemia

Answer

Bradycardia, alkalosis, and thrombocytopenia

Question 5

PHTLS supports a strategy of 'permissive hypotension' in penetrating trauma patients with uncontrolled internal hemorrhage. What is the PRIMARY goal of this approach?

Accepted Answer

To avoid diluting clotting factors and dislodging early clots while maintaining minimal perfusion

Answer

To minimize the risk of pulmonary edema from aggressive fluid loading

Answer

To prevent cerebral herniation from excessive intracranial pressure

Answer

To reduce cardiac workload and myocardial oxygen demand

Question 6

According to PHTLS principles, which assessment finding most reliably indicates that a trauma patient has transitioned from compensated to decompensated hemorrhagic shock?

Accepted Answer

A falling systolic blood pressure despite ongoing care

Answer

Heart rate rising above 100 bpm

Answer

Capillary refill time greater than 2 seconds

Answer

Patient reporting feeling thirsty and anxious