Term
Members of the critical care transport team include |
|
Definition
EMT, Paramedic, nurse, RT, perfusionist, and occasionally physicians |
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Term
what is the goal of critical care transport |
|
Definition
continuous Intensive care bed-to-bed providing the same or higher level of care |
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Term
True or False There exsists a standardized curriculum for providing continuing education credits to critical care transport providers |
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Definition
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Term
True or false the majority of ambulance accidents occur when the vehicle is traveling without lights and sirens |
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Definition
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Term
true or false federal law requires that all emergency personnel working on the roadways must wear florescent and retro reflective vest |
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Definition
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Term
True or False the critical care transport providers must always assume responsibility and accountability for his or her actions |
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Definition
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Term
what is the decision to use critical care transport is based on |
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Definition
medical over sight clinical judgement logistical considerations |
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Term
although debated by historians, the first air medical transport could have occurred in what conflict? |
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Definition
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Term
the first helicopter evacuation of a wounded soldier occurred in which military conflict |
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Definition
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Term
Rotor wing transport is typically used for transports less than how many nautical miles? |
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Definition
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Term
true or false air medical accidents are usually caused by a single event |
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Definition
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Term
four major contributing factors to HEMS crash as identified by the NTSB: |
|
Definition
Human Error weather mechanical failure obstacle strikes |
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Term
true or false weather has frequently been found to be the primary cause of HEMS accidents |
|
Definition
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Term
What is the "cardinal sin" of requesting air medical transport |
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Definition
transporting the patient by air when they could have reached an appropriate hospital quicker by ground transport |
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Term
___ minutes or ____minute ground transport time is considered to be the minimum to which air medical transport is beneficial to the patient |
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Definition
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Term
what criteria is considered DEBATABLE criteria for the use of HEMS |
|
Definition
Death of an occupant in the vehicle |
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Term
define helicopter shopping |
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Definition
when sequential calls are made to numerous air medical providers in an attempt to find one to take a mission when it has been declined by others |
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Term
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Definition
The 51% rule allows any crew member the right to decline a flight without fear of repercussion from administration or other crew members |
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Term
what is the ideal size for a helicopter landing zone |
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Definition
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Term
the slope of the landing zone cannot exceed ____ degrees |
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Definition
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Term
Most aircraft are designed to approach the aircraft from a ____ degree angle to the doors |
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Definition
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Term
describe the "SLOW" acronym used to establish a landing zone |
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Definition
S-size of landing zone should be 100X100 L-Landing area O-Obstacles W-Wind |
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Term
CAMTS standards require following by a communicator for both flight and ground transports. avaiation need to report position every ___ minutes, ground crews need to report position every____ minutes. |
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Definition
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Term
TS standards require that a post accident incident plan needs to be implemented___minutes after a transport vehicle fails to give a position report, or is overdue to arrive |
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Definition
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Term
CAMTS standard require that a pilot have___ rotorcraft hours with ____hours as a pilot in charge and ____hours at night as the pilot in charge |
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Definition
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Term
rotor wing transports typically occur at altitudes less than ______feet |
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Definition
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Term
Fixed wing transports are typically used for transports greater than ____ miles |
