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CCEMTP
Critical Care Transport Series (Test Review)
311
Medical
Professional
10/15/2006

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Cards

Term
The probabilty that the test will be positive in the presence of disease.
Definition
SENSITIVITY
Term
CBC consists of:
Definition
HCT

WBC

RBC

Hgb
Term
RBC normal value
Definition
5.0 mm3
Term
Hgb normal value
Definition
15g/dl
Term
HCT normal value
Definition
45%
Term
WBC normal value
Definition
4,000 - 10,000/mm3
Term
Left Shift
Definition
Bacterial
Term
Right Shift
Definition
Viral
Term
Normal Platelet count
Definition
250,000 - 400,000
Term
Platelet count is also useful for:
Definition
Assessing a pt. with a bleeding disorder.
Term
The purpose of ABG is to differentiate __________ vs __________.
Definition
Metabolic vs Respiratory
Term
BUN/Creatnine Ratio of _____ is indicative of __________.
Definition
>10:1

Renal Failure
Term
Normal BUN _____

Normal Creatnine _____
Definition
7-18 mg/dl

~1.0 mg/dl
Term
Normal value of Na+ (Sodium)
Definition
135-145 mEq/L
Term
The most common cause excessive Na+ is __________ of IV fluids.
Definition
iatrogenic
Term
The most common cause of decreased Na+ is ________________ and excessive fluid loss conditions.
Definition
lack of intake
Term
Normal K+ range
Definition
3.5-5
Term
What 2 things increase K+
Definition
renal dysfunction

and

acidosis
Term
CK-MB is ________ specific and undetectable to ___U/L
Definition
cardiac

7
Term
Liver enzymes generally no more than ____.
Definition
30
Term
Avg. adult urine output
Definition
30-70 ml/hr
Term
Avg. pediatric urine output
Definition
1ml/kg/hr
Term
Avg. neonatal urine output
Definition
2ml/kg/hr
Term
High specific gravity is > ______, which indicates fluid loss , nephrosis and diabetes.
Definition
1.02
Term
PT of_____seconds is an indicator for coumadin therapy.
Definition
<2
Term
PTT of _____seconds is an indicator for heparin therapy.
Definition
25-38
Term
Easiest method to break the circle of transmission.
Definition
Handwashing
Term
The probability that the test will be negative in the absence of disease.
Definition
SPECIFICITY
Term
_____ is a bacterial organism, transmitted via ________ ________ and must be ________ by the host.
Definition
TB

respiratory droplets

inhaled
Term
TB Symptoms:
Definition
Cough
night sweats
blood tinged sputum
chest pain
pleurisy
fever
anorexia
weight loss
Term
Hepatitis A is transmitted via which route?
Definition
oral-fecal
Term
Hepatitis B is transmitted via ____________________ isolated in blood, saliva, semen and all mucous membranes.
Definition
bloodborne pathogens
Term
Lung landmarks: Apex is _____cm above the inner third of the anterior clavicle and the base is ___th rib at the __________ line and ___th rib at __________ line.
Definition
2-4cm

6th midclavicular

8th midaxillary
Term
Two factors important in the generation of breath sounds are distance from the source of the sound to the __________ affected by obesity and __________ including: consolidation, atelectasis and bronchiectasis.
Definition
chest wall

vortices
Term
Durations of BS are:
Definition
long

short

continous

interrupted.
Term
Ausculatory sites:

_____ intercostal space midclavicular

5th intercostal space _____________

_____ intercostal space __________ axillary
Definition
2nd

midaxillary

7th

posterior
Term
__________ sounds are abnormal:

