PHTLS EXAM QUESTIONS AND ANSWERS SOLVED #17
Principles vs Preference - correct answer Principle describes the "what" of care and
preference describes the "how" of care.
Ethical Principles: - correct answer Nonmaleficence, Beneficence, Autonomy Justice =
Do no harm, Do good, Right to consent / refusal, fair distribution of goods / services
Advanced Directives & Order of Importance - correct answer Means of patient making
medical decisions in advance in case of incapacitated condition; Order for life sustaining
treatment (POLST) / Out of Hospital medical order / DNR order >> Medical Power of
Attorney (MPOA) >> Living will
Golden Hour / Period - correct answer Short period of time from injury to definitive care
after which chance of survival is significantly lower; We abide by the Platinum 10, where
we transport within 10 minutes of arrival
Why Trauma Patients Die - correct answer Massive acute blood loss > Injury to vital
organs > Airway obstruction and ventilatory failure
Golden Principle #1 - correct answer Ensure Safety of Care Provider and Patient
(Scene Safety / BSI)
Golden Principle #2 - correct answer Assess scene for need of additional resources
Golden Principle #3 - correct answer Recognize physics of trauma (how did this happen
/ what happened / how bad is it)
Golden Principle #4 - correct answer Identify life threats (XABCDE)
Golden Principle #5 - correct answer Manage Airway while ensuring C-Spine
immobilization
Golden Principle #6 - correct answer Support breathing
Golden Principle #7 - correct answer Control significant external hemorrhages (Every
Red Blood Cell Counts)
Golden Principle #8 - correct answer Provide basic shock therapy such as splinting
injuries and maintaining BODY TEMPERATURE
Golden Principle #9 - correct answer Determine need for spinal stabilization
Golden Principle #10 - correct answer Initial transport to appropriate Trauma center
Golden Principle #11 - correct answer Initiate fluid recovery
, Golden Principle #12 - correct answer SAMPLE history and Secondary Check
Golden Principle #13 - correct answer Relieve patient pain
Golden Principle #14 - correct answer Communicate patient and circumstance of the
injury to receiving facility (Prearrival // Verbal upon arrival // PCR)
Critical Trauma Signs - correct answer Threatened airway // Impaired ventilation //
Hemorrhage // Shock of any kind / GCS < 13 // Seizure or motor deficits // Penetrating
trauma to head, neck, torso.
Shock - correct answer Hypo-perfusion
Organ Tolerance to Ischemia - correct answer Heart / Brain / Lungs (4-6 minutes)
//Kidney, Liver, GI (45-1.5 hours) // Musculoskeletal (4-6 hours)
Fick Principle - correct answer Steps of Oxygenation: Loading O2 on RBC in lung,
Delivering RBS to tissue, Off-loading oxygen from RBC to tissue cells
How we can maintain Fick Principle - correct answer Ventilation // Maintain cardio
system // Maintain body temperature
Causes for hypotension - correct answer heart not filling up with enough volume or
heart is filled to much and overstretch causes failure to deliver good stroke volume
Edema - correct answer When we have to much fluid in interstitial space and so gap
between cells and capillaries increases and we have reduced efficacy of oxygen and
nutrient load / off load
Oncotic pressure - correct answer Total influence of a protein and minerals on the
osmotic activity of plasma water.
Movement of fluid through capillaries is determined by... - correct answer Difference in
hydrostatic pressure within capillary (pushes out) and outside capillary (pushes in) //
Permeability of capillaries // Oncotic pressure difference inside and outside the capillary
Autonomic nervous system - correct answer Involuntary functions with sympathetic
nervous system = the GO system and parasympathetic system = the PAUSE system
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