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

PHTLS identifies hypoxia and hypotension as the two most devastating secondary insults to the injured brain.

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

PHTLS classifies TBI as Mild (GCS 13-15), Moderate (GCS 9-12), and Severe (GCS 3-8).

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

A unilateral fixed and dilated pupil indicates compression of the third cranial nerve from uncal herniation.

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

PHTLS recommends maintaining SBP >110 mmHg in severe TBI patients to ensure adequate cerebral perfusion pressure.

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

PHTLS restricts hyperventilation to cases showing signs of active herniation as a temporizing measure, targeting ETCO2 of 30-35 mmHg.

PHTLS - Prehospital Trauma Life Support Practice Test