PHTLS - Prehospital Trauma Life Support Scene Assessment and Safety 2 — Questions and Answers
Question 1: During scene size-up, what should the prehospital provider determine about the mechanism of injury?
- Only whether the injury was intentional or accidental
- The forces involved, body areas potentially affected, and number of patients (Correct answer)
- The exact speed of the vehicle at impact
- Whether the patient has insurance coverage
Correct answer: The forces involved, body areas potentially affected, and number of patients
Understanding the mechanism helps providers estimate energy transfer, predict injury patterns, and make appropriate triage and transport decisions.
Providers should determine: type of event, forces and energy involved, body regions likely affected, number of patients, and need for additional resources. For MVCs, this includes intrusion, rollover, ejection, and windshield damage.
Question 2: What does PHTLS identify as the most common hazard that injures or kills emergency responders at scene?
- Hazardous materials exposure
- Traffic-related incidents at roadway scenes (Correct answer)
- Structural collapse
- Electrical hazards
Correct answer: Traffic-related incidents at roadway scenes
Traffic-related incidents, including being struck by passing vehicles, are the leading cause of line-of-duty injuries and deaths for emergency responders.
Safe positioning practices include parking apparatus to create a buffer zone, wearing high-visibility reflective vests, placing cones and flares upstream, and positioning the largest vehicle at an angle upstream to protect the work zone.
Question 3: When should a prehospital provider NOT enter a trauma scene?
- When the patient appears critically injured
- When active hazards exist that have not been controlled (Correct answer)
- When bystanders are present
- When the incident occurred more than 30 minutes ago
Correct answer: When active hazards exist that have not been controlled
Providers should never enter a scene with uncontrolled hazards as becoming a victim reduces available resources.
Examples include active shooter situations, hazardous materials, structural instability, active fire, downed power lines, and hostile environments. An injured provider becomes an additional patient requiring rescue resources.
Question 4: What information should be relayed to dispatch during the scene size-up that may change the response?
- Patient's name and date of birth
- Number of patients, apparent severity, special hazards, and resource needs (Correct answer)
- Exact diagnosis of each patient's injuries
- Estimated time to clear the scene
Correct answer: Number of patients, apparent severity, special hazards, and resource needs
Early communication about patient count, severity, hazards, and resource needs allows dispatch to send appropriate additional resources.
Critical information includes exact location, number of patients, apparent severity, specific hazards, resource needs, and access/egress issues. This allows proactive resource deployment.
Question 5: According to PHTLS, how should a prehospital provider approach a trauma patient at a crime scene?
- Avoid the patient until police complete their investigation
- Provide patient care while minimizing disturbance to potential evidence (Correct answer)
- Collect all evidence and give it to police before treating
- Ignore all crime scene considerations and focus only on patient care
Correct answer: Provide patient care while minimizing disturbance to potential evidence
Patient care is the priority, but providers should minimize evidence disturbance when possible.
Practical steps include documenting the patient's initial position, avoiding unnecessary movement of objects, cutting around bullet holes in clothing, and noting anything unusual observed. No patient should ever have care delayed to preserve evidence.
Question 6: What role does environmental assessment play in the PHTLS scene size-up?
- It only matters for hypothermia risk
- It identifies weather, terrain, lighting, and conditions that affect patient care and provider safety (Correct answer)
- It determines which hospital to transport to
- It is only relevant for wilderness rescue scenarios
Correct answer: It identifies weather, terrain, lighting, and conditions that affect patient care and provider safety
Environmental conditions including weather, terrain, lighting, temperature, and accessibility all affect patient care and provider safety.
Weather affects hypothermia risk and helicopter availability. Terrain influences access and transport options. Lighting affects assessment quality. Temperature extremes influence treatment priorities. These factors must be integrated into clinical decision-making.
PHTLS - Prehospital Trauma Life Support Scene Assessment and Safety 2
During scene size-up, what should the prehospital provider determine about the mechanism of injury?