ITLS - International Trauma Life Support: Q’s And A’s
Which injuries are by and large responsible for the majority of mortality from
trauma in the world? Right Ans - Motion
What are the three separate events in an MVC? Right Ans - Machine
collision, body collision, organ collision
Five forms of MVCs? Right Ans - Frontal, lateral, rear, rollover, rotational
Common injuries for frontal collisions? Right Ans - Windshield, whiplash,
steering wheel, compression, dashboard
Common injuries for lateral collisions? Right Ans - Lateral displacement,
side impact
Common injuries for rear collisions? Right Ans - Whiplash, spinal,
deceleration
Common injuries for rollover collisions? Right Ans - Axial-loading,
ejections, impact, whiplash, etc.
Common injuries for rotational collisions? Right Ans - frontal impact,
lateral impact injuries
Should you board someone with a penetrating injury if the injury is not near
the spine? Right Ans - No
What are the five different blast injuries? Right Ans - Primary, secondary,
tertiary, quaternary, quinary
Primary blast injuries? Right Ans - initial air blast
Secondary blast injuries? Right Ans - shrapnel hits
Tertiary blast injuries? Right Ans - body being thrown into ground or other
objects
,Quaternary blast injuries? Right Ans - Thermal burns or respiratory
injuries from inhalation of fumes
Quinary blast injuries? Right Ans - contamination by chemical, biological,
or radiological material
What is the highest cause of death in young people? Right Ans - Trauma
What are the three things that you're allowed to interrupt the primary
survey? Right Ans - Scene becomes unsafe, treatment of airway
obstruction, treatment of cardiac arrest
What's the goal to complete primary survey? Right Ans - less than two
minutes and on scene time of 5 minutes or less
What is the "fix-it" process? Right Ans - Delegating to team interventions
and continuing the assessment
What's the first thing to be done in a trauma? Right Ans - Control bleeding
then airway
If the chest is moving but you don't feel air, is the pt breathing adequately?
Right Ans - No
What is the general rule for all patients with multi-system trauma? Right
Ans - High-flow supplemental oxygen, keeping the pulse oximeter reading
around 95% rather than 100%
What should be done with bleeding that is not controlled with pressure?
Right Ans - Tourniquet, if a hemostatic agent and pressure fails.
When should you obtain a SAMPLE history and why? Right Ans - At the
same time you are performing the pt assessment (another EMT can be doing
this) because you may be obtaining info from bystanders who won't be
transporting.
What are the critical injuries and conditions in which you should transport
immediately? Right Ans - AMS, abnormal breathing, abnormal circulation,
,injuries that could lead to shock, significant mechanism of injury or general
health
What procedures should not be performed before rapid transport? Right
Ans - non-lifesaving procedures such as splinting, bandaging, IV access, or
elective endotracheal intubation
Per ITLS, when should reassessment in the ongoing exam occur? Right Ans
- critical patients every 5 minutes, stable patients every 15 minutes.
During what occurrences, should the ongoing exam be performed? Right
Ans - each time the pt is moved, each time an intervention is performed, any
time the patient's condition worsens.
When should a secondary assessment be performed? Right Ans - During
transport rather than on scene, unless primary survey does not reveal a
critical condition
What does TIC stand for? Right Ans - Tenderness, instability, and crepitus
When should a glucose check be obtained for AMS in a trauma? Right Ans -
Ongoing exam
What is serum lactate a good marker for? Right Ans - Tissue hypoxia,
predictor of shock
What is a FAST exam and what is it good for? Right Ans - Focused
Assessment with Sonography in Trauma, good for assessing trauma in the
abdomen
What is the chest wall comprised of? Right Ans - skin, subcutaneous tissue,
muscle, ribs, and the neurovascular bundle (which runs around the lower
border of the rib)
How much blood can the adult thoracic cavity contain? Right Ans - Up to 3
liters on each side
What does the mediastinum include? Right Ans - heart, aorta, pulmonary
artery, superior and inferior vena cava, trachea, major bronchi, and esophagus
, Where is the diaphragm located? Right Ans - lower six ribs and xyphoid
process
What nerve innervates the diaphragm and where does it originate in the
cervical spine? Right Ans - Phrenic nerve, originating from C3-C5
What injuries are responsible for most deaths on scene? Right Ans - Chest
injuries
What life-threatening thoracic should be identified immediately during the
ITLS primary survey? Right Ans - Airway obstruction, flail chest, open
pnuemo, massive hemothorax, tension pnuemo, cardiac tamponade
What injuries should be identified during the ITLS secondary survey? Right
Ans - Myocaradial contusion, traumatic aortic rupture, tracheal or bronchial
tree injury, diaphragmatic tears, pulmonary contusion, blast injuries
Can flail segments be seen in the posterial wall? Right Ans - Not typically
due to the muscles
How are large flail chests best treated? Right Ans - ET ventilation, and
assisted ventilation with PEEP
How are small flail chests best treated? Right Ans - Oxygen and CPAP
ventilation
What effect does an open pneumothorax have on intrathoracic pressure?
