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Los 24 capítulos de la 11.ª edición de ATLS: en cada uno, los puntos clave y 8 preguntas de práctica, además de exámenes de práctica y estaciones de habilidades. Para el curso Provider y el Refresher.
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ATLS 118 preguntas
Capítulo 1 de 24
Initial Assessment: Primary Survey
PUNTOS CLAVE
Before arrival, agree triage priorities, team roles, equipment and the hospital's available definitive care; the same xABCDE priorities apply to children, older adults and pregnant patients.
xABCDE runs in a fixed order: catastrophic external bleeding, then airway (with cervical spinal motion kept restricted), breathing and ventilation, circulation, disability, and finally exposure alongside active warming.
Assessment and treatment happen together; an immediately life-threatening problem is treated the moment it is found, and a definitive diagnosis is never a prerequisite.
Major blood loss is concealed in five internal compartments, with external loss the sixth site: chest, abdomen, pelvis, retroperitoneum and long bones, alongside external bleeding.
Obtain two large-bore peripheral cannulae of at least 18 gauge in an adult, moving to intraosseous or central access if peripheral attempts fail.
The Glasgow Coma Scale runs from 3 to 15, made up of eye opening out of 4, verbal response out of 5 and motor response out of 6; the motor component carries the most prognostic weight, and a total of 8 or less usually signals the need for a definitive airway.
Adjuncts to the primary survey are ECG and pulse oximetry monitoring, capnography, eFAST, chest and pelvic radiographs, blood gas with lactate and base deficit, blood group and crossmatch, and gastric and urinary catheters; each is used only if it does not hold up treatment.
Aim for urine output of about 0.5 mL/kg/h in an adult, 1 mL/kg/h in a child and 2 mL/kg/h in an infant under one year as one marker of perfusion.
Keep the core temperature above 36°C: strip wet clothing, cover and actively warm the patient, warm crystalloid to roughly 39°C, use a fluid warmer for blood products, and warm the resuscitation room.
Repeat xABCDE after any deterioration, intervention or move. Begin the secondary survey only after immediate threats have been addressed and vital functions are improving.
Decide early whether the patient's needs exceed local capability, arrange transfer while resuscitation continues, and hand over physiology, treatment and remaining concerns directly.
Preserve privacy and dignity during examination, use respectful communication, and note injury patterns that could inform later prevention work.
A motorcyclist arrives after a high-speed crash. A thigh tourniquet remains effective after transfer to the bed. He is obtunded with gurgling respirations, systolic pressure 68 mm Hg, absent left breath sounds, and left hyperresonance. Blood is already running. The pelvis is stable and focused cardiac imaging shows no effusion. Which pair of tasks should the leader assign during the next minute?
Mostrar respuesta y explicación
Respuesta correcta: C.External limb bleeding is controlled, while airway obstruction and left-sided tension physiology remain immediate threats. Blood resuscitation continues alongside airway suction and pleural decompression. A binder treats an unstable pelvic ring, tourniquet replacement treats renewed limb bleeding, and pericardial drainage treats tamponade; the findings here point to none of those problems.
Pregunta 2 de 8
A 47-year-old pedestrian struck by a car has a systolic pressure of 76 mm Hg, a distended tender abdomen, and no external bleeding. After two units of blood, pressure rises to 104 mm Hg but falls to 82 mm Hg ten minutes later. eFAST shows free intraperitoneal fluid. What is the most appropriate interpretation and disposition?
Mostrar respuesta y explicación
Respuesta correcta: D.A transient responder improves and then deteriorates because bleeding continues or resuscitation is insufficient. In the setting of shock, abdominal findings, and a positive eFAST, CT adds delay without changing the need for hemorrhage control. Crystalloid and vasopressors do not substitute for blood and definitive control.
Pregunta 3 de 8
During the secondary survey of an initially stable patient, the oxygen saturation falls from 98% to 86%, the heart rate rises, and the patient becomes agitated. A chest tube placed during the primary survey is no longer swinging. What should the trauma team leader direct first?
Mostrar respuesta y explicación
Respuesta correcta: A.Any important deterioration restarts the primary survey. Tube obstruction or displacement, recurrent pneumothorax, airway problems, and hemorrhage must be evaluated immediately. Increasing oxygen while waiting for a blood gas treats the measured saturation without finding the cause. Manipulating the drainage chamber or giving sedation before reassessing the patient can delay treatment of a reversible life threat.
Pregunta 4 de 8
A rural emergency department has stabilized a patient with a severe open pelvic fracture using a binder, blood products, antibiotics, and warming. The patient is currently responding, but the hospital has no pelvic surgeon, interventional radiology, or massive transfusion capacity beyond four more units. Which additional investigation is most appropriate before transfer?
