PHTLS Shock and Hemorrhage Control 3

Question 1

Tranexamic acid (TXA) is most effective when administered within what time frame after traumatic injury?

Accepted Answer

Within 3 hours

Answer

The CRASH-2 trial demonstrated TXA is most effective when given within 3 hours of injury; after this window it may increase mortality.

Question 2

A patient has an arterial bleed from the axilla that cannot be controlled with a standard tourniquet. What is the BEST hemorrhage control option?

Accepted Answer

Pack the wound with hemostatic gauze and apply direct pressure

Answer

Junctional wounds like the axilla cannot be controlled with a standard tourniquet, so wound packing with hemostatic gauze and sustained direct pressure is the appropriate technique.

Question 3

What is the primary mechanism by which hypothermia worsens hemorrhagic shock?

Accepted Answer

It impairs coagulation enzyme function

Answer

Clotting enzymes are temperature-dependent; hypothermia slows their activity, impairing coagulation and worsening the lethal triad.

Question 4

Which component of Damage Control Resuscitation (DCR) directly addresses dilutional coagulopathy?

Accepted Answer

High-ratio packed red blood cells to FFP

Answer

DCR uses a balanced 1:1:1 ratio of PRBCs to FFP to platelets to replace all lost blood components and prevent dilutional coagulopathy.

Question 5

A motorcyclist ejected at high speed has distended neck veins, absent breath sounds on the left, and hypotension. After needle decompression fails to improve vitals, what condition should you consider?

Accepted Answer

Cardiac tamponade

Answer

Persistent hypotension with distended neck veins after ruling out tension pneumothorax suggests cardiac tamponade (Beck's triad), which requires pericardiocentesis or thoracotomy.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Shock and Hemorrhage Control 3