PHTLS Pre & Post 5

Question 1

A 28-year-old motorcyclist is ejected at highway speed. Which pre-hospital assessment finding indicates the HIGHEST immediate life threat?

Accepted Answer

Absent breath sounds on the left with tracheal deviation to the right

Answer

Absent breath sounds with tracheal deviation indicates tension pneumothorax, which causes obstructive shock and death within minutes if untreated.

Question 2

In the PHTLS framework, which action is classified under 'Scene Size-Up' rather than the Primary Survey?

Accepted Answer

Determining mechanism of injury

Answer

Mechanism of injury assessment occurs during scene size-up before the provider contacts the patient, informing the index of suspicion for the primary survey.

Question 3

Which PHTLS principle BEST explains why on-scene time should be limited to 10 minutes or less for critical trauma patients?

Accepted Answer

Because definitive hemorrhage control can only be achieved in the operating room

Answer

For life-threatening internal hemorrhage, definitive care requires surgical intervention; prolonged scene time delays the only intervention that can stop the bleeding.

Question 4

A post-cardiac-arrest trauma patient has return of spontaneous circulation (ROSC). Which target should the PHTLS provider aim for regarding oxygenation?

Accepted Answer

SpO2 of 94–99% to avoid hyperoxia

Answer

Post-ROSC, PHTLS guidelines recommend targeting SpO2 94–99% because hyperoxia (SpO2 100%) can increase oxidative stress and worsen neurological outcomes.

Question 5

During post-incident critique of a multi-system trauma call, the team identifies that a tourniquet was applied 8 minutes after hemorrhage was recognized. What PHTLS principle does this violate?

Accepted Answer

Hemorrhage control as part of circulation management in the primary survey

Answer

In PHTLS, life-threatening external hemorrhage should be controlled during the C (Circulation/Hemorrhage control) step of the primary survey, not deferred.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Pre & Post 5