PHTLS Special Trauma Considerations 3

Question 1

A trauma patient is found to be 8 months pregnant and has no palpable pulse after blunt chest trauma. After 4 minutes of unsuccessful resuscitation, the most appropriate next step is:

Accepted Answer

Perform field cesarean delivery to improve maternal CPR effectiveness

Answer

Perimortem cesarean delivery (resuscitative hysterotomy) performed within 4-5 minutes of cardiac arrest can relieve aortocaval compression and improve maternal CPR outcomes.

Question 2

Which of the following best explains why children are at higher risk for hypothermia following trauma compared to adults?

Accepted Answer

Children have a greater surface area-to-body mass ratio

Answer

Children's larger surface area relative to their body mass results in more rapid heat loss to the environment after trauma.

Question 3

An intoxicated trauma patient has a GCS of 12. The PHTLS provider should:

Accepted Answer

Assume a concurrent traumatic brain injury until proven otherwise

Answer

Alcohol intoxication and TBI present similarly; providers must assume TBI in any intoxicated trauma patient to avoid undertreating a potentially life-threatening injury.

Question 4

When managing an obese trauma patient, which assessment finding is most likely to be UNDERESTIMATED due to body habitus?

Accepted Answer

Severity of abdominal tenderness and rigidity

Answer

Thick abdominal adipose tissue can mask peritoneal signs, leading to underestimation of intra-abdominal injury severity on physical exam.

Question 5

A trauma patient who is a Jehovah's Witness declines blood transfusion. The patient is conscious, alert, and has decision-making capacity. The PHTLS provider should:

Accepted Answer

Document the refusal, focus on volume-sparing hemorrhage control, and transport

Answer

A competent adult has the right to refuse treatment; the provider should respect this, document it thoroughly, optimize hemorrhage control without blood products, and transport.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Special Trauma Considerations 3