PHTLS Airway and Ventilation 4

Question 1

A trauma patient with severe facial injuries has an unsecurable airway via orotracheal intubation. What is the next definitive option?

Accepted Answer

Surgical cricothyrotomy

Answer

Surgical cricothyrotomy is the definitive rescue airway when oral and nasal intubation are not possible due to facial trauma.

Question 2

In PHTLS, what does the mnemonic 'MOANS' help assess?

Accepted Answer

Anticipated difficulty of bag-valve-mask ventilation

Answer

MOANS (Mask seal, Obesity/Obstruction, Age, No teeth, Stiff) predicts difficulty with BVM ventilation before intubation.

Question 3

What physiologic effect does hyperventilation cause in a trauma patient with TBI that makes it harmful?

Accepted Answer

Causes cerebral vasoconstriction reducing blood flow and oxygen delivery

Answer

Hyperventilation lowers CO2, causing cerebral vasoconstriction that reduces cerebral blood flow and worsens ischemia in the injured brain.

Question 4

A patient has diminished breath sounds on the left with a deviated trachea to the right and a BP of 70/40. Which condition does this represent?

Accepted Answer

Left-sided tension pneumothorax

Answer

Left-sided absent breath sounds, rightward tracheal deviation, and shock are classic signs of left-sided tension pneumothorax.

Question 5

When using a two-handed BVM technique during trauma resuscitation, why is it preferred over single-handed technique?

Accepted Answer

It achieves a better mask seal and reduces leak, improving ventilation

Answer

A two-person technique with two hands on the mask creates a superior seal, ensuring more consistent tidal volume delivery.

PHTLS - Prehospital Trauma Life Support Practice Test