Right Ans - It equalizes the intrathoracic pressure and atmospheric pressures
resulting in partial or complete lung collapse
What is a massive hemothorax? Right Ans - hemothorax resulting in at
least 1500 cc blood loss in the pleural space
Signs of a tension pneumothorax? Right Ans - decreased LOC,
rapid/shallow breathing, weak/thready/absent radials,
diaphoretic/cool/clammy/cyanotic, JVD, TD, decreased/absent breath sound,
hyper-resonant sound on one side
Which injuries are by and large responsible for the majority of mortality from
trauma in the world? Right Ans - Motion
What are the three separate events in an MVC? Right Ans - Machine
collision, body collision, organ collision
Five forms of MVCs? Right Ans - Frontal, lateral, rear, rollover, rotational
Common injuries for frontal collisions? Right Ans - Windshield, whiplash,
steering wheel, compression, dashboard
Common injuries for lateral collisions? Right Ans - Lateral displacement,
side impact
Common injuries for rear collisions? Right Ans - Whiplash, spinal,
deceleration
Common injuries for rollover collisions? Right Ans - Axial-loading,
ejections, impact, whiplash, etc.
Common injuries for rotational collisions? Right Ans - frontal impact,
lateral impact injuries
Should you board someone with a penetrating injury if the injury is not near
the spine? Right Ans - No
What are the five different blast injuries? Right Ans - Primary, secondary,
tertiary, quaternary, quinary
Primary blast injuries? Right Ans - initial air blast
Secondary blast injuries? Right Ans - shrapnel hits
Tertiary blast injuries? Right Ans - body being thrown into ground or other
objects
,Quaternary blast injuries? Right Ans - Thermal burns or respiratory
injuries from inhalation of fumes
Quinary blast injuries? Right Ans - contamination by chemical, biological,
or radiological material
What is the highest cause of death in young people? Right Ans - Trauma
What are the three things that you're allowed to interrupt the primary
survey? Right Ans - Scene becomes unsafe, treatment of airway
obstruction, treatment of cardiac arrest
What's the goal to complete primary survey? Right Ans - less than two
minutes and on scene time of 5 minutes or less
What is the "fix-it" process? Right Ans - Delegating to team interventions
and continuing the assessment
What's the first thing to be done in a trauma? Right Ans - Control bleeding
then airway
If the chest is moving but you don't feel air, is the pt breathing adequately?
Right Ans - No
What is the general rule for all patients with multi-system trauma? Right
Ans - High-flow supplemental oxygen, keeping the pulse oximeter reading
around 95% rather than 100%
What should be done with bleeding that is not controlled with pressure?
Right Ans - Tourniquet, if a hemostatic agent and pressure fails.
When should you obtain a SAMPLE history and why? Right Ans - At the
same time you are performing the pt assessment (another EMT can be doing
this) because you may be obtaining info from bystanders who won't be
transporting.
What are the critical injuries and conditions in which you should transport
immediately? Right Ans - AMS, abnormal breathing, abnormal circulation,
,injuries that could lead to shock, significant mechanism of injury or general
health
What procedures should not be performed before rapid transport? Right
Ans - non-lifesaving procedures such as splinting, bandaging, IV access, or
elective endotracheal intubation
Per ITLS, when should reassessment in the ongoing exam occur? Right Ans
- critical patients every 5 minutes, stable patients every 15 minutes.
During what occurrences, should the ongoing exam be performed? Right
Ans - each time the pt is moved, each time an intervention is performed, any
time the patient's condition worsens.
When should a secondary assessment be performed? Right Ans - During
transport rather than on scene, unless primary survey does not reveal a
critical condition
What does TIC stand for? Right Ans - Tenderness, instability, and crepitus
When should a glucose check be obtained for AMS in a trauma? Right Ans -
Ongoing exam
What is serum lactate a good marker for? Right Ans - Tissue hypoxia,
predictor of shock
What is a FAST exam and what is it good for? Right Ans - Focused
Assessment with Sonography in Trauma, good for assessing trauma in the
abdomen
What is the chest wall comprised of? Right Ans - skin, subcutaneous tissue,
muscle, ribs, and the neurovascular bundle (which runs around the lower
border of the rib)
How much blood can the adult thoracic cavity contain? Right Ans - Up to 3
liters on each side
What does the mediastinum include? Right Ans - heart, aorta, pulmonary
artery, superior and inferior vena cava, trachea, major bronchi, and esophagus
, Where is the diaphragm located? Right Ans - lower six ribs and xyphoid
process
What nerve innervates the diaphragm and where does it originate in the
cervical spine? Right Ans - Phrenic nerve, originating from C3-C5
What injuries are responsible for most deaths on scene? Right Ans - Chest
injuries
What life-threatening thoracic should be identified immediately during the
ITLS primary survey? Right Ans - Airway obstruction, flail chest, open
pnuemo, massive hemothorax, tension pnuemo, cardiac tamponade
What injuries should be identified during the ITLS secondary survey? Right
Ans - Myocaradial contusion, traumatic aortic rupture, tracheal or bronchial
tree injury, diaphragmatic tears, pulmonary contusion, blast injuries
Can flail segments be seen in the posterial wall? Right Ans - Not typically
due to the muscles
How are large flail chests best treated? Right Ans - ET ventilation, and
assisted ventilation with PEEP
How are small flail chests best treated? Right Ans - Oxygen and CPAP
ventilation
What effect does an open pneumothorax have on intrathoracic pressure?
Right Ans - It equalizes the intrathoracic pressure and atmospheric pressures
resulting in partial or complete lung collapse
What is a massive hemothorax? Right Ans - hemothorax resulting in at
least 1500 cc blood loss in the pleural space
Signs of a tension pneumothorax? Right Ans - decreased LOC,
rapid/shallow breathing, weak/thready/absent radials,
diaphoretic/cool/clammy/cyanotic, JVD, TD, decreased/absent breath sound,
hyper-resonant sound on one side