wet vs. dry

bronchial vs. __________

resonance - diminished or absent __________

crackles, wheezes, ________, stridor and pleural friction rub.
Definition
Adventitious
vesicular
intensity
rhonchi
Term
Consolidation is ______ or ______ filled spaces, commonly found with ___________.
Definition
fluid or air
pneumonia
Term
Perform ________ ________ assessment by palpation of the chest wall while patient is _________.
Definition
tactile fremitus
talking
Term
Cheyne-Stokes respirations are caused by:
Definition
* ^ICP
* CHF
* Renal failure
* meningitis
* drug overdose
Term
Biot's (ataxic) breathing is caused by:
Definition
* Meningitis
* CNS dysfunction
Term
Kussmal breathing is caused by:
Definition
* Metabolic causes
* Renal Failure
Term
Apneustic caused by repiratory center ________.
Definition
lesions
Term
Abnormalities of respiration: (5)
Definition
* Respiratory depression
* Respiratory failure
* Respiratory insufficiency
* Respiratory arrest
* V/Q defect / mismatch
Term
Pulse oximeter false readings include:
Definition
* CO Poisoning
* Temperature extremes
* Vasoconstriction
Term
End tidal CO2 is attached to artificial airway device with color changes due to __________ reaction.
Definition
acid base
Term
Complications of mechanical ventilation are:
Definition
* Barotraumas
* Airway trauma
* atelectasis
* pneumothorax
* O2 toxicity
* Device dependence
Term
RSI preoxygenation should be performed a minimum of ___mins.
Definition
2
Term
__________ will cause chest wall muscle spasm if administered rapidly or in excessive amounts, dose is _____mcg/kg.
Definition
Fentanyl
3-5 mcg/kg
Term
__________ is only used in head injury patients with ^ICP, do not use in asthmatics, may cause bronchospasm.
Definition
Thiopental (pentathol)
Term
Order of paralysis:
Definition
a. eyes, face, neck
b. extremities
c. abdomen
d. intercoastals, glottis
e. diaphragm
Term
Depolarizing agents substitute for _____ and ______ to receptors causing depolarization, muscle is unable to return to resting state and __________ is achieved.
Definition
ACH BINDS
Paralysis
Term
Non-depolarizing agents block the uptake of _____ and _____ to the receptor but do not __________ __________, does not cause __________ and tend to last a long time.
Definition
ACH
BIND
stimulate depolarization
fasciculation
Term
Sux dosage: Duration?
Definition
1.0mg/kg
duration 5-10mins
Term
During transport of a sedated and paralyzed pt., indications that meds are wearing off are:
Definition
*Tachycardia
*^BP
*Muscle movement
Term
RSI Steps:
Definition
a. IV, pulse oximeter, check equipment
b. preoxygenate
c. premedicate with lido and sedative
d. medicate
e. sellicks maneuver
f. intubate
Term
Normal tidal volume = __________