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Definition
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Term
fixed wing transports can occur at altitudes up to _______. |
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Definition
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Term
this type of test will only result in a positive when the condition is present in a patient |
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Definition
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Term
_________is the probability that a test will be negative in the absence of a disease |
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Definition
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Term
as respirations increase what would you expect the pH to do? |
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Definition
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Term
as respirations decrease what would you expect the Hydrogen ions to do? |
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Definition
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Term
what are the two primary acid excreting organs? |
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Definition
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Term
what causes a left shift (alkalosis) |
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Definition
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Term
your patient has a core temerature of 105 degrees, would you expect to see a right shift (acidosis) or a left shift (alkalosis) |
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Definition
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Term
you observe lab values that show an increase in pH, a decrease in PaCO2, and no change in HCO3. based on this information, you can assume the patient is in |
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Definition
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Term
you observe lab values that show a decrease in pH , an increase in PaCO2, and no change in HCO3. based on this information , you can assume the patient is in |
|
Definition
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Term
you are treating a patient with a suspected C2 fracture of the spinal cord. what type of respiratory compromise is the patient at risk for? |
|
Definition
Respiratory acidosis due to decreased ventilations |
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Term
you are transporting a 24 year old body builder who overdosed on diuretics in an attempt to slim down for a competition, what acid base dysfunction would you find |
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Definition
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Term
your patient is on a transport vent. their ETCO2 is 26mmHg. what is causing this acid base disturbance? |
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Definition
you are hyperventiliating the patient and blowing off the CO2 |
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Term
If the HCO3 moves opposite the pH, the metabolic system is the body compensating for a respiratory or metabolic imbalance? |
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Definition
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Term
your patient has the following lab values: pH: 7.43, PaCO2:60, HCO3: 32 what acid base disturbance is this? |
|
Definition
compensated respiratory alkalosis |
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Term
your 32 year old male patient has a hemoglobin of 5. is this value high or low |
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Definition
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Term
you are transporting a 25 year old female who is 72 hours postpartum. she is in full DIC what value would you expect for her platelets? |
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Definition
her platelets should be low |
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Term
What test measures to effectiveness of coumadin? |
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Definition
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Term
which test would be most appropriate for determining renal function? |
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Definition
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Term
what is the normal value for sodium? |
|
Definition
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Term
you are treating a 62 year old male patient with a gastrointestinal bleed. the patients potassium is 6.5 mEq/L is this low or high? |
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Definition
this is an elevated potassium level |
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Term
what cardiac bio marker is considered most specific for myocardial damage? |
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Definition
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|
Term
How is uncompensated respiratory acidosis characterized? |
|
Definition
Decrease in pH Increase in PaCO2 no change in HCO3 |
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Term
How is uncompensated respiratory alkalosis characterized? |
|
Definition
increased pH decreased PaCO2 no change in HCO3 |
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Term
How is uncompensated metabolic acidosis characterized? |
|
Definition
decrease pH no change in PaCO2 decreased HCO3 |
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Term
How is uncompensated metabolic alkalosis characterized? |
|
Definition
increased pH no change in PaCO2 increased HCO3 |
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Term
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Definition
pH:7.34-7.45 PaCO2:35-45mmHg HCO3:22-26 mEql Base excess -3 to +3 mmol/l PaO2: 80-100 mmHg SaO2: 90-100% |
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Term
what is the golden rule for ABG analysis? |
|
Definition
for every 10 mmHg of change in CO2 the pH will change 0.08 in the opposite direction. with every change in HCO3 of 10 mEq, the PH will change 0.15 in the same direction |
