Prehospital Trauma Life Support (PHTLS) Practice Test

Which factor warrants classification of a patient as a critical trauma patient?

1. An extremity fracture

2. Preexisting major medical problem

3. Bleeding from the nose

4. Deployment of air bags in a motor vehicle crash

The correct answer is: Preexisting major medical problem

A critical trauma patient is typically defined by the severity of their injuries and the immediate threat to their life. In this context, a preexisting major medical problem significantly influences the patient's stability, complicating their trauma care. Such conditions can exacerbate the impact of even minor injuries, making the patient more vulnerable to adverse outcomes. For example, someone with a significant cardiovascular disease or a history of chronic respiratory issues might not tolerate the physiological stress that accompanies trauma as well as a healthy patient. The presence of a preexisting illness is crucial in assessing trauma severity because it can impede recovery, highlighted by the interaction or exacerbation between the trauma incurred and the existing medical condition. Therefore, patients with serious underlying conditions warrant acute evaluation and management as they might rapidly deteriorate even under conditions where their trauma would not typically classify them as critical. In contrast, factors like an extremity fracture, bleeding from the nose, or the deployment of airbags indicate injuries or events that, while they may require attention, do not automatically elevate a patient to critical status. For instance, an extremity fracture may be serious, but if managed appropriately, it usually does not pose an immediate life threat. Similarly, nasal bleeding can often be a minor injury unless associated with other severe conditions. Air