Ventilate with _____ml/kg
Definition
500-600
10-15
Term
Sigh is ______ times the VT
Definition
1.5 - 2
Term
Avg. Ventilator trigger sensitivity
Definition
-2cm H2O
Term
Ventilatory rate _____ bpm
Definition
10-20
Term
PIP should be < than ___cm H20, but may be higher in the presence of _____ and obstructive diseases.
Definition
40
ARDS
Term
________ requires mechanical ventilation with PEEP.
Definition
ARDS
Term
_____________ should be set at 10-15 above PIP and the ____________ should be set at 10-15 below PIP.
Definition
High-pressure alarm
Low-pressure alarm
Term
Ventilator set-up procedure:
Definition
(1) FiO2
(2) Select mode of ventilation
(3) Set rate
(4) Set VT
(5) Set flowrate
(6) Connect ventilator
(7) PIP
(8) Set PEEP
(9) Set pressure alarms
(10) Patency of circuit and connections
(11) Monitor and document settings
Term
The signs and symptoms of O2 toxicity are:
Definition
Pulmonary infiltrates, VQ mismatch with decreased O2 transfer.
Term
When ventilating a head injury patient, you should maintain a PaCO2 of ________mmHg.
Definition
28-32mmHg.
Term
Immediately cover the opening of a displaced chest tube with ____________ and monitor for ____________.
Definition
occlusive dressing
tension pneumothorax
Term
The criteria for assessing a chest tube site is to look for:
Definition
*Intact dressing
*signs of infection
*insure tube is securely sutured
*Integrity of tube
Term
The amount of suction in a chest tube can be regulated by changing?
Definition
the amount of water in the water seal of the device or bottle.
Term
________ ________ is only for the emergency relief of a tension pneumothorax.
Definition
Pleural decompression
Term
Tunneled catheters and porta caths are not to be used with a __________ __________.
Definition
pressure infuser
Term
I,II,III
Definition
The bipolar leads
Term
aVR, aVL, aVF (augmented)
Definition
The unipolar leads
Term
V1 - V6
Definition
Precordial leads
Term
The twelve lead ECG only uses ___ electrodes.
Definition
10
Term
By placing the electrodes on the chest, you can only monitor the rhythm. In order to assess axis, hemiblock, and BBB, you must have the leads on __________.
Definition
the limbs.
Term
V4R is placed on the ___th intercostal space right ____________. This is used for the discovery of _________________.
Definition
5th
mid-clavicular
right ventricular MI.
Term
__________ __________ in the presence of an AMI means 4X greater mortality and indicates proximal occlusion of a ________ ________.
Definition
Anterior hemiblock
coronary artery
Term
Lidocaine and __________ are contraindicated in the presence of a __________ ________.
Definition
procainamide
bifasicular block
Term
You can determine a _____ in a 12lead ECG by V1 with a classic RSR prime.
Definition
RBBB
Term
_______ is a post-synaptic dopamine antagonist with high potency __________ which allows the patient to process incoming stimuli.
Definition
Haldol
neuroleptic
Term
The mechanism of action(s) of Butyrophonomes such as ________ and ________ block neuromuscular action at the postsynaptic receptor. ________ is achieved by decreasing binding of dopamine to receptor sites.
Definition
Inapsine and Haldol
Sedation
Term
End points of procainamide
Definition
(a) QRS widens by more than 50%
(b) Dysrrhythmia suppressed
(c) Max dosage of 17mg/kg
(d) Hypotension
Term
Adverse effects of Lidocaine
Definition
(a)Parasthesis
(b)Slurred speech
(c)Altered LOC
(d)Muscle twitching
(e)Convulsions
(f)Arrhythmias
Term
Indications for decreased dose of Lidocaine (1/2)
Definition
(a)Age >70
(b)Hepatic dysfunction
(c)CHF
(d)Concurrent medications, cimetidine (Tagamet), beta blockers
Term
Pro-arrhythmics will:
Definition
Cause a rhythm.
Term
Bizarre side effect of procainamide is
Definition
systemic lapis erythematosus.
Term
What do you know about Verapamil?
Definition
(1)Atrial fibrillation, SVT with narrow complexes only
(b)Onset 3-5 mins IV
(c)Half-life 3-7 hrs
(d)dosing 2.5-5mg over 2mins.,no response, 5-10mg every 15-30 minutes up to 20mg.
(e)Give over 3 mins. in elderly or dehydrated pts.
Term
__________ ________ is when the diastolic BP is >120mmHg without the presence of ____________. Goal of therapy is to decrease BP over 24-48 hrs.
Definition
Hypertensive urgency
end organ damage
Term
__________ is less potent than albuterol, available as inj.,P.O., mdi, bronchodilation with onset 5-30 mins. via IH and duration of 4-8 hrs, oral dosing not recommended for acute attacks.
Definition
Terbutaline
Term
Absolute contraindications of Thrombolytic therapy:
Definition
(a)Major surgery within 6wks.
(b)GI bleed within 6/mo.
(c)Intracranial neoplasm
(d)Stroke within 6/mo.
(e)Active bleeding
(f)Head trauma within a month