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Term
sequence of ABG interpretation |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
measures effectiveness of Coumadin Normal: 11.2-13.2 seconds |
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Term
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Definition
1.5-2.5 in persons recieving warfarin otherwise 1 |
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Term
|
Definition
1.5-2.5 in persons recieving warfarin otherwise 1 |
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Term
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Definition
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Term
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Definition
evaluates renal function and hydration status. normal: 8-20 mg/dl |
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Term
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Definition
waste product of protien metabolis found in urine female normal: 0.8-1.4 mg/dl male normal: 0.6-1.2 mg/dl |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
creatinine phosphate (CPK) |
|
Definition
normal: 5-35 mcg/ml rises within 4-6 hours of AMI: peaks at 24: returns to normal in 3-4 days |
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Term
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Definition
Cardiac specific elevated within 2-6 hours of cardiac injury:peaks in 12-16 hours normal: <0.2-1 |
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Term
what size syringe should be used on hemodyalisis shuntsto prevent damage from excess infusion pressure? |
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Definition
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Term
all medications should be flushed with ___ml of saline to avoid clots |
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Definition
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|
Term
a power PICC can accomidate pressure up to ____PSI |
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Definition
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|
Term
these catheters can be single, double or triple lumen large bore catheters. |
|
Definition
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|
Term
SVAD (port a caths) require what kind of needle |
|
Definition
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|
Term
True or false if a Central venous access devise is infusing sluggishly, it should be vigourously flushed with 20-30 ml of normal saline |
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Definition
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Term
the typical arterial line transducer will need ot be changed out every____hours. |
|
Definition
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|
Term
what is the most important reason not to let the arterial line flush bag run dry? |
|
Definition
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|
Term
how will it affect the readings if a transducer is placed too low |
|
Definition
the readings will be falsely high. |
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Term
if the arterial wave form is lost, how do you check catheterpatentcy? |
|
Definition
by attaching a 3cc syringe to the stop cock and withdrawing blood |
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Term
classic signs and symptoms of dissecting aortic aneurysm: |
|
Definition
- Flank pain - Acute severe back pain (non-traumatic) - sense of impending death - "ripping" or "tearing" pain in chest |
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Term
pericarditis pain is positional |
|
Definition
worse when pt. lies flat relieved when pt. sits forward |
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Term
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Definition
normal 15-30 systolic 5-15 diastolic |
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Term
|
Definition
normal values: 20-30 sys 0-8 dia only seen during insertion of PA |
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Term
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Definition
reflects RVEDP or Preload normal values 2-6 mmHg |
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Term
|
Definition
Pulmonary Artery Pulmonary Artery Pressure |
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Term
|
Definition
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|
Term
______ is the amount of blood ejected from the ventricles with each contraction |
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Definition
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Term
Which vessel is occluded if pts. left ventricle (widow maker) |
|
Definition
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|
Term
Which vessel is occluded in an inferior MI? |
|
Definition
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|
Term
Signs of transfusion reaction |
|
Definition
severe symptoms similar to anaphalaxis
fever hypotension tachycardia shock DIC |
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|
Term
Subtle indication of a transufsion reaction include? |
|
Definition
increased HR and body temp. |
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Term
Patients receiving large volume of whole blood should be monitored for what electrolyte balance? |
|
Definition
hypocalcemia secondary to citric acid in whole blood binds calcium |
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Term
Who is the universal recipient? |
|
Definition
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|
Term
What happens to RH- blood exposed to RH+ blood? |
|
Definition
antibodies to antigens could be produced |
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Term
patients with hepatic disease may be prone to which of the following complications following massive blood transfusion |
|
Definition
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|
Term
complications can occur up to ___ days post transfusion? |
|
Definition
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|
Term
