PHTLS - Prehospital Trauma Life Support Traumatic Brain Injury Questions and Answers

Question 1

A 50-year-old male involved in a high-speed motor vehicle collision presents with a decreasing level of consciousness.
His vital signs are: BP 180/100 mmHg, HR 52 bpm, and his respirations are irregular and shallow.
This constellation of signs is known as Cushing's triad and is indicative of what critical condition?

Accepted Answer

Increased intracranial pressure with impending cerebral herniation

Answer

Decompensated hemorrhagic shock

Answer

Neurogenic shock from a spinal cord injury

Answer

A primary cardiac event preceding the trauma

Question 2

Which of the following is a primary goal in the prehospital management of a traumatic brain injury (TBI) to prevent or mitigate secondary brain injury?

Accepted Answer

Preventing episodes of hypoxia and hypotension

Answer

Administering hypertonic saline to all patients with a GCS less than 13

Answer

Maintaining a systolic blood pressure below 90 mmHg to prevent cerebral hemorrhage

Answer

Inducing mild therapeutic hypothermia in the field

Question 3

A 33-year-old male is found unconscious after being struck by a vehicle. He opens his eyes only to a sternal rub, makes incomprehensible sounds, and withdraws his arm from painful stimuli. What is his Glasgow Coma Scale (GCS) score?

Accepted Answer

GCS 8

Answer

GCS 7

Answer

GCS 9

Answer

GCS 6

Question 4

In an adult patient with a suspected isolated severe traumatic brain injury, prehospital providers should titrate fluid administration to maintain a minimum systolic blood pressure of at least:

Accepted Answer

110 mmHg

Answer

90 mmHg

Answer

120 mmHg

Answer

100 mmHg

Question 5

You are assessing a patient who was assaulted and struck in the head. You note their right pupil is 6mm and non-reactive to light, while the left pupil is 3mm and briskly reactive. This finding is most likely caused by:

Accepted Answer

Compression of the third cranial (oculomotor) nerve

Answer

The influence of opiate intoxication

Answer

Direct trauma to the left eyeball

Answer

Bilateral optic nerve damage

Question 6

For a TBI patient WITHOUT signs of active cerebral herniation, what is the recommended target range for end-tidal carbon dioxide (EtCO2) to avoid secondary brain injury?

Accepted Answer

35-45 mmHg

Answer

25-30 mmHg

Answer

30-35 mmHg

Answer

45-50 mmHg