(g)pregnancy
Term
Relative contraindications of Thrombolytic therapy:
Definition
(a)CPR >10 mins.
(b)Age >75
(c)HTN >180/110
(d)Remote Hx. of stroke
Term
Heparin monitoring parameter is a PTT of ______ times control.
Definition
1.5 - 2
Term
Coumadin monitoring parameter is INR of ______ and the antagonist is ______.
Definition
2-3
Vitamin K
Term
Stimulation of Alpha 1 results in
Definition
*Vasoconstriction
*^BP
*Decreased cardiac output
Term
Dopamine calculation
Definition
Dose x weight in kg x 60 / [concentration in mcg/ml]
Term
Dopamine low dose at 1-3mcg will ______________ via the __________ receptors.
Definition
dilate renal arteries
dopaminergic
Term
Dopamine dosage greater than 15mcg will result in ________ ________, vasoconstriction.
Definition
alpha effect
Term
__________ is the drug of choice in cardiogenic shock with normal heart rates.
Definition
Dobutamine (Dobutrex)
Term
Crystalloids require _____ times more volume than __________.
Definition
2-3
colloids
Term
AB positive
Definition
Universal recipient
Term
O negative
Definition
Universal donor
Term
____________________ is used to restore clotting factors for patients with deficiencies.
Definition
Fresh frozen plasma
Term
Whole blood is used for patients with significant ____________ and ____________.
Definition
hypovolemia and blood loss.
Term
Packed RBC are indicated for symptomatic __________ and _____ blood loss.
Definition
anemia
active
Term
Leveling for the Swan-Ganz is at the _____________, located at the ___th intercostal space ___________.
Definition
phlebostatic axis
4th
mid-axillary.
Term
Normal ICP range
Definition
0-15
Term
__________ MI is the most lethal and __________ MI is the most common.
Definition
Anterior-most lethal
Inferior-most common
Term
Normal PR interval
Definition
.12 - .20 seconds
Term
The QRS marks the beginning of _______________.
Definition
mechanical systole.
Term
Patients with an ICD should avoid:
Definition
hand-held metal detectors
Term
Haldol is simular to ____________.
Definition
phenothiazines.
Term
A test used to determine the presence of occult blood in the GI tract is the _________.
Definition
Guaiac.
Term
Hemolytic transfusions can occur as long as ___ days after transfusion.
Definition
14 days
Term
__________ is an ACE inhibitor which has a side effect of cough, hypotension and angioedema.
Definition
Captopril
Term
Quinidine Pronestyl and Norpace
Definition
Class I antiarrhythmics
Term
Name an example of a Class IB drug
Definition
Lidocaine
Term
Which antiarrhythmic is a Class II (beta blocker)
Definition
Propanolol (Inderal)
Term
Amiodarone and Bretylium are in what Class
Definition
Class III
Term
Amiodarone ________ AV node conduction and ________ function.
Definition
decreases
sinus node
Term
Class IV drugs are:
Definition
Calcium Channel Blockers
Term
Adenosine is unclassified in the ____________ classification system.
Definition
Vaughn-Williams
Term
Class IA effects:
Definition
(a) Blocks fast sodium channels
(b) ^ QRS and QT
(c) Decreased automaticity
(d) Moderate effects on ERP and APD (end renal perfusion / atrial premature depolarization)
Term
Class IB effects:
Definition
(a) Minimal effects on phase O and ERP
(b) Decreased APD and automaticity
(c) No changes in QRS or QT interval
Term
Class II - Beta Blockers are:
Definition
(a) Supraventricular and ventricular arrhytmias.
(b) Decreases conduction velocity and automaticity.
(c) ^ ERP and PR interval.
Term
Class III effects:
Definition
(a) ^APD and ERP
(b) ^PR, QRS, and QT intervals
Term
Class IV effects:
Definition
(a) ^ PR interval
(b) Decreased conduction velocity in SA and AV nodes.
Term
Indications for IABP
Definition
*Cardiogenic shock
*Unstable angina
*Impending infarction
*LVF
*Sepsis
*Acute ischemia
Term
The purpose of the IABP is to ________ coronary artery perfusion, ________ myocardial oxygen demand and ________ the workload of the left ventricle.
Definition
increase
decrease
decrease
Term
Correct placement of the IABP catheter is at the level of the __________, 1-2cm distal to the __________, above the renal arteries, viewed on a chest film; the distal end will be seen at the ___ or ___ intercostal spaces.
Definition
aortic arch
subclavian
2nd or 3rd
Term
____________ should be monitored during transport to assure that the distal tip of the IABP has not migrated into the ____________ or occluded the __________.
Definition
Left radial pulse
left subclavian
subclavian
Term
The normal and desired trigger is _______ on the ECG, and the back-up trigger is _______, used during CPR.
Definition
R wave
pressure
Term
Breath sound pitch or _________ is normally ______ and abnormally _____.
Definition
frequency