What medication can be safely added to blood bag or given IV while blood is being administered? |
|
Definition
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|
Term
What solution is used to prime IV blood tubing? |
|
Definition
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|
Term
What gauge IV should be used for blood administration? |
|
Definition
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|
Term
At what rate should fresh frozen plasma be administered? |
|
Definition
as fast as patient can tolerate |
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Term
Which blood product is best suited for a patient in massive hemmorhagic shock? |
|
Definition
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|
Term
Blood can not be returned to the blood bank after how long at room temperature? |
|
Definition
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|
Term
What blood product is typically used to improve oxygen carrying capacity? |
|
Definition
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|
Term
What is typically used to correct a coagulation factor deficiency |
|
Definition
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|
Term
WBC are responsible for protecting the body from invasion by foreign substances such as bacteria, fungi, and viruses? |
|
Definition
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|
Term
Who is the universal donor? |
|
Definition
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|
Term
Where are red blood cells produced? |
|
Definition
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|
Term
Pulmonary Artery diastolic pressure (PAD) |
|
Definition
|
|
Term
Pulmonary Artery Pressure |
|
Definition
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|
Term
CVP Central Venous Pressure |
|
Definition
|
|
Term
MAP Mean Arterial Pressure |
|
Definition
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Hypervolemia Pulmonary HTN Cardiac Tampanode Left Ventrical Failure |
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|
Term
Pulmonary Artery Pressure PAP |
|
Definition
15-30 mmHg systolic 5-15 mmHg diastolic |
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|
Term
if transducer is higher than phlebostatic axis, what readings would you expect? |
|
Definition
inaccurately low readings |
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|
Term
If transducer is lower than phlebostatic axis, what readings would you expect? |
|
Definition
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|
Term
Right Ventricular Pressure RVP |
|
Definition
20-30 mmHg systolic 0-8 mmHg diastolic |
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|
Term
|
Definition
- Left arterial pressure - left ventricular end diastolic pressure - normal 4-12 mmHg |
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|
Term
Before transporting a patient with a pulmonary artery catheter, what value should be assessed? |
|
Definition
a current wedge pressure to confirm catheter placement |
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|
Term
treatment for spontaneous wedging? |
|
Definition
- turn pt on their side - aspirate for blood return - have pt raise arm nearest catheter and cough |
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|
Term
Left ventricular preload is measured by the ____ and is the same as _____. |
|
Definition
Wedge Left ventricular end diastolic pressure |
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Term
|
Definition
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|
Term
infusion of the pulmonary artery balloon should be no longer than ____ sec. |
|
Definition
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|
Term
Right ventrical pressure is measured when? |
|
Definition
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|
Term
What causes elevated CVP and RAP? |
|
Definition
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|
Term
Normal value CVP and RAP? |
|
Definition
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|
Term
When should you level the transducer? |
|
Definition
- upon insertion - upon pt change in position - just prior to taking a reading |
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|
Term
What is the phlebostatic axis? |
|
Definition
level with right atrium at 4th intercostal space |
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|
Term
The pulmonary artery catheter must always maintain which of the following constant flows in order to maintain patency of the line? |
|
Definition
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|
Term
What syringes should be used to inflate the pulmonary artery balloon? |
|
Definition
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|
Term
Which lumen measures CVP? |
|
Definition
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|
Term
The proximal (blue) lumen measures what? |
|
Definition
Pulmonary Artery Pressure |
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|
Term
What is the most important info obtained from Hemodynamic Monitoring? |
|
Definition
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|
Term
The catalyst that changes fibrinogen into fibrin threads is? |
|
Definition
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|
Term
Normal ICP _____ treat when > ____ |
|
Definition
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|
Term
In a pt with increased ICP, ventilate to maintain PaCO2 of |
|
Definition
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|
Term
Fever increases respirations by ___ breaths/min for each degree of temp increase |
|
Definition
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Term
|
Definition
Ascending / descending pattern |
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Term
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Definition
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|
Term
Broncho-vesicular (around sternum) produces a _____ pitch |
|
Definition
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|
Term
Want CPP to be > ___ mmHg. Treatment should begin when CPP below ___. |
|
Definition
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Term
|
Definition
