PHTLS - Prehospital Trauma Life Support Shock and Hemorrhage Control Questions and Answers

Question 1

A 25-year-old male has sustained a gunshot wound to the upper right thigh.
Bright red blood is spurting from the wound.
Direct pressure is ineffective.
What is the MOST appropriate next step in managing this hemorrhage?

Accepted Answer

Immediately apply a tourniquet high and tight on the extremity.

Answer

Apply a hemostatic dressing and continue direct pressure.

Answer

Administer a rapid bolus of 1 liter of normal saline.

Answer

Package the patient for immediate transport without further intervention.

Question 2

Which of the following is a primary goal of 'permissive hypotension' in the management of a trauma patient with suspected non-compressible torso hemorrhage?

Accepted Answer

To prevent clot dislodgement by avoiding aggressive fluid resuscitation.

Answer

To rapidly normalize blood pressure to 120/80 mmHg.

Answer

To increase urine output and confirm adequate renal perfusion.

Answer

To aggressively administer crystalloids until the radial pulse is bounding.

Question 3

According to PHTLS principles, Tranexamic Acid (TXA) is most effective when administered to a trauma patient with significant hemorrhage under which condition?

Accepted Answer

Within 3 hours of the injury.

Answer

Anytime within 24 hours of the injury.

Answer

Only after 2 liters of crystalloid have been administered.

Answer

For isolated, compressible extremity hemorrhage.

Question 4

You are treating a patient with a suspected unstable pelvic fracture after a high-speed MVC. The patient is tachycardic and hypotensive. Besides IV access and fluid administration, which intervention is critical for controlling internal hemorrhage?

Accepted Answer

Application of a pelvic binder or sheet.

Answer

Log rolling the patient to assess their back.

Answer

Placing the patient in a prone position.

Answer

Applying bilateral traction splints.

Question 5

In the PHTLS patient assessment sequence (XABCDE), what does the 'X' represent and why is it addressed first?

Accepted Answer

eXsanguinating Hemorrhage, because it is the most immediate threat to life.

Answer

X-factor, for considering unknown variables in the mechanism of injury.

Answer

eXamine, for a detailed head-to-toe examination before other steps.

Answer

Xiphoid process, as a landmark for chest compressions if needed.

Question 6

When applying a commercial windlass-style tourniquet to an upper arm, which of the following actions is correct?

Accepted Answer

Position the tourniquet 2-3 inches proximal to the wound, but not over a joint.

Answer

Place the tourniquet directly over the elbow joint to compress the brachial artery.

Answer

Tighten the windlass only until venous bleeding stops.

Answer

Loosen the tourniquet for 30 seconds every 15 minutes to allow for distal perfusion.