low

high
Term
Breath sound intensity is determined by: (4)
Definition
1)Air flow rate
2)Position of pt.
3)Consistency of flow
4)Ausculatory site
Term
Causes of tachypnea: (3)
Definition
1)Salicyate toxicity (ASA poisioning)
2)Lesions to respiratory center
3)Fever (pyrexia)
Term
Fever will increase respiratory rate ________ for each degree.
Definition
4 breaths
Term
Indications for RSI:
Definition
1)Full stomach theory
2)^ICP
3)Overdose
4)Burns
5)Chest trauma
6)UGI bleed
Term
Ketamine:
*Strong __________ with hypnotic effect.
*May be used in ______ ________.
*Emergence reaction up to ___ hrs post administration.
*Dose?
Definition
bronchodilator
status asthmaticus
24
2 mg/kg
Term
Standard ventilator flow rate
Definition
30-60 LPM
Term
Causes of pt. bucking ventilator: (3)
Definition
1)Hypoxia
2)Suctioning required
3)Additional sedation requried
Term
Lidocaine:

Bolus dose:_____ followed by _____ every 10mins.

Max dosage _____ for pulseless arrest, Class _____.

______ and repeat in ______ minutes for pulseless arrest.
Definition
1)1-1.5mg/kg for VT, followed by .5-1.5mg/kg every 10mins.

2)Max dose 3mg/kg, Class IB

3)1-1.5mg/kg and repeat in 3-5 minutes
Term
Bretylium uses are ______ and ______.
Definition
VT and VF
Term
Bretylium dose:
Definition
5-10mg/kg, repeat q5 up to 3 times.
Term
VAD potential complications: (5)
Definition
1)inf
2)Thrombosis
3)Migration
4)extravasation
5)air embolism
Term
Two responsibilities of the CCEMTP during transport, to avoid liability are:
Definition
Provide appropriate care
Function within scope of practice
Inform medical control or receiving facilty of changes or extenuating circumstances
Document thoroughly and stay available to answer questions post transfer.
Term
Never deactivate a pacemaker/AICD without:
Definition
An M.D. order
Term
Indications for ICP
Definition
GCS<8 and positive CT scan
Term
The law requiring that patients be provided written information on the right to make medical decisions.
Definition
The Patient Self Determination Act
Term
Types of urinary diversion (5)
Definition
1)ideal conduit
2)ureterostomy
3)nephrostomy
4)cystostomy
5)Indiana Pouch
Term
________ is black,tarry stool indicative of an _____________,____________ or _____________.
Definition
Malena
upper GI bleed,peptic ulcer or small bowel disease.
Term
Factors affecting hemodynamic monitoring:
Definition
1)HR
2)Preload
3)Afterload
4)Contractility
Term
Subtle indicators of a transfusion reaction are:
Definition
^HR and ^Temp
Term
Causes of low PAP are:
Definition
hypervolemia
RVF
Term
Causes of high PAP are:
Definition
LVF, hypervolemia and pulmonary HTN
Term
All pressures are elevated and equalized in the presence of __________.
Definition
tamponade
Term
Vent off __________ prior to air transport.
Definition
ostomies
Term
All NG/OG tubes should be left open to air during ______________.
Definition
air transport.
Term
Complications of PAC are: (6)
Definition
1)Balloon rupture
2)PA perforation
3)Pneumothorax
4)Hemorrhage
5)Dysrhythmias
6)Infection
Term
Contraindications of gastric tubes are: (3)
Definition
1)Esophageal varices
2)Nasal insertion in the presence of a head injury of facial trauma
3)Must be able to control their own airway unless intubated.
Term
In sepsis you have high ___ and low ____,which is treated with fluids and vasopressors.
Definition
High CO and low SVR
Term
_______________ is the smallest lumen, single or multiple lumens inserted centrally or peripherally and used for short-term therapy, high risk of infection.
Definition
Non-tunneled
Term
_______________ are large bore, thick walled silicone catheters for long-term continuous or intermittent therapy.
Definition
Tunneled catheters
Term
Brain 80%, Blood 10% and CSF 10%
Definition
Monroe-Kellie Doctrine
Term
The ____ is the only catheter, which allows you to drain CSF and you never drain more than ___ml/hr.
Definition
IVC

