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A 24-year-old man is brought in after a high-speed motor vehicle crash. He is tachypneic (RR 36), has tracheal deviation to the left, absent breath sounds on the right, jugular venous distention, and oxygen saturation of 82% despite 15 L/min oxygen via non-rebreather. The skilled operator and fully prepared chest-tube equipment are already at the bedside, allowing immediate definitive pleural decompression. What is the most appropriate next step?

A 25-year-old male is brought in after a motorcycle crash. He is unconscious, has gurgling respirations, and blood in his oropharynx. What is the first priority in his airway management?

A 27-year-old man is struck by a vehicle. On arrival, he is unresponsive (GCS 6), RR 10, pulse 130, BP 80/50, SpO₂ 88%. There is active bleeding from a thigh wound. The thigh wound is spurting rapidly with uncontrolled life-threatening blood loss. A second team member is already providing effective assisted ventilation. What is the first priority action in this patient?

A 40-year-old trauma patient opens eyes only to pain, utters incomprehensible sounds, and withdraws from painful stimuli. What is the GCS score?

A 45-year-old man with multiple fractures is hypothermic (31°C) in the trauma bay despite warmed fluids. Which additional step best prevents further heat loss?

The most important, immediate step in the management of an open pneumothorax is

A 45-year-old woman is brought in after a rollover MVC. She is obtunded, has snoring respirations, SpO₂ 84% despite jaw thrust, HR 120, BP 90/60. What is the next best step?

A 28-year-old male presents after a high-speed motor vehicle collision. He is hypotensive and has an unstable pelvis on exam. FAST is negative. Which of the following is the best immediate step to control pelvic hemorrhage in the resuscitation bay?

A 79-year-old woman on apixaban falls down stairs and presents alert but with new confusion. Vitals are normal. There is no external bleeding. Which of the following is the best initial imaging study?

Which is part of the secondary survey rather than the primary survey?

An MVC victim is diagnosed with a right hemothorax. Tube thoracostomy is performed and drains 1,800 mL of blood immediately. After transfusing 2 L of whole blood, the patient's vital signs are stabilized. In the primary survey, xABCDE seem otherwise controlled. What is the next crucial step?

A 33-year-old man receives multiple stab wounds to the neck and has an expanding neck hematoma with stridor and progressive respiratory compromise. He is in obvious respiratory distress. Expert oral intubation and rapid supraglottic rescue fail, oxygenation cannot be maintained, and the cricothyroid membrane is intact and accessible below the injury. Which is the most appropriate immediate airway management?

A trauma patient with shock receives multiple units of stored PRBCs. He develops tetany and refractory hypotension. Which electrolyte abnormality is most likely?

A trauma patient has a GCS of 15, but reports numbness and weakness in both legs. What is the best next step?

A victim of an explosion presents with bilateral tympanic membrane rupture but normal vital signs. Six hours later, he develops worsening abdominal pain, guarding, and tachycardia while oxygenation and the chest examination remain normal. What injury is now particularly concerning?

A patient after a high-energy MVC has normal initial chest X-ray. Six hours later, she develops hypoxia, patchy bilateral infiltrates, and no JVD. Which mechanism best explains the deterioration?

Which of the following statements is true?

A hemodynamically unstable adult with penetrating abdominal trauma arrives in the ED. There is no obvious exsanguinating hemorrhage, and airway and breathing are controlled. FAST reveals free fluid. According to ATLS principles, what is the most appropriate next step in management?

A 47-year-old construction worker is intubated after a fall of 6 meters. He has asymmetric pupils: right pupil dilated and poorly reactive, left pupil reactive. His systolic blood pressure is 160 mm Hg and oxygen saturation is 98% on controlled ventilation. Intracranial computed tomography shows a large temporal intracerebral hematoma with mass effect and midline shift. While the neurosurgical team prepares for urgent operative decompression, which single immediate intervention is most appropriate to lower intracranial pressure and temporize herniation physiology?

A 45-year-old woman sustains burns to her entire right arm and entire back. Using the Rule of Nines, what is the %TBSA burned?