PHTLS Shock and Hemorrhage Control 5

Question 1

A 22-year-old stab victim has a wound to the right groin with pulsatile bright red bleeding. After failed tourniquet placement, what is the best hemorrhage control technique?

Accepted Answer

Use a junctional tourniquet device (e.g., SAM-JT or JETT) or deep wound packing

Answer

Groin wounds with arterial hemorrhage require junctional hemorrhage control devices or deep wound packing since standard limb tourniquets cannot achieve adequate compression at this location.

Question 2

Which of the following BEST describes 'obstructive shock' in the trauma setting?

Accepted Answer

Shock caused by a physical impediment to cardiac output

Answer

Obstructive shock results from a mechanical barrier to cardiac output, such as tension pneumothorax or cardiac tamponade, preventing adequate forward flow.

Question 3

During reassessment of a trauma patient, you note the original tourniquet site has been on for 90 minutes. The patient is now at the hospital. What is the CORRECT action?

Accepted Answer

Notify the receiving team of the application time and leave removal to the surgical team

Answer

Tourniquet removal should be performed only by the surgical team in a controlled setting; prehospital providers must document and communicate the application time to the receiving team.

Question 4

In hemorrhagic shock, which organ is MOST vulnerable to ischemic injury due to its high metabolic demand and limited tolerance for hypoperfusion?

Accepted Answer

Cardiac myocytes

Answer

Cardiac myocytes have very high oxygen demands and limited anaerobic capacity, making the heart extremely vulnerable to ischemia during states of reduced perfusion.

Question 5

A patient with a penetrating chest wound develops worsening respiratory distress, tracheal deviation, and absent breath sounds on the right. After needle decompression at the 2nd intercostal space, midclavicular line, symptoms persist. What is the next step?

Accepted Answer

Perform needle decompression at the 4th/5th ICS, anterior axillary line

Answer

If needle decompression at the 2nd ICS MCL fails, PHTLS guidelines recommend attempting decompression at the 4th or 5th intercostal space at the anterior axillary line as an alternative site.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Shock and Hemorrhage Control 5