10ml/hr.
Term
The preferred sites for placement of the Swan-Ganz catheter are the ____________ and the _______________.
Definition
subclavian and the internal jugular vein.
Term
The Head of the bed should be elevated to ______ degrees in most cases, but you need to choose a position that optimizes ____ and minimizes _____, maintain head neck alignment.
Definition
15-30 degrees
CPP
ICP
Term
The transfusion rate for blood products is initially at a rate of ______ and evaluate for _____________, monitor vitals every 15 mins. and after 30 mins. adjust the flow rate per order, then monitor vitals every ___ mins.
Definition
1ml/min
hemolytic reaction
30 mins.
Term
The primary intracellular cation is __________ and the primary extracellular cation is __________.
Definition
Potassium (K+)
Sodium (Na+)
Term
____________ is when there is hemoglobin present in the urine, unattached to ____________.
Definition
Hemoglobinuria
red blood cells (RBC)
Term
A culture test is used to identify __________, while a __________ test is used to determine the best antibiotic.
Definition
organisms
sensitivity
Term
Lab values for ____ will show abnormalties in clotting tests.
Definition
DIC
Term
Transmission of the Herpes Zoster virus is a disease called __________.
Definition
shingles.
Term
Sux cannot be reversed with ________, Sux dose is ______ and indicated in patients with agonal respirations.
Definition
narcan
1mg/kg
Term
Sux is a __________ muscle relaxant.
Definition
depolarizing
Term
The correct procedure for a tracheostomy incision is ____ superior to the _____________.
Definition
1cm
suprasternal notch
Term
Low values on hemodynamic monitor may be caused by the ___________ being above the ________________ or air bubbles or clot in the catheter.
Definition
transducer
phlebostatic level
Term
____________ decrease the risk of volume overload with multiple infusions.
Definition
Packed Red Blood Cells
Term
Diastole is a phase that is ______ as long as systole.
Definition
twice
Term
The sympathetic nervous system controls the heart by ________ of the heart via the ______ ______.
Definition
innervation
cardiac plexus
Term
______________ can be indicated on the ECG by an elevated ST segment. Ischemia is noted by by ST depression without _____________.
Definition
Myocardial injury
reciprocal change
Term
The ICD analyzes the heart rhythm by: (3)
Definition
*Consideration of rate
*Onset of rate increase
*Stability of the complex.
Term
Name 3 indications for intra-aortic balloon pump counter pulsation.
Definition
1)Cardiogenic shock
2)Postoperative left ventricular failure
3)Severe unstable angina.
Term
Romazicon and ___________ are used to reverse the effect of sedation.
Definition
Flumazenil
Term
Propofol is a ________________ used to induce and maintain anesthesia.
Definition
sedative hypnotic
Term
Romazicon and ____________ are used to reverse the effects of sedation.
Definition
Flumazenil
Term
____________ has no chronotropic effects.
Definition
Dobutamine (Dobutrex)
Term
Name an example of a Class III antidysrhythmic.
Definition
Bretylium
Term
Diltiazem is a ________________.
Definition
calcium channel blocker.
Term
Streptokinase and TPA both convert __________ to plasmin.
Definition
plasminogen
Term
___________________ is not a major component of a neuro exam.
Definition
Receptive nerve function
Term
The primary risk factor ____________ is diabetes.
Definition
renal failure
Term
________ and ________ are colloid solutions.
Definition
Albumin and dextran
Term
Left ventricular afterload is also known as ______.
Definition
SVR
Term
Normal stroke volume
Definition
60-100cc/beat
Term
BP, HCT and pH are altered by ______________.
Definition
renal failure
Term
___________ and ________ will help decrease ICP. (Medications)
Definition
Methylprednisone and thiopental
Term
Ketamine, diazepam and nitroprusside will cause _______________.
Definition
an increase in ICP.
Term
Venous access ports such as porta-caths require the use of a ______ or ______ needle.
Definition
huber or gripper
Term
Liver ailments can cause patients to present with __________.
Definition
jaundice
Term
True/False:
Migraines can be treated with beta blockers.
Definition
True
Term
Vecuronium is a ________________ used to maintain paralysis following intubation, and lasting approx. 30 mins.
Definition
nondepolarizing-blocking agent
Term
____________ can cause an allergic reaction and last up to 2 days.
Definition
Theophylline
Term
Left upper quadrant pain and referred pain to the scapula are signs of a damaged _______.
Definition
spleen
Term
___________ during or following dialysis is a sign of excessive filtation of the blood.
Definition
Hypotension
Term
_________ _________ is a significant concern for patients with renal failure, elderly patients and patients receiving positive chronotropic drugs.
Definition
Prolonged paralysis
Term
When obtaining a PAWP the balloon shouldnot remain inflated longer than _____.
Definition
30 secs.
Term
In a hypertensive emergency, you may administer a _______________ known as Nifedipine, or an ____________, known as Captopril.
Definition
calcium channel blocker
ACE inhibitor
Term
The reversal agent for non-depolarizing NMBA is ____________.
Definition
Endrophonium Chloride (Tensilon)
Term
__________ are normally found in urine, abnormal findings include WBC, RBC and albumin.
Definition
Urochromes
Term
The definition for __________ is muscle twitching that occurs just prior to paralysis with NMBA agents.
Definition
fasciculation
Term
The dosage of Vecuronium (Norcuron) is ______ and is a _______________.
Definition
.1mg/kg and is a long acting non-depolarizing agent.
Term
Peritoneal dialysis involves the concept of ________ and ________ of waste products within the ______________.
Definition
osmosis and diffusion
peritoneal cavity.
Term
Diffusion is the movement of particles from an area of ______ concentration, to an area of ______ concentration.
Definition
higher to lower
Term
Fistula graft rejection is not a risk factor for peritoneal dialysis because it uses the patient's own vessels to surgically form an __________ between an artery and vein.
Definition
anastomosis
Term
Side effects of Anectine (Sux) are hyperkalemia, muscle fasciculation, ^ICP and _____________.
Definition
malignant hyperthermia.
Term
The continous flush solution delivers a volume of _____.
Definition
3ml/hr
Term
The pressure infuser should be inflated to ______.
Definition
300mm/hg
Term
Side effects of beta blockers: (5)
Definition
1)Bradycardia
2)Heart blocks
3)Hypotension
4)Impotence
5)Bronchoconstriction
Term
Contraindications of beta blockers: (4)
Definition
1)Bradycardia
2)Heart block
3)Hypotension
4)Asthma
Term
Side effects of ACE inhibitors are ________ and ________.
Definition
hypotension and angioedema.
Term
Cardizem (Diltiazem) is useful in the treatment of ________ and ________.
Definition
Atrial Fibrillation and Atrial Flutter.
Term
Calcium Channel Blockers are contraindicated in the presence of _____, identified by a ________.
Definition
WPW, identified by a delta wave.
Term
___________ is indicated in the presence of narrow complex tachycardia when it is refractory to adenosine, normal dosage is ____________.
Definition
Verapamil
2.5-5mg over 2 mins.
Term
O2 cylinder capacity

