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Elscores: Aug. 27, 24- 2024/2025
ABSITE Trauma Questions and Answers
When does the first mortality peak for trauma occur?
:-- Within seconds to minutes after injury
The trauma system and acute patient care has the greatest impact on patients in which mortality
peak for trauma?
:-- Second mortality peak (golden hour)
Most of the deaths during the second mortality peak for trauma occur from?
:-- Hemorrhage, central nervous system injuries
When does the third mortality peak for trauma occur?
:-- 24 hours after injury, from multisystem organ failure and sepsis
How long should the primary survey in the initial evaluation of a trauma patient take?
:-- No more than 5 minutes, unless an intervention is needed.
What mnemonic is used to conduct the primary survey?
:-- ABCDE: Airway, Breathing, Circulation, Disability, Exposure
What are the goals during airway assessment?
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Elscores: Aug. 27, 24- 2024/2025
:-- Secure the airway, protect the spinal cord
What is required for spinal immobilization?
:-- A rigid cervical collar, use of a full backboard
Contraindications to nasotracheal intubation:
:-- Apnea, maxillofacial fracture
What is the quickest way to test for an adequate airway in an awake, alert patient?
:-- Ask a question, if the patient is able to speak the airway is intact.
Indications for a surgical airway:
:-- Anatomic distortion as a result of neck injury, massive maxillofacial trauma, inability
to visualize the vocal cords (blood, secretions, airway edema)
What are the goals during the breathing assessment?
:-- Secure oxygenation and ventilation; treat life-threatening thoracic injuries
What should be done on physical examination to adequately assess breathing?
:-- Inspection (air movement, cyanosis, tracheal shift, JVD, respiratory rate, asymmetric
chest expansion, open chest wounds, use of accessory muscles of respiration)
Auscultation/percussion (hyperresonance or dullness over lung fields)
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Elscores: Aug. 27, 24- 2024/2025
Palpation (flail segments, subcutaneous emphysema)
What life-threatening conditions must be treated during the breathing assessment if
encountered?
:-- Open pneumothorax, tension pneumothorax, massive hemothorax
What is the most common cause for upper airway obstruction?
:-- The tongue
What is the preferred emergency airway procedure?
:-- Cricothyroidotomy
In a patient with poor peripheral upper extremity access, what alternative routes can be
considered for intravenous access?
:-- Femoral vein at the groin, venous cutdown on greater saphenous vein at the ankle,
subclavian vein, IJ
What are the goals of the circulation assessment?
:-- Treatment of bleeding, assuring adequate tissue perfusion
What is the initial test for adequate circulation?
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Elscores: Aug. 27, 24- 2024/2025
:-- Palpation of pulses
What systolic blood pressure are you expecting with a palpable radial pulse?
:-- 80 mm Hg
What systolic blood pressure are you expecting with a palpable femoral/carotid pulse?
:-- At least 60 mm Hg
What should be done of physical examination to adequately assess circulation?
:-- Obtain heart rate and blood pressure; check peripheral perfusion and capillary refill,
mental status; examine the skin
Which patients may not demonstrate tachycardia with hypovolemic shock?
:-- Patients on beta-blockers, well-conditioned athletes, patients with concomitant spinal
cord injury
During femoral catheter placement, what is the pneumonic used to remember the anatomy of
the groin?
:-- NAVEL (from lateral to medial): Nerve, Artery, Vein, Extralymphatic space,
Lymphatics
What is the preferred alternative route if intravenous access cannot be obtained on a small child?
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