PHTLS Traumatic Brain Injury 2

Question 1

A patient with a severe TBI has a GCS of 6 and a systolic BP of 80 mmHg. What is the PHTLS priority for this patient?

Accepted Answer

Restore systolic BP to ≥90 mmHg as quickly as possible

Answer

Hypotension (SBP <90 mmHg) doubles mortality in severe TBI, so restoring perfusion pressure is the immediate priority.

Question 2

Which herniation pattern is characterized by unilateral fixed and dilated pupil combined with contralateral motor weakness?

Accepted Answer

Uncal (transtentorial) herniation

Answer

Uncal herniation compresses CN III on the ipsilateral side, causing a blown pupil, and compresses the cerebral peduncle, causing contralateral weakness.

Question 3

In the context of TBI, what does the Monroe-Kellie doctrine state?

Accepted Answer

The skull is a rigid compartment so any volume increase must displace another component

Answer

The Monroe-Kellie doctrine holds that brain, blood, and CSF occupy a fixed skull volume, so expansion of one component compresses the others.

Question 4

A TBI patient is breathing at a rate of 6 breaths per minute. What is the PHTLS-recommended bag-valve-mask intervention?

Accepted Answer

Assist ventilations to achieve 10 breaths/min for adults

Answer

PHTLS recommends assisting ventilation to approximately 10 breaths/min in adults to correct hypoventilation without causing harmful hypocapnia.

Question 5

Which of the following BEST describes cerebral perfusion pressure (CPP)?

Accepted Answer

Mean arterial pressure minus intracranial pressure

Answer

CPP = MAP − ICP; maintaining adequate CPP is the primary goal in managing severe TBI.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS Traumatic Brain Injury 2