Air Methods Critical Care Exam Prep
2026/2027 – Flight Paramedic, EMS
Critical Care, and Practice Questions
Test Bank
1. What is the characteristic ECG finding in 3rd degree AV block? -
ANSWER✔ P wave independent of QRS
2. A 36-year-old patient presents in ventricular tachycardia (VTACH). What is
the most appropriate drug? - ANSWER✔ Amiodarone (Cordarone)
3. A 45-year-old patient is placed on VV ECMO due to severe ARDS. An
ABG after 2 hours shows pH 7.11, PCO2 63, PaO2 126. What is the most
appropriate action? - ANSWER✔ Increasing sweep gas flow
4. A 45-year-old male on VV ECMO due to severe ARDS has an ABG after 2
hours: pH 7.37, PCO2 35, PaO2 64, SpO2 78%. What is the most
appropriate action? - ANSWER✔ Increase ECMO blood flow
5. A 54-year-old female on VV ECMO via internal jugular and femoral veins
has SpO2 72% with streaks of bright red blood in the access/drainage
cannula. Attempts to increase ECMO flow worsen hypoxia. What is the
patient experiencing? - ANSWER✔ Recirculation
6. A 65-year-old male presents with chest pain 8/10 that lessens when leaning
forward. 12-lead ECG reveals diffuse ST elevation across most leads. What
is the most likely diagnosis? - ANSWER✔ Acute pericarditis
7. A holosystolic murmur at the left sternal border means which valve is most
likely affected? - ANSWER✔ Tricuspid valve
8. A lactate level greater than what value is a poor prognostic sign? -
ANSWER✔ Lactate > 4
,9. What is the first-line medication for an unstable patient with wide-complex
tachycardia? - ANSWER✔ Amiodarone
10.In a patient on VV ECMO, what complication occurs when oxygenated
blood from the return cannula is drawn back into the drainage cannula? -
ANSWER✔ Recirculation
11.Which ECG finding is classic for acute pericarditis? - ANSWER✔ Diffuse
ST elevation
12.A patient on VV ECMO has hypercapnia. How should sweep gas flow be
adjusted? - ANSWER✔ Increase sweep gas flow
13.A patient on VV ECMO has hypoxemia despite maximal FiO2 on the
ventilator. What circuit adjustment is most effective? -
ANSWER✔ Increase ECMO blood flow
14.What is the most common cause of differential hypoxemia in peripheral VA
ECMO? - ANSWER✔ Harlequin syndrome (north-south syndrome)
15.Which medication is preferred for narrow-complex tachycardia in a
hemodynamically stable patient? - ANSWER✔ Adenosine
16.A patient with acute pericarditis may have a pericardial friction rub. What
position typically relieves the pain? - ANSWER✔ Leaning forward
17.What is the initial energy dose for synchronized cardioversion of unstable
atrial fibrillation? - ANSWER✔ 120-200 J (biphasic)
18.Which drug is used for acute-onset atrial fibrillation with a rapid ventricular
response? - ANSWER✔ Ibutilide
19.A patient on VA ECMO has upper body hypoxia and lower body normal
oxygenation. What is this phenomenon called? - ANSWER✔ Differential
hypoxemia (Harlequin syndrome)
20.What is the first intervention for suspected recirculation on VV ECMO? -
ANSWER✔ Check cannula position and consider repositioning
21.Which electrolyte abnormality is most commonly associated with digoxin
toxicity? - ANSWER✔ Hypokalemia
, 22.A patient presents with pulseless electrical activity (PEA). What is the most
important intervention? - ANSWER✔ Identify and treat the underlying
cause (Hs and Ts)
23.What is the recommended initial dose of epinephrine for cardiac arrest in
adults? - ANSWER✔ 1 mg IV/IO every 3-5 minutes
24.Which rhythm requires immediate defibrillation? - ANSWER✔ Ventricular
fibrillation
25.A patient with severe ARDS on VV ECMO has a PaO2 of 55 mmHg despite
circuit adjustments. What is the next step? - ANSWER✔ Consider adding a
second drainage cannula or converting to VA ECMO
26.What is the normal range for mixed venous oxygen saturation (SvO2)? -
ANSWER✔ 60-80%
27.Which vasopressor is first-line for septic shock? -
ANSWER✔ Norepinephrine
28.A patient on ECMO develops circuit thrombosis. What laboratory value
should be monitored closely? - ANSWER✔ Platelet count and fibrinogen
29.What is the target activated clotting time (ACT) for most ECMO circuits? -
ANSWER✔ 180-220 seconds
30.A patient with massive pulmonary embolism presents with hypotension.