D cylinder
Definition
360 L
Term
O2 cylinder capacity

E cylinder
Definition
625 L
Term
O2 cylinder capacity

M cylinder
Definition
3,000 L
Term
O2 cylinder capacity

G cylinder
Definition
5,300 L
Term
O2 cylinder capacity

H cylinder
Definition
6,900 L
Term
Calcium Channel Blocker side effects: (3)
Definition
1)Hypotension
2)Weakness
3)Chronic edema
Term
The Big Four critical moments in critical care transport are:
Definition
1)Contact with referring staff
2)Contact with patient
3)Touch, procedure and equipment
4)Contact with receiving staff
Term
Beta-blockers that may be administered via IV route: (4)
Definition
*Lopressor (Metoprolol)
*Labetolol (Normodyne)
*Inderal (Propanolol)
*Tenormin (Atenolol)

* Note: Most beta-blockers end in "ol"
Term
RSI sequence:
Definition
a)Apply monitors (SpO2 and ECG)
b)Pre-oxygenate
c)Medicate with sux
d)Intubate
e)Medicate with Norcuron
Term
Procedure for deactivating an AICD:
Definition
1)Palpate the boundaries
2)Approach from directly above with cardiac magnet
3)Synchronous tone lasts 30 seconds followed by a continous tone=unit off
4)Remove magnet straight up.
Term
The normal SVR is ________ dynes/sec/cm5
Definition
900-1400
Term
Pull the PAC back into the __________ if you note an RVP waveform and PVC's.
Definition
RA (right atrium)
Term
Balloon Pumps:

