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ATLS Shock Exam Questions and Answers 2024/2025( A+ GRADED 100% VERIFIED).
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ATLS Shock Exam Questions and Answers 2024/2025( A+ GRADED 100% VERIFIED).
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ATLS ShockWhat is the first step in managing shock in trauma patients? - ANS recognize its presence
What is shock? - ANS abnormality of the circulatory system that results in inadequate organ
perfusion and tissue oxygenation
What is the second step in managing shock in trauma patients? - ANS identify probable cause
of shock and adjust treatment accordingly
What is the most common cause of shock in trauma patients? - ANS Hemorrhage
What is the most effective method of restoring adequate cardiac output, end organ perfusion,
and tissue oxygenation? - ANS Restore venous return to normal by locating and stopping the
source of bleeding
-volume repletion will allow recovery from shock state only when bleeding has stopped
What are the goals of treating hemorrhagic shock? - ANS -definitive control of hemorrhage and
restoration of adequate circulating volume
Narrowed pulse pressure suggests what? - ANS significant blood loss and involvement of
compensatory mechanisms
What is the most common cause of shock after injury and virtually all patients with multiple
injuries also have some degree of what? - ANS Hemorrhage; hypovolemia
What is the focus in hemorrhagic shock? - ANS promptly identify and stop hemorrhage
what selected additional tests can confirm the cause of shock but not delay appropriate
resuscitation? - ANS chest and pelvic x-rays and FAST exam
What additional adjuncts may be necessary to determine the source of blood loss? - ANS chest
x-ray, pelvic x-ray, abdominal assessment with either FAST or DPL, and bladder catheterization
Class I Hemorrhage - ANS exemplified by the condition of an individual who has donated 1 unit
of blood
-<15%
-clinical symptoms of volume loss are minimal
-uncomplicated situations, minimal tachycardia occurs
-No changes in BP, pulse pressure, or respiratory rate
-Does not require replacement cause transcapillary refill and other compensatory mechanisms
will restore blood volume in 24 hours
, What is the base deficit of class I hemorrhage? - ANS 0 to -2 mEq/L
Class II hemorrhage - ANS -uncomplicated hemorrhage for which crystalloid fluid resuscitation
is required
-15-30% blood volume loss
-clinical signs: tachycardia, tachypnea, and decreased pulse pressure
-Later sign: rise in diastolic blood pressure due to increase in circulating catecholamines
-CNS changes - anxiety, fever, hostility
-Urine output mildly affected
-measured urine output 20-30mL/hour
-May eventually require blood transfusion
What is the base deficit for class II hemorrhage? - ANS -2 to -6 mEq/L
Class III hemorrhage - ANS -31-40% blood volume loss
-inadequate perfusion including marked tachycardia and tachypnea, significant changes in
mental status, measurable fall in systolic blood pressure
-priority of initial management is to stop hemorrhage by emergency operation or embolization
-most patients will require packed red blood cells and blood products to reverse shock state
What is the base deficit for class III hemorrhage? - ANS -6 to -10 mEq/L
Class IV hemorrhage - ANS ->40% blood volume loss
--degree of exsanguination is immediately life threatening
-marked tachycardia, significant decrease in systolic blood pressure, and a very narrow pulse
pressure or unmeasurable and mental status is markedly depressed
-skin is cold and pale
-frequently require rapid transfusion and immediate surgical intervention
What is the base deficit for class IV hemorrhage? - ANS -10 mEq/L or less
What factors may confound and profoundly alter the classic hemodynamic response to the
acute loss of circulating blood volume? - ANS patient age, severity of injury (particularly the
type and anatomic location of injury), time lapse between injury and initiation of treatment,
prehospital fluid therapy, and medications used for chronic conditions
What 2 ways do major soft tissue injuries and fractures compromise hemodynamic status of
injured patients? - ANS 1. blood is lost into site of injury particularly major fractures
-fractured tibia or humerus: loss of up to 750mL of blood
-femur fractures: 1500mL
-several liters of blood can accumulate in a retroperitoneal
hematoma associated with pelvic fracture
2. edema that occurs in injured soft tissues constitutes another source of fluid loss
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