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|
Term
What is a very significatn concern with an upper GI bleed? |
|
Definition
Esophageal varicies Portal HTN |
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|
Term
What is the minimum I:E ratio. The higher you set the Peak flow, the longer your ____ time may be. |
|
Definition
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|
Term
The greater the dead space, the fewer ___ that reach the Alveoli? What can increase dead space? |
|
Definition
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|
Term
Balloon placement too high and too lo will cause |
|
Definition
low - comprimising renal function high - obstruct L subcavian or L carotid artery |
|
|
Term
|
Definition
1-2cm below origin of left sublcavian artery
above the renal artery branches |
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|
Term
What is the most abundant cation in the blood that helps with osmotic pressure and acid base balance? |
|
Definition
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|
Term
The value of the pletelet count tells you what info? |
|
Definition
number of clotting factor |
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|
Term
These two tests are primarily used to test renal perfusion |
|
Definition
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|
Term
What type of diseases would you expect to see an elevated WBC in? |
|
Definition
Leukemia infections meningitis |
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|
Term
Which one would you expect to see decreased WBC in? |
|
Definition
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|
Term
Tidal volume on ventilator |
|
Definition
7-12 ml/kg of ideal body weight |
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|
Term
What cardiac isoenzyme would you check that is specific for an MI when elevated? |
|
Definition
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|
Term
|
Definition
|
|
Term
What are depolarizing neuromuscular agents? |
|
Definition
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|
Term
If you have aerosol droplets it is ____ |
|
Definition
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|
Term
The tip of the balloon will have to be above ____ and below _____ and visible between ____ and ____ intercostal space. |
|
Definition
above renal arteries below subclavian arteries 2nd 3rd |
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|
Term
In IABP what are the 2 biggest timing issues you could have? |
|
Definition
early inflation and late deflation |
|
|
Term
if you have just droplets, you have ____ |
|
Definition
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|
Term
Hep B is ____ more times infectious than ____. Also, people who get infected with HBV can get ____ . You have ____ to get _____. |
|
Definition
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|
Term
IABP triggers on the ART line when ____ and on the EKG ____ |
|
Definition
Art line: DN EKG: ST segment |
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|
Term
HIV is a ____, and it is found in ____, _____, ____, but not found in ____, _____, _____. |
|
Definition
Virus blood, semen, breast milk urine, saliva, emesis |
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|
Term
Describe the appropriate response to transfusion reaction |
|
Definition
- stop flow - keep blood bag and tubing - contact Dr. - antihistimine admin |
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|
Term
Aids is defined as T-cell count less than ____ and have at least ____ recognized oppotunistic infection. |
|
Definition
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|
Term
_____ is a waste product of protein metabolism found in urine and aids in the diagnisis of _____. |
|
Definition
creatnine renal dysfunction |
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|
Term
Difficult intubation mnemonic is? |
|
Definition
Look externally Evaluate 3-3-2 Mallimpati score Obstructions Neck mobility |
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|
Term
During cardiac arrest IABP must be placed in _____ mode instead of ____ mode |
|
Definition
|
|
Term
|
Definition
At a constant pressure, the volume of a gas is directly proportional to its temp temp up, gas up temp down, gas down |
|
|
Term
|
Definition
states that gas molecules will move from an area of higher concentration to a lower concentration |
|
|
Term
|
Definition
temp and pressure held constant, the relative rate of diffusion of a gas is inversely proportional to the square roots of the density of those gases |
|
|
Term
Axis determinations are used for? |
|
Definition
- diagnosing ventricular tach - diagnosing hemiblocks - identifying pt whose infarction has become critical leading to hemodynamic instability |
|
|
Term
Dalton's Law
Dalton's Gang |
|
Definition
The total pressure of a gas mixture is the sum of individual partial pressure of all the gases in the mixture |
|
|
Term
Pt with suspected dissecting aneurysm target HR ____ and sys pressure you want between ____ and you should give ___ med. |
|
Definition
60-80 100-120 beta blockers |
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|
Term
Prothrombin time (PT) measures the effectiveness of _____ anticoagulant meds. Normal value is _____. |
|
Definition
|
|
Term
High and low ranges for CBC?
RBC/ Hemoglobin/ Hematocrit |
|
Definition
RBC - high 5, low 1.5 HGB - high 15, low 5 HCT - high 45, low 10 |
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|
Term
Three major types of antigens are? |
|
Definition
|
|
Term
|
Definition
cerebal perfusion pressure |
|
|
Term
Low HDL is a single predicter of what syndrome? |
|
Definition
ACS Acute Coronary Syndrome |
|
|
Term
Cerebrospinal fluid test
high glucose with low protiens is indicitave of what type of menangitis |
|
Definition
|
|
Term
|
Definition
When temp remains constant, the volume of gas is inversely proportional to its pressure P1V1 = P2V2 Boyle's Burst Bubble |
|
|
Term
|
Definition
Fixed amount of gas at a fixed volume, pressure is proportional to temperature |
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|
Term