Mostrar respuesta y explicación
Respuesta correcta: B.Transfer planning begins as soon as required capability is recognized. Necessary resuscitation and immediately actionable tests continue, but imaging that will not alter pretransfer care should not delay definitive treatment. The receiving center can complete injury characterization after ongoing hemorrhage risk is addressed.
Pregunta 5 de 8
An intubated patient with blunt trauma has a pelvic fracture, blood at the urethral meatus, and no urine output measurement. The circulation assessment is ongoing and the patient is a transient responder to blood. Which approach to the urinary catheter is most appropriate?
Mostrar respuesta y explicación
Respuesta correcta: C.Urine output is useful, but suspected urethral injury is a contraindication to blind transurethral catheterization. The catheter is an adjunct and must not displace the priorities of blood resuscitation and hemorrhage control. Repeated instrumentation can worsen the injury.
Pregunta 6 de 8
A hemodynamically stable patient has a negative initial eFAST after a high-energy deceleration injury. Two hours later, abdominal pain is increasing, the pulse has risen from 82 to 108 beats/min, and the base deficit has worsened. Which principle should drive the next step?
Mostrar respuesta y explicación
Respuesta correcta: D.Trauma findings evolve, and eFAST has important anatomic and timing limitations. New tachycardia, worsening metabolic evidence of hypoperfusion, and increasing pain require renewed primary assessment and targeted investigation. A normal pressure or earlier negative test must not end reassessment.
Pregunta 7 de 8
During the disability step of the primary survey you score the Glasgow Coma Scale. Which statement about its three components is correct?
Mostrar respuesta y explicación
Respuesta correcta: C.Eye opening carries a maximum of 4, verbal response 5 and motor response 6, giving a best total of 15 and a worst of 3, and the motor score is the part that correlates best with outcome. Because each component starts at 1, a deeply unresponsive patient scores 3, not 0. When the verbal response cannot be tested, as after intubation, it is recorded as non-testable and reported alongside the eye and motor scores; awarding a full verbal score of 5 inflates the total and hides the deficit.
Pregunta 8 de 8
A 24-year-old motorcyclist is alert after a crash. Heart rate is 124/min, systolic pressure 114 mm Hg, the knees are mottled, capillary refill is 4 seconds and the base deficit is -8 mmol/L. There is no external bleeding. A colleague argues that the normal blood pressure makes serious bleeding unlikely. What is the best interpretation?
Mostrar respuesta y explicación
Respuesta correcta: B.A fall in systolic pressure is a late event: compensatory mechanisms can hold it near normal until about 30% of the blood volume has been lost, so tachycardia, poor peripheral perfusion and a worsening base deficit are the useful early signals. Treating a normal systolic pressure as proof against major blood loss inverts that principle, and blaming the tachycardia on limb pain delays the search for and control of bleeding.
Breathing and Ventilation Assessment and Management
Circulation Assessment and Volume Resuscitation
Disability: Neurological Assessment and Management
Exposure and Environmental Threats in the Primary Survey
Thermal Injuries
Musculoskeletal Trauma
Trauma in the Pediatric Patient
Trauma in the Older Adult
Trauma in the Pregnant Patient
Initial Assessment: Secondary Survey
Transfer to Definitive Care
Trauma Systems
Triage and Disaster Management
Injury Prevention
Trauma-Informed Care and Social Determinants of Health
Communicating Serious News in the Acute Trauma Setting
Thoracic, Abdominopelvic, and Genitourinary Trauma
Penetrating Trauma
Ocular Trauma
Injury in Combat Zones and Austere Environments
Preguntas frecuentes
¿Se parecen las preguntas al examen ATLS real?
Sí. Todas las preguntas están escritas en formato de examen y siguen la 11.ª edición de ATLS. Parte de los exámenes de práctica se basa en preguntas reales de examen, para que sepas qué esperar ese día.
¿Por qué la lección está en inglés?
El curso ATLS de la app está en inglés, el idioma del manual ATLS. Así practicas con los mismos términos que en el curso.
¿Qué edición de ATLS siguen las preguntas?
La 11.ª edición, incluida la secuencia xABCDE.
¿Cuántas preguntas de ATLS hay en la app?
Más de 400: 8 preguntas de práctica por cada uno de los 24 capítulos, además de preguntas que solo aparecen en los exámenes de práctica.
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ATLS® es una marca registrada del American College of Surgeons. ORReady es una herramienta de estudio independiente: no está afiliada al American College of Surgeons ni cuenta con su aval o patrocinio. Solo con fines educativos; no sustituye el juicio clínico ni los protocolos locales.
