Deck 42: Major Trauma Initial Assessment and Management

Question 1

The correct sequence of primary survey in trauma patient is:

A) Airway, cervical spine stabilisation, breathing and ventilation, circulation, neurological status
B) Airway, breathing, cervical spine stabilisation, breathing and ventilation, circulation, neurological status
C) Cervical spine stabilisation, breathing, airway, circulation, neurological status
D) Airway, breathing, circulation and neurological status

Answer 1

Airway, cervical spine stabilisation, breathing and ventilation, circulation, neurological status

Question 2

Tension pneumothorax is a life-threatening injury. Which clinical findings are specific to this condition?

A) Hypertension and bradycardia
B) Severe respiratory distress, tracheal deviation, hypotension, tachycardia
C) Chest pain, decreased respiratory effort and hypotension
D) Tachycardia, decreased saturations, bruising on chest, chest pain

Answer 2

Severe respiratory distress, tracheal deviation, hypotension, tachycardia

Question 3

Cardiogenic shock in trauma patient may be caused by cardiac tamponade. Which among the following make up the defining symptoms for tamponade?

A) Distended neck veins, cyanosis, tachycardia
B) Distended neck veins, hypotension, muffled heart sounds
C) Cyanosis, tachycardia, hypotension, tracheal deviation
D) Dyspnoea, cyanosis, hypotension, tachycardia

Answer 3

Distended neck veins, hypotension, muffled heart sounds

Question 4

A 40-year-old male patient presents to the ED after a motor vehicle collision (MVC) yelling in pain. He is noted to have severe dyspnoea, decreased left-sided chest movement and tracheal deviation to the right side. You are the emergency nurse caring for this patient. What will you do first?

A) Prepare a needle for thoracentesis
B) Initiate two large-bore IV cannulas
C) Initiate high-flow oxygen via a non-rebreather mask
D) Prepare chest tube
E) Ensure airway is patent

Question 5

A 19-year-old woman walks into the ED post MVC with complaints of neck pain and a tingling sensation on both arms and legs. You are the triage nurse assessing the patient. What is your first intervention?

A) Ensure adequate airway and breathing
B) Initiate immobilisation and stabilisation of cervical spine
C) Initiate oxygen therapy
D) Administer analgesia

Question 6

Paediatric patients in shock are given fluid resuscitation. The initial fluid bolus is:

A) 15 mL/kg of NaCl or Hartmann's
B) 20 mL/kg of NaCl or Hartmann's
C) 20 mL/kg of packed RBC
D) 15 mL/kg of packed RBC

Question 7

Which among the following are included in the secondary survey assessing trauma patients?

A) Full set of vital signs, comfort measures, taking a detailed history, head-to-toe assessment and inspection of posterior surfaces
B) Full set of vital signs, allergies, mechanism of injury, physical assessment, administration of fluids and analgesia
C) Spinal immobilisation, full set of vital signs, administration of oxygen and analgesia, blood tests
D) C-spine and spinal immobilisation, full set of vital signs, head-to-toe assessment, inspection of posterior surface

Question 8

An emergency nurse is about to insert an indwelling catheter (IDC). Which of the following is the major contraindication in inserting an IDC?

A) Vomiting
B) Upper abdominal pain
C) Blood at the urethral meatus
D) Pregnancy

Question 9

Which of the following is contraindicated in patients with maxillary/facial injuries and basilar skull fracture?

A) Insertion of indwelling catheter
B) Insertion of orogastric tubes
C) Insertion of nasogastric tube
D) Administration of oxygen via nasal cannula

Question 10

To prevent secondary brain injury, what is the ideal blood pressure for patients who have uncontrolled haemorrhage with suspected traumatic brain injuries?

A) At a range of 80-90 mmHg SBP
B) At least 90 mmHg SBP
C) At a range of 90-100 mmHg SBP
D) At least 120 mmHg SBP