PHTLS Thoracic Trauma 4

Question 1

A trauma patient has no breath sounds on the left after intubation. The most immediate action is to:

Accepted Answer

Withdraw the ETT 2 cm and reassess breath sounds

Answer

Absent unilateral breath sounds after intubation most commonly indicate right mainstem intubation; withdrawing the ETT slightly and reassessing is the first corrective action.

Question 2

Which of the following best explains why pulmonary contusion causes hypoxemia?

Accepted Answer

Hemorrhage into alveoli creates an intrapulmonary shunt

Answer

Blood-filled alveoli are perfused but not ventilated, creating an intrapulmonary shunt that results in hypoxemia refractory to supplemental oxygen.

Question 3

In the PHTLS approach, which of the following thoracic injuries is managed primarily by rapid transport rather than scene intervention?

Accepted Answer

Cardiac tamponade

Answer

Cardiac tamponade requires pericardiocentesis or surgical drainage, which are hospital-level interventions; prehospital care focuses on rapid transport and supportive care.

Question 4

A 55-year-old is ejected from a vehicle and presents with subcutaneous emphysema across the entire chest and neck. What thoracic injury should be highest on the differential?

Accepted Answer

Tracheobronchial injury

Answer

Widespread subcutaneous emphysema following blunt thoracic trauma is a hallmark of tracheobronchial disruption, allowing large volumes of air to escape into soft tissues.

Question 5

Which of the following is the most reliable clinical sign distinguishing tension pneumothorax from massive hemothorax in the field?

Accepted Answer

Tracheal deviation and neck vein status

Answer

Tension pneumothorax causes JVD and tracheal deviation from increased intrathoracic pressure, while massive hemothorax produces flat neck veins due to hemorrhagic shock.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Thoracic Trauma 4