PHTLS Pre & Post 4

Question 1

During scene size-up, which finding most strongly suggests a high-energy mechanism of injury requiring full spinal precautions?

Accepted Answer

Intrusion of >12 inches into the passenger compartment

Answer

Greater than 12 inches of intrusion into the passenger compartment indicates high-energy transfer and mandates full spinal precautions regardless of symptoms.

Question 2

A PHTLS provider arrives at a mass casualty incident with 20 patients. What is the FIRST action to take?

Accepted Answer

Secure the scene and ensure personal safety

Answer

Scene safety is always the first priority; providers cannot help patients if they become casualties themselves.

Question 3

Which pre-hospital vital sign trend in a trauma patient BEST indicates early decompensated shock?

Accepted Answer

Heart rate 130, BP 88/60, RR 26

Answer

A heart rate >120, systolic BP <90, and RR >20 together represent the classic triad of decompensated hemorrhagic shock.

Question 4

In PHTLS, 'permissive hypotension' during fluid resuscitation of a penetrating torso trauma patient targets a systolic BP of approximately:

Accepted Answer

80–90 mmHg

Answer

Permissive hypotension targets a systolic BP of 80–90 mmHg to maintain end-organ perfusion while minimizing clot disruption before surgical hemorrhage control.

Question 5

A post-resuscitation patient who was GCS 8 on arrival improves to GCS 14 after airway management and oxygenation. What does this MOST likely indicate?

Accepted Answer

Hypoxia was a major contributor to the altered mental status

Answer

Rapid improvement in GCS following airway management strongly suggests hypoxia was the primary driver of altered mental status rather than structural brain injury.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Pre & Post 4