_____ and ____ monitoring do not allow for CSF drainage |
|
Definition
Subarachnoid bolt Intraparenchymal |
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|
Term
ETCO2 < _____ after ____ min of CPR is generally considered a reliable indicator that resuscitation will be unsuccessful. |
|
Definition
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|
Term
O2 sat in TBI pt should be maintained at least ____ % and ETCO2 at _____ mmHg. |
|
Definition
|
|
Term
|
Definition
right ventricle inferior posterior wall of left ventricle |
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|
Term
____ in acute life-threatening hypermetabolic state that when excessive amounts of TH are release in pt with Thyrotoxicosis |
|
Definition
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|
Term
|
Definition
left atrium posterolateral wall of left ventricle |
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|
Term
____ reflects pressure in the great veins. |
|
Definition
|
|
Term
|
Definition
Central Venous Access Cathetor |
|
|
Term
|
Definition
Peripherally inserted central catheter |
|
|
Term
|
Definition
Cerebral Perfusion Pressure |
|
|
Term
|
Definition
Heart Rate x Stroke Volume |
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|
Term
|
Definition
Mean arterial pressure 70-100 mmHg |
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|
Term
|
Definition
subcutaneous vascular access device |
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|
Term
to be clinically significant, ST must be |
|
Definition
> 1mm in limb leads > 2mm in precordial leads |
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|
Term
Electrolyte imbalance with shortened QT interval |
|
Definition
|
|
Term
What electrolyte imbalance presents with prolonged QT intervals and false ST changes? |
|
Definition
|
|
Term
What electrolyte imbalances present with tall, tented "T" waves |
|
Definition
Hyperkalemia and Hypermagnesemia |
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|
Term
What electrolyte imbalances present with flattened T waves |
|
Definition
Hypokalemia and Hypomagnesemia |
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|
Term
How can you make posterior diagnosis? |
|
Definition
look at anterior leads as a mirror image |
|
|
Term
Which leads look at lateral surface? |
|
Definition
|
|
Term
Which leads look at septum? |
|
Definition
|
|
Term
Which leads look at anterior surface |
|
Definition
|
|
Term
Which leads look at right side of heart and left interior ventricle |
|
Definition
|
|
Term
extreme right axis deviation |
|
Definition
down in leads I,II,III means ventricular in orgin |
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|
Term
Right axis deviation is indicative of |
|
Definition
|
|
Term
|
Definition
90 dergrees to 180 degrees down in lead I up or down in lead II Up in lead III |
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|
Term
pathologic left axis deviation indicates |
|
Definition
|
|
Term
pathologic left axis deviation |
|
Definition
- 40 degrees to - 90 degrees up in lead I down in lead II,III |
|
|
Term
physiologic left axis deviation |
|
Definition
0 to -40 degrees up in lead I, II down in lead III |
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|
Term
|
Definition
0-90degrees up in lead I II III |
|
|
Term
how much ST depression indicates ischemia |
|
Definition
|
|
Term
how much ST elevation is considered infarction |
|
Definition
|
|
Term
in a normal EKG what is the cardiac axis |
|
Definition
|
|
Term
what polarity are the precordial leads |
|
Definition
|
|
Term
limb leads look at what section of the heart |
|
Definition
|
|
Term
4 primary characteristics of cardiac cells |
|
Definition
automaticity excitability conductivity contractility |
|
|
Term
what electrolyte imbalance causes torsades |
|
Definition
|
|
Term
|
Definition
|
|
Term
CHF Pharmacology neumonic LMNOP |
|
Definition
lasix morphine nitro oxygen pressors |
|
|
Term
|
Definition
|
|
Term
how should BP be lowered in hypertensive crisis |
|
Definition
MAP should not be lowered more than 20% in the first hour |
|
|
Term
|
Definition
hypertension with end organ failure ie seizures, flash pulmonary edema, acute renal failure, MI, AMS |
|
|
Term
target HR and BP in patients with dissecting aneurysm |
|
Definition
HR 60 -80 BP 100-120 systolic |
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Term
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Definition
BUN Creatinine urinary output electrolytes |
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Term
3 main functions of renal system |
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Definition
excretion elimination regulation |
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Term
gold standard for monitoring ICP |
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Definition
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Term
cause of autonomic dysreflexia in spinal cord injury patients |
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Definition
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Term
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Definition
80% Brain 10% CSF 10% Blood volume |
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Term
deterioration of ____GCS is significant |
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Definition
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Term
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Definition
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Term
Central perfusion pressure |
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Definition
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Term
where are cardiac and respiratory centers |
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Definition
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Term
what is the autonomic control center |
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Definition
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Term
where is pneumotaxic center |
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Definition
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