PHTLS - Prehospital Trauma Life Support Traumatic Brain Injury 2

Question 1

What is the most important prehospital intervention to prevent secondary brain injury according to PHTLS?

Accepted Answer

Preventing hypoxia and hypotension

Answer

Administering mannitol in the field

Answer

Applying ice packs to the head

Answer

Elevating the head of the stretcher to 90 degrees

Question 2

How does the Glasgow Coma Scale classify traumatic brain injury severity?

Accepted Answer

Mild 13-15, Moderate 9-12, Severe 3-8

Answer

Mild 3-8, Moderate 9-12, Severe 13-15

Answer

All GCS scores below 15 are severe

Answer

GCS is not used for TBI classification

Question 3

What pupil findings suggest uncal herniation in a TBI patient?

Accepted Answer

Unilateral fixed and dilated pupil (blown pupil) on the side of the lesion

Answer

Bilateral pinpoint pupils

Answer

Bilateral equal and reactive pupils

Answer

Alternating pupil size with each assessment

Question 4

According to PHTLS, what blood pressure target should be maintained in a patient with severe TBI?

Accepted Answer

Systolic blood pressure greater than 110 mmHg

Answer

Any blood pressure that produces a palpable pulse

Answer

Permissive hypotension with SBP 80-90 mmHg

Answer

Blood pressure is not important in TBI management

Question 5

What is the role of hyperventilation in TBI management according to current PHTLS guidelines?

Accepted Answer

Hyperventilation is ONLY indicated as a temporizing measure when signs of cerebral herniation are present

Answer

Routine hyperventilation is recommended for all TBI patients

Answer

Hyperventilation should never be used under any circumstances

Answer

Hyperventilation is the primary treatment for all levels of TBI

Question 6

How should a scalp laceration with active hemorrhage be managed in a TBI patient?

Accepted Answer

Control hemorrhage aggressively with direct pressure and wound closure, as scalp bleeding can cause significant blood loss

Answer

Ignore the scalp wound and focus only on the brain injury

Answer

Apply a loose bandage only

Answer

Do not touch head wounds in TBI patients