ITLS - International Trauma Life Support Patient Assessment and Management Questions and Answers 1 — Questions and Answers
Question 1: During the ITLS Primary Survey of a trauma patient, which of the following is the correct and immediate action for an identified airway obstruction?
- Continue the survey to assess breathing and circulation.
- Immediately intervene to clear the obstruction before proceeding. (Correct answer)
- Complete the full primary survey and then address the airway.
- Apply a cervical collar and move to the breathing assessment.
Correct answer: Immediately intervene to clear the obstruction before proceeding.
The ITLS Primary Survey protocol dictates that it should only be interrupted for scene safety issues, airway obstruction, or cardiac arrest. A compromised airway is an immediate life threat that must be managed before any other assessment or intervention continues.
Question 2: You are assessing a 34-year-old male who was the unrestrained driver in a high-speed frontal impact collision. He is unconscious, tachycardic, and hypotensive. His trachea is deviated to the left, and he has absent breath sounds on the right side of his chest. Which intervention is the highest priority?
- Initiating two large-bore IVs and administering a fluid bolus.
- Applying a pelvic binder due to the high-risk mechanism.
- Performing needle decompression of the right chest. (Correct answer)
- Immediately securing the patient to a long spine board for transport.
Correct answer: Performing needle decompression of the right chest.
The patient's signs and symptoms—tracheal deviation, absent breath sounds on one side, and hemodynamic instability after thoracic trauma—are classic indicators of a tension pneumothorax. This is an immediate life threat that requires urgent decompression to relieve pressure on the heart and great vessels, thereby restoring circulation.
Question 3: Which of the following is a key component of the ITLS Secondary Survey?
- A rapid head-to-toe check for life-threatening injuries.
- Obtaining a SAMPLE history. (Correct answer)
- Assessing airway, breathing, and circulation (ABCs).
- Determining the patient's level of consciousness using AVPU.
Correct answer: Obtaining a SAMPLE history.
The ITLS Secondary Survey is a more detailed, systematic head-to-toe examination performed after the primary survey and immediate life-saving interventions are complete. A critical part of this survey is gathering a patient history using the AMPLE or SAMPLE mnemonic (Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading to injury).
Question 4: In the assessment of a pediatric trauma patient, which finding should be considered a more significant indicator of shock compared to an adult patient?
- Hypotension.
- Tachycardia. (Correct answer)
- Altered mental status.
- Slow capillary refill.
Correct answer: Tachycardia.
Children can maintain their blood pressure for a longer period during shock due to a robust compensatory mechanism. Tachycardia is often one of the earliest and most reliable signs of shock in a pediatric patient. Hypotension is a late and ominous sign, indicating decompensated shock.
Question 5: A patient has sustained a penetrating injury to the chest and you have identified an open pneumothorax (sucking chest wound). What is the appropriate initial management for this injury in the field?
- Pack the wound with sterile gauze.
- Immediately perform a needle decompression.
- Apply an occlusive dressing taped on three sides. (Correct answer)
- Log roll the patient onto the injured side.
Correct answer: Apply an occlusive dressing taped on three sides.
The correct management for an open pneumothorax is to apply an occlusive dressing taped on three sides. This creates a one-way valve effect, allowing air to escape from the pleural space during exhalation but preventing air from entering during inhalation, which helps to prevent the development of a tension pneumothorax.
Question 6: According to ITLS guidelines, a Rapid Trauma Survey is performed instead of a Focused Exam when which of the following is present?
- An isolated injury to a single limb.
- The patient complains of pain in only one specific area.
- A significant mechanism of injury. (Correct answer)
- The patient is alert, oriented, and has stable vital signs.
Correct answer: A significant mechanism of injury.
A Rapid Trauma Survey is a quick, systematic head-to-toe assessment to identify all life-threatening injuries. It is indicated for patients with a significant mechanism of injury, an altered mental status, or abnormal findings in the Initial Assessment, as these suggest a higher likelihood of multi-system trauma. A Focused Exam is reserved for patients with a minor, isolated injury and no significant mechanism.
ITLS - International Trauma Life Support Patient Assessment and Management Questions and Answers 1
During the ITLS Primary Survey of a trauma patient, which of the following is the correct and immediate action for an identified airway obstruction?