ATLS 10 POST-TEST AND PRE-TEST ACTUAL EXAM 160 QUESTIONS AND CORRECT DETAILED ANSWERS|ALREADY GRADED A+

ATLS 10 POST-TEST AND PRE-TEST 2023-

2024 ACTUAL EXAM 160 QUESTIONS AND

CORRECT DETAILED ANSWERS|ALREADY

GRADED A+

Laryngeal fracture is confirmed with what test?

Computed tomography (CT)

Airway obstruction objective signs

Agitation (hypoxia)

Obtundation (hypercarbia)

Cyanosis (nail beds, circumoral skin)

Increased work of breathing (retractions, accessory muscles)

Pulse oximetry

Abnormal breath sounds (snoring, gurgling, stridor, hoarseness)

Risk factors for ventilation compromise

Direct trauma to the chest

Rib fractures

Intracranial injuries

Cervical spine injury

High cervical spine injuries above ___ will ___

Low cervical spine injuries below ___ will ___, but ___

C3, paralyze the diaphragm.

C3, maintain the diaphragm, but paralyze the intercostal and abdominal

muscles (diaphragmatic or see-saw breathing)

Signs of inadequate ventilation

Asymmetric tidal breathing

Inadequate chest wall excursion

Laboured breathing

Decreased or absent breath sounds

Tachypnea

Pulse oximetry

Capnography

Altered mental status

Symptoms of inadequate ventilation

Dyspnea

Orthopnea

Urge to sit up to breathe

Confusion

Potential situations causing difficulties in airway maneuvers

C-spine injury

Severe arthritis of the C-spine

Significant maxillofacial or mandibular trauma

Limited mouth opening

Retrognathia

Short, muscular necks

Bariatrics

Pediatrics

LEMON Assessment for Difficult Airway

Look externally (e.g. small mouth, large overbite, facial trauma)

Evaluate 3-3-2 rule (incisor teeth distance of 3 finger breadths; hyoid

bone

Mallampati score to evaluate hypopharynx (soft palate) evaluation

Obstructions that can make laryngoscopy and ventilation difficult.

Neck mobility (C-spine flexion, extension) - obviously cannot be

performed in blunt trauma with suspected C-spine injury, also in those

with C-spine surgery, Down syndrome, and rheumatoid arthritis.

The ATLS airway decision scheme only applies in which scenarios?

Acute respiratory distress

Apneic patient

Immediate airway needed

Potentially have C-spine injury

Equipment checklist for airway maneuvers

Suction

Oxygen

OPA and NPA

Bag-mask

Laryngoscope

Gum elastic bougie (GEB)

Extraglottic devices (LMA, LTA)

Surgical or needle cricothyroidotomy kit

Endotracheal tubes

Pulse oximeter

CO2 detection device

Drugs

Methods to pre-oxygenate

Supplemental oxygen

Bag-mask

Oropharyngeal airway

Nasopharyngeal airway

Scenario: Can't oxygenate or can't intubate

Definitive airway or surgical airway

Scenario: Easy airway (LEMON)

Attempt intubation with cricoid pressure, ± drug-assistance.

Scenario: Difficult airway (LEMON)

Call for help and consider awake intubation.

Adjuncts for difficult airway or failed airway:

Gum elastic bougie

Intubating supraglottic device (e.g. ILMA, ILTA)

Mallampati Score

I - soft palate, fauces, uvula, tonsillar pillars

II - soft palate, fauces and uvula

III - soft palate and base of uvula

IV - soft palate not visible

3-3-2 Rule

3 finger-breadths wide between maxillary and mandibular incisors.

3 finger-breadths from the base of the mandible to the tip of the chin.

2 finger breaths from the hyoid bone to the thyroid notch.

Describe Chin-Lift technique:

Place fingers of one hand under the mandible and lift it upwards to bring

chin anterior. Open the mouth with the thumb of the same hand.

Describe Jaw-Thrust technique:

Grasp the angles of the jaw and then displace the mandible forward (e.g.

into the facemask to get a better seal).

Nasopharyngeal Airway insertion technique:

1. Ensure no contraindications (nasal trauma, suspicion of cribriform

plate injury).

2. Lubricate the device.