PHTLS - Prehospital Trauma Life Support Spinal Trauma Management Questions and Answers

Question 1

A 22-year-old male is involved in a high-speed motorcycle collision.
He is found wearing a full-face helmet.
He is unconscious, breathing spontaneously, and has a strong radial pulse.
According to PHTLS principles, what is the most appropriate action regarding the helmet?

Accepted Answer

Remove the helmet only if it interferes with airway management or breathing.

Answer

Leave the helmet in place to provide initial stabilization and transport immediately.

Answer

Immediately remove the helmet using a single-rescuer technique to assess the airway.

Answer

Cut the chin strap and perform a jaw-thrust maneuver with the helmet on.

Question 2

You are assessing a patient who fell 15 feet from a ladder. The patient is hypotensive with a blood pressure of 80/50 mmHg, has a heart rate of 58 bpm, and their skin is warm and dry. Which of the following conditions is MOST likely responsible for this presentation?

Accepted Answer

Neurogenic shock from a spinal cord injury.

Answer

Hypovolemic shock due to internal bleeding.

Answer

Cardiogenic shock from a myocardial contusion.

Answer

Septic shock from a delayed presentation.

Question 3

Which of the following findings in a conscious adult patient with blunt trauma is an absolute indication for initiating spinal motion restriction (SMR)?

Accepted Answer

The presence of a painful and distracting long bone fracture.

Answer

A significant mechanism of injury, such as a vehicle rollover.

Answer

Intoxication with alcohol or drugs.

Answer

An isolated gunshot wound to the lower leg.

Question 4

A 68-year-old female experiences a syncopal episode and falls down two stairs. She is now alert, oriented, and denies any neck pain. She has no palpable tenderness along her spine, no focal neurologic deficits, and no evidence of intoxication. However, she has a large, painful hematoma on her forehead. What is the most appropriate spinal management for this patient?

Accepted Answer

Apply a cervical collar and secure her to the ambulance cot.

Answer

Apply a cervical collar and secure her to a long backboard for transport.

Answer

Allow the patient to ambulate to the stretcher without any spinal precautions.

Answer

Assist the patient to the stretcher and transport in a position of comfort.

Question 5

A patient involved in a rear-end motor vehicle collision is complaining of neck pain. Your assessment reveals marked weakness and numbness in both arms and hands, but he is able to move his legs and wiggle his toes with good strength. This pattern of neurologic deficit is most characteristic of which spinal cord injury syndrome?

Accepted Answer

Central Cord Syndrome

Answer

Anterior Cord Syndrome

Answer

Brown-Séquard Syndrome

Answer

Cauda Equina Syndrome

Question 6

According to PHTLS guidelines, the use of a long spine board for trauma patients is PRIMARILY indicated for which purpose?

Accepted Answer

Facilitating patient extrication from a vehicle or confined space.

Answer

Providing comfort during long transports.

Answer

Routine immobilization for all patients with a significant mechanism of injury.

Answer

Maintaining a definitive airway in an unconscious patient.