PHTLS - Prehospital Trauma Life Support Special Trauma Considerations Questions and Answers

Question 1

An 82-year-old male who takes metoprolol for hypertension falls and complains of abdominal pain.
His vital signs are BP 100/60 mmHg, HR 70 bpm, and RR 22.
Why should the provider be concerned about this patient's heart rate?

Accepted Answer

The patient's beta-blocker medication may be masking tachycardia associated with hemorrhagic shock.

Answer

It is a normal heart rate and not a cause for concern in this context.

Answer

The heart rate suggests a primary cardiac event, like a myocardial infarction, caused the fall.

Answer

A heart rate of 70 is indicative of a neurogenic shock state.

Question 2

A 5-year-old child falls from a height. Initially, they are alert with a BP of 95/60 mmHg and HR of 130 bpm. Fifteen minutes later, the child suddenly becomes lethargic and their BP drops to 70/40 mmHg. This rapid deterioration is best explained by which pediatric physiological principle?

Accepted Answer

A child's cardiovascular system can compensate for significant volume loss until a critical point, after which it decompensates rapidly.

Answer

Children have an underdeveloped sympathetic nervous system that fails quickly.

Answer

Pediatric head injuries always cause immediate and severe hypotension.

Answer

The child's lower total blood volume makes even minor blood loss catastrophic.

Question 3

You are treating a 30-year-old female who is 34 weeks pregnant and was involved in a motor vehicle collision. She is fully immobilized on a backboard. During transport, she becomes pale, lightheaded, and her BP drops to 88/50 mmHg. What is the MOST appropriate immediate intervention?

Accepted Answer

Manually displace the uterus to the patient's left side.

Answer

Administer a 1-liter bolus of lactated Ringer's solution.

Answer

Place the patient in the Trendelenburg position.

Answer

Rapidly transport without further intervention.

Question 4

Which of the following represents a significant challenge in the prehospital management of a trauma patient with morbid obesity?

Accepted Answer

Accurate assessment and intervention are often hindered by obscured anatomical landmarks.

Answer

They have a decreased risk of pulmonary contusion due to excess chest wall padding.

Answer

Blood pressure is typically lower, which can mask the signs of developing shock.

Answer

The risk of airway compromise during immobilization is significantly lower.

Question 5

A 72-year-old male on warfarin (Coumadin) sustains a ground-level fall and strikes his head. His only complaint is a minor headache, his GCS is 15, and there are no external signs of trauma. What is the most critical consideration for this patient?

Accepted Answer

The risk of a significant intracranial hemorrhage is high, even with a minor mechanism of injury.

Answer

The patient can be safely released to a family member for observation at home.

Answer

The primary concern is a cervical spine fracture, as head injury is unlikely.

Answer

Warfarin use will cause falsely elevated blood pressure readings.

Question 6

You are treating a patient with extensive full-thickness burns to the face and neck after being pulled from a house fire. The patient has a hoarse voice, carbonaceous sputum, and singed nasal hairs. What is the highest priority intervention?

Accepted Answer

Anticipating the need for a definitive airway and preparing for early intubation.

Answer

Applying cool, moist sterile dressings to the facial burns.

Answer

Calculating the Total Body Surface Area (TBSA) to guide fluid resuscitation.

Answer

Obtaining intravenous access for immediate pain management.