ITLS - International Trauma Life Support Thoracic and Abdominal Trauma Questions and Answers

Question 1

A patient with multiple rib fractures after a blunt force injury to the chest develops paradoxical chest wall motion.
They are becoming increasingly anxious, tachypneic, and hypoxic.
What is the most appropriate and critical intervention for managing the respiratory compromise associated with this flail chest?

Accepted Answer

Provide positive pressure ventilation with a bag-valve-mask.

Answer

Administer high-flow oxygen and apply a bulky dressing to the flail segment.

Answer

Position the patient lying on the injured side to splint the chest.

Answer

Perform immediate needle decompression of the affected side.

Question 2

You are treating a patient with a penetrating abdominal wound and a loop of small intestine is protruding. Which of the following describes the correct prehospital management for this abdominal evisceration?

Accepted Answer

Cover the exposed organ with a sterile, saline-moistened dressing.

Answer

Gently attempt to replace the intestine back into the abdominal cavity.

Answer

Apply a dry sterile dressing and firm direct pressure to the organ.

Answer

Pack the wound around the intestine with sterile gauze to control bleeding.

Question 3

A patient sustained a stab wound to the central chest. During your assessment, you note hypotension, distended jugular veins, and muffled heart sounds. This triad of signs, known as Beck's Triad, is most indicative of which life-threatening condition?

Accepted Answer

Pericardial (cardiac) tamponade

Answer

Massive hemothorax

Answer

Tension pneumothorax

Answer

Aortic dissection

Question 4

A patient involved in a motorcycle collision has significant tenderness in the left upper abdominal quadrant and complains of pain in their left shoulder (Kehr's sign). The patient is pale, with a heart rate of 120 and a blood pressure of 98/60 mmHg. These findings are most concerning for a lacerated:

Accepted Answer

Spleen

Answer

Liver

Answer

Stomach

Answer

Kidney

Question 5

You are assessing a patient with a gunshot wound to the right chest who is in profound shock. You note absent breath sounds on the right side and flat neck veins. Which of these two critical thoracic injuries is most likely, given the state of the neck veins?

Accepted Answer

Massive hemothorax

Answer

Tension pneumothorax

Answer

Open pneumothorax

Answer

Pulmonary contusion

Question 6

What is the single most important prehospital intervention for a hemodynamically unstable patient with suspected significant intra-abdominal hemorrhage following blunt trauma?

Accepted Answer

Minimizing on-scene time and ensuring rapid transport to a trauma center.

Answer

Initiating two large-bore IVs and rapidly infusing 2 liters of crystalloid.

Answer

Performing a detailed abdominal assessment to locate the source of pain.

Answer

Applying a pneumatic anti-shock garment (PASG).