What is the most appropriate intervention? - ANSWER✔ Thrombolytics or
embolectomy
31.What is the first-line treatment for acute ischemic stroke within 4.5 hours of
symptom onset? - ANSWER✔ IV alteplase (tPA)
32.A patient with status epilepticus does not respond to benzodiazepines. What
is the next medication? - ANSWER✔ Fosphenytoin or levetiracetam
33.What is the most common complication of central venous catheterization? -
ANSWER✔ Pneumothorax
2026/2027 – Flight Paramedic, EMS
Critical Care, and Practice Questions
Test Bank
1. What is the characteristic ECG finding in 3rd degree AV block? -
ANSWER✔ P wave independent of QRS
2. A 36-year-old patient presents in ventricular tachycardia (VTACH). What is
the most appropriate drug? - ANSWER✔ Amiodarone (Cordarone)
3. A 45-year-old patient is placed on VV ECMO due to severe ARDS. An
ABG after 2 hours shows pH 7.11, PCO2 63, PaO2 126. What is the most
appropriate action? - ANSWER✔ Increasing sweep gas flow
4. A 45-year-old male on VV ECMO due to severe ARDS has an ABG after 2
hours: pH 7.37, PCO2 35, PaO2 64, SpO2 78%. What is the most
appropriate action? - ANSWER✔ Increase ECMO blood flow
5. A 54-year-old female on VV ECMO via internal jugular and femoral veins
has SpO2 72% with streaks of bright red blood in the access/drainage
cannula. Attempts to increase ECMO flow worsen hypoxia. What is the
patient experiencing? - ANSWER✔ Recirculation
6. A 65-year-old male presents with chest pain 8/10 that lessens when leaning
forward. 12-lead ECG reveals diffuse ST elevation across most leads. What
is the most likely diagnosis? - ANSWER✔ Acute pericarditis
7. A holosystolic murmur at the left sternal border means which valve is most
likely affected? - ANSWER✔ Tricuspid valve
8. A lactate level greater than what value is a poor prognostic sign? -
ANSWER✔ Lactate > 4
,9. What is the first-line medication for an unstable patient with wide-complex
tachycardia? - ANSWER✔ Amiodarone
10.In a patient on VV ECMO, what complication occurs when oxygenated
blood from the return cannula is drawn back into the drainage cannula? -
ANSWER✔ Recirculation
11.Which ECG finding is classic for acute pericarditis? - ANSWER✔ Diffuse
ST elevation
12.A patient on VV ECMO has hypercapnia. How should sweep gas flow be
adjusted? - ANSWER✔ Increase sweep gas flow
13.A patient on VV ECMO has hypoxemia despite maximal FiO2 on the
ventilator. What circuit adjustment is most effective? -
ANSWER✔ Increase ECMO blood flow
14.What is the most common cause of differential hypoxemia in peripheral VA
ECMO? - ANSWER✔ Harlequin syndrome (north-south syndrome)
15.Which medication is preferred for narrow-complex tachycardia in a
hemodynamically stable patient? - ANSWER✔ Adenosine
16.A patient with acute pericarditis may have a pericardial friction rub. What
position typically relieves the pain? - ANSWER✔ Leaning forward
17.What is the initial energy dose for synchronized cardioversion of unstable
atrial fibrillation? - ANSWER✔ 120-200 J (biphasic)
18.Which drug is used for acute-onset atrial fibrillation with a rapid ventricular
response? - ANSWER✔ Ibutilide
19.A patient on VA ECMO has upper body hypoxia and lower body normal
oxygenation. What is this phenomenon called? - ANSWER✔ Differential
hypoxemia (Harlequin syndrome)
20.What is the first intervention for suspected recirculation on VV ECMO? -
ANSWER✔ Check cannula position and consider repositioning
21.Which electrolyte abnormality is most commonly associated with digoxin
toxicity? - ANSWER✔ Hypokalemia
, 22.A patient presents with pulseless electrical activity (PEA). What is the most
important intervention? - ANSWER✔ Identify and treat the underlying
cause (Hs and Ts)
23.What is the recommended initial dose of epinephrine for cardiac arrest in
adults? - ANSWER✔ 1 mg IV/IO every 3-5 minutes
24.Which rhythm requires immediate defibrillation? - ANSWER✔ Ventricular
fibrillation
25.A patient with severe ARDS on VV ECMO has a PaO2 of 55 mmHg despite
circuit adjustments. What is the next step? - ANSWER✔ Consider adding a
second drainage cannula or converting to VA ECMO
26.What is the normal range for mixed venous oxygen saturation (SvO2)? -
ANSWER✔ 60-80%
27.Which vasopressor is first-line for septic shock? -
ANSWER✔ Norepinephrine
28.A patient on ECMO develops circuit thrombosis. What laboratory value
should be monitored closely? - ANSWER✔ Platelet count and fibrinogen
29.What is the target activated clotting time (ACT) for most ECMO circuits? -
ANSWER✔ 180-220 seconds
30.A patient with massive pulmonary embolism presents with hypotension.
What is the most appropriate intervention? - ANSWER✔ Thrombolytics or
embolectomy
31.What is the first-line treatment for acute ischemic stroke within 4.5 hours of
symptom onset? - ANSWER✔ IV alteplase (tPA)
32.A patient with status epilepticus does not respond to benzodiazepines. What
is the next medication? - ANSWER✔ Fosphenytoin or levetiracetam
33.What is the most common complication of central venous catheterization? -
ANSWER✔ Pneumothorax
