PHTLS - Prehospital Trauma Life Support Prehospital Trauma Life Support Spinal Trauma Management 1

Question 1

According to PHTLS guidelines, what is the recommended approach to spinal motion restriction for a patient with penetrating trauma to the torso and NO neurological deficits?

Accepted Answer

Spinal motion restriction is NOT indicated, as it delays transport without proven benefit

Answer

Apply full spinal motion restriction due to the high-energy mechanism

Answer

Apply a cervical collar only and transport supine

Answer

Defer the decision to medical direction before moving the patient

Question 2

Which combination of signs and symptoms is most consistent with neurogenic shock following a high cervical spinal cord injury?

Accepted Answer

Hypotension and bradycardia

Answer

Hypotension and tachycardia

Answer

Hypertension and bradycardia

Answer

Hypertension and tachycardia

Question 3

A conscious, cooperative trauma patient denies neck pain, has no midline spinal tenderness, and has a normal neurological exam but was involved in a high-speed rollover. According to PHTLS clinical decision criteria, which additional factor would most support withholding spinal motion restriction?

Accepted Answer

Patient has no distracting painful injuries and a normal level of consciousness

Answer

Blood alcohol level is elevated

Answer

Patient has a laceration to the scalp

Answer

Patient is under 40 years of age

Question 4

A trauma patient is wearing a well-fitted football helmet with complementary shoulder pads. What does PHTLS recommend regarding helmet management?

Accepted Answer

Leave both the helmet and shoulder pads in place, as they maintain neutral spinal alignment

Answer

Remove the helmet immediately to allow full cervical spine assessment

Answer

Remove only the face mask and leave the rest of the equipment in place

Answer

Remove the helmet but leave the shoulder pads to allow airway access

Question 5

What is the primary disadvantage of leaving a trauma patient immobilized on a rigid long backboard for an extended period during transport?

Accepted Answer

It increases the risk of pressure injuries and respiratory compromise

Answer

It provides insufficient restriction of lateral spinal motion

Answer

It is incompatible with standard ambulance cot mounting systems

Answer

It prevents accurate blood pressure measurement in the field

Question 6

Before applying a rigid cervical collar to a trauma patient with a suspected spinal injury, what is the most critical first step the provider must perform?

Accepted Answer

Manually stabilize the head and neck in a neutral in-line position

Answer

Select the correct collar size by measuring the patient's neck

Answer

Establish IV access to prepare for potential neurogenic shock

Answer

Obtain a baseline Glasgow Coma Scale score to document neurological status