Dicrotic notch is when the _________ closes and the beginning of _________.
Definition
aortic valve
augmentation
Term
Thermodilution,___ml given in less than __ secs.
Definition
10ml in less than 4 seconds
Term
Nipride must be ______________ and NTG must be in a _____________, be sure to saturate the IV tubing.
Definition
wrapped in foil

glass bottle
Term
RAP/CVP value
Definition
2-6 mmHg
Term
RVP value
Definition
20-30mmHg / 0-5mmHg
Term
PAP value
Definition
20-30mmHg / 10-15mmHg
Term
PAWP value
Definition
4-12mmHg
Term
Information only, not a question
LVEDP=PAWP=PCWP=LAP=PAD (PRELOAD)
Definition
No answer, information only!
Term
Cardiac Index (CI) is __________/_____, normal values are 2.5-5 L/m/m2, a value of less than ____ is indicative of cardiogenic shock.
Definition
cardiac output (CO) / body surface area (BSA)

1.8 L/m/m2
Term
Describe the mechanism of action of benzodiazepines.
Definition
Inhibits pre and postsynaptic dopamine and opens chloride channels in the cell membrane, leading to hyperpolarization and decreased neuronal response.
Term
An example of a non-tunneled catheter is a:
Definition
Peripherally Inserted Central Venous Catheter (PICC)
Term
Define Boyle's Law:
Definition
The volume is directly proportional to the pressure if the temperature remains constant. Increase in pressure = Decrease in volume.
Term
Define Dalton's Law:
Definition
The pressure of a gas equals the sum of the partial pressures, making up the mixture.
Term
________ and ________ will prolong the QT interval and are useful in the treatment of A-fib.
Definition
Quinidine and Procardia (Nifedipine)
Term
The __________ __________ is palpated between the first and second prominent structures.
Definition
cricothyroid membrane
Term
It is hard to see newer pacer spikes because, they are bipolar, what are the two best ways to see these?
Definition
1) 12 Lead ECG, best seen in V4
2) Turn off filter on monitor
Term
Information only, not a question!
Inflated balloon sails into distal pulmonary circulation, lodges in small branch of pulmonary artery and occludes it.
Definition
Review for information only! No answer!
Term
Information only, not a question!
Reposition the patient if you note a dampened waveform suggesting wedge without the balloon inflated and be prepared to pull back slightly into the PA.
Definition
Review for information only! No answer!
Term
ISAL (I See All Leads)
List them:
Definition
Inferior=II,III,aVF
Septal=V1,V2
Anterior=V3,V4 Lateral=V5,V6,I and aVL
Term
Indications for urinary catheter: (4)
Definition
1)Relief of urinary tract obstruction
2)Urinary drainage in pts. who have bladder dysfunction with urinary retention (eg, some pts. with neurogenic bladder or spinal cord injuries)
3)Urologic surgery
4)Strict measurement of urinary output in critically ill patients.
Term
The technique used in conjunction with NMBAs to determine the desired degree of pt. paralysis:
Definition
Train-of-Four monitoring
Term
Dopamine wheel with concentration of 800mg/500ml for an 80kg individual, infused with a micro drip set will equal:
Definition
5mcg per 15ml
Term
To interpret the heart rhythm, the ICD:
Definition
Considers rate, onset of rate increase, and stability of the complex.
Term
Pacemaker codes:
O=_____
A=_____
V=_____
D=_____
P=_____
S=_____
,which will include:
Definition
O=none
A=atrium
V=ventricle
D=dual
P=pacing
S=shock
which will include in the following order: chambers paced, chambers sensed, response to sensing, programmability (rate,modulation), antidysrhythmia function.
Term
CPP=MAP-ICP
Definition
Pressure gradient driving blood flow and delivery of nutrients to the brain.
Term
An abnormal wave formation involving plateau waves resembling a pattern simular to VF and indicating impending herniation and neurolgical deterioration:
Definition
A waves
Term
MAP (formula)
Definition
Systolic + 2(diastolic)/3
Term
The purpose of DTR evaluation is to rule out lesions affecting the spinal nerves,
0=_____
1=_____
2=_____
3=_____
4=_____.
Definition
0=no response
1=slow
2=brisk or expected
3=slightly hyperreflexive
4=greatly hyperreflexive
Term
____________ produce bronchodilation in cholinergic mediated bronchodilation.
Definition
Anticholinergics
Term
Augmented diastolic should be more than the ________ ______.
Definition
unassisted systolic.
Term
The first use of helicopters for air medical transport occurred as a result of:
Definition
The Korean conflict of 1950
Term
A Critical Care Transport Team is composed of:
Definition
EMT driver, RN, Paramedic
Term
A common problem of specimen collection associated with the breakdown or RBCs and subsequent release of hemoglobin is known as:
Definition
Hemolysis
Term
The primary intracellular cation important for repolarization of cardiac cells:
Definition
Potassium
Term
Neurogenic shock will result in:
Definition
peripheral vasodilation
Term
Mean arterial pressure (MAP), minus intracranial pressure (ICP), equals:
Definition
Cerebral perfusion pressure (CPP)
Term
T/F:
A trauma pt. with a suspected basilar skull FX is a good candidate for an NG tube.
Definition
False
Term
A decrease in hematocrit and hemaglobin is likely to be seen with:
Definition
Anemia
Term
An inappropriate motor response in a comatose pt. charaterized by flexion of the arms, wrists, and fingers, adduction of the upper extremeties, and extension, medial rotation and planter flexion of the lower extremities is known as:
Definition
Decorticate posture
Term
Shock can occur as a result of fluid shifting from the intravascular space to the extravascular space. This can result from:
Definition
Decreased colloidal osmotic pressure
Term
The initial signs and symptoms of __________ shock will be hindered if the pt. is taking beta-blockers:
Definition
compensated
Term
T/F:
Antigens are a major component of the immune system.
Definition
False
Term
T/F:
Venous blood never passes through the lungs during right to left cardiac shunting.
Definition
False
Term
In assessing a pt. with asthma, the PaO2 will assist in obtaining information of what nature:
Definition
The efficiency of gas exchange
Term
Hemoglobin is not a component of _____ measurement.
Definition
ABG
Term
In regard to pleural decompression, the "Angle of Louis" is:
Definition
used to locate the second intercostal space.
Term
200cc of clear amber fluid have been withdrawn from the right pleural space of a pt. who has just undergone pleural decompression. Which of the following positions would maximize the pts. oxygenation?
Definition
Left Lateral Recumbent
Term
Chest tube pts. should ideally be transported in what position?
Definition
Fowler's
Term
T/F:
Most automatic ventilators can be safely used in all age groups.
Definition
True
Term
The most serious drawback of using positive pressure/demand valves?
Definition
High airway pressures are created
Term
Sterile technique is indicated when using which ET suctioning catheter.
Definition
Whistle-tip
Term
To perform retrograde intubation, the guide wire must be:
Definition
Approximately 70cm in length
Term
Wedging a PA catheter reveals what information?
Definition
LVEDP
Term
A Swan-ganz catheter is in place. If no waveform shows on the monitor you should?
Definition
Flush the catheter
Term
Zero referencing balances the transducer to _______________.
Definition
atmospheric pressure
Term
Which type of blood preparation would eliminate disease transmission and the possibilty of transfusion reaction?
Definition
Autologous
Term
T/F:
The normal electrical state of the cardiac cells is known as the action potential.
Definition
False
Term
The shape and appearance of a waveform is referred to as the ___________.
Definition
morphology
Term
T/F:
Calculation of the electrical axis of the T wave and P wave are a primary component of 12Lead ECG interpretation.
Definition
False
Term
Haliperidol is indicated for:
Definition
Acute psychotic episodes
Term
The mechanism of action for Benzodiazepines:
Definition
Inhibits pre and post synaptic dopamine
Term
Flumazenil antagonizes ___________ receptor sites.
Definition
Benzodiazapine
Term
T/F:
Morphine is not a CNS stimulant.
Definition
True
Term
An ________ catheter must be in place to monitor proper timing of the balloon pump.
Definition
arterial
Term
The proper position of the intra-aortic balloon is in the ______________, distal to the left subclavian artery.
Definition
thoracic aorta
Term
A pt. presenting with profuse hematemesis with frank red blood, and a history of significant alcohol abuse is most likely caused by:
Definition
Esophageal varices
Term
Enteral feeding sets should be changed ____________ to prevent diarrhea and other gastrointestinal complications.
Definition
every 24 hrs
Term
The intracranial volume-pressure curve demonstrates the relationship between:
Definition
Changes in volume and intracranial pressure.
Term
An intracranial pressure of 19 mmHg indicates the ICP is:
a. normal
b. slightly elevated
c. moderately elevated
d. severely elevated
Definition
b. slightly elevated
Term
Ketamine
Diazepam
Nitroprusside
will _________ ICP.
Definition
increase
Term
The circulating blood volume of a neonate is?
Definition
85-90 cc/kg
Term
An early sign of shock in the pediatric pt. is?
Definition
Prolonged capillary refill
Term
The antihypertensive medication of choice for managing severe pre-eclampsia is:
Definition
Hydralazine
Term
An alternative method for measuring total BSA burned:
Definition
Rule of the Palm
Term
T/F:
A chest tube should be placed when a pulmonary embolus is suspected.
Definition
False
Term
What is the best way to confirm proper chest tube positioning?
Definition
Chest X-Ray
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