Prehospital Trauma Life Support (PHTLS) Practice Test

What is the usual cause of delayed death due to trauma?

1. Biochemical and pathophysiological effects of inadequate initial resuscitation

2. Acute circulatory failure

3. Brain injury

4. Acute hypoxia

The correct answer is: Biochemical and pathophysiological effects of inadequate initial resuscitation

Delayed death due to trauma is often the result of the biochemical and pathophysiological effects stemming from inadequate initial resuscitation efforts. This inadequate resuscitation can lead to a cascade of physiological changes, including the development of coagulopathy, hypoperfusion, and organ dysfunction. Trauma patients who do not receive timely and appropriate intervention may experience progressive deterioration in their condition, which can manifest days after the initial injury. In cases of trauma, the body's inflammatory responses can become exaggerated and lead to conditions such as acute respiratory distress syndrome (ARDS) or multiple organ dysfunction syndrome (MODS). Without sufficient restoration of blood volume, oxygenation, and circulation during the early stages of treatment, these complications can contribute to delayed mortality. Other causes such as acute circulatory failure or brain injury can lead to immediate death or critical conditions, while acute hypoxia is a direct and urgent concern that typically requires rapid intervention to prevent death. However, the long-term, progressive deterioration associated with inadequate resuscitation is a leading factor in delayed mortality following trauma. This subtle but crucial point highlights the importance of effective early intervention and monitoring in trauma care.