AIR METHODS CRITICAL CARE END OF COURSE EXAM QUESTIONS AND ANSWERS SURE A.pdf

AIR METHODS CRITICAL CARE END OF COURSE EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔Most common spontaneous recurrance - ✔✔anterior shoulder

✔✔Most common dislocation - ✔✔hip

✔✔First adjustment on ventilator - ✔✔TV first, not rate

✔✔drugs for AAA - ✔✔Nipride and Beta Blockers

✔✔Kehr's sign - ✔✔-Referred pain down the left shoulder
-indicative of a ruptured spleen or ectopic pregnancy

✔✔Kernig's sign - ✔✔-Sign of bacterial meningitis
-positive with back, leg pain on knee extension

✔✔Brudzinski's sign - ✔✔-Back, leg pain on neck flexion
-Possible Bacterial Meningitis or subarachnoid bleed

✔✔Hamman's sign - ✔✔- Crunching sound heard with auscultation over the anterior
chest synchronized with heartbeat
- tracheobronchial injury

✔✔Steeple sign - ✔✔- Possible croup (laryngotracheobronchitis)
-found on A/P xray neck view

✔✔Thumbprint sign - ✔✔Radiographic appearance on lateral x-ray that signifies
epiglottitis

✔✔Acidosis - ✔✔- pCo2 up = pH down
- pH down = HCO3 down
- pCo2 > 45
- pH < 7.35
- HCO3 < 22

✔✔Alkalosis - ✔✔- pCo2 down = pH up
- pH up = HCO3 up
- pCo2 < 35
- pH > 7.45
- HCO3 > 22

✔✔Primary cause of death with ventilator dependent patients - ✔✔Ventilator acquired
pneumonia

,✔✔Mannitol (Osmitrol) - ✔✔- 1-2 g/kg
-reduce ICP
-reduce IOP
-promote diuresis for ARF
-remove (excrete) toxic substances

✔✔Ativan - ✔✔-seizures
- 1-2 mg
- max 4mg

✔✔Ketamine - ✔✔- Induction agent of choice with bronchospastic patient
-RSI
- 1 - 2 mg/kg
- 40-60 second onset
- 10 - 20 minute duration
- combative: 5mg/kg IM or IN
- pain: 0.1 - 0.2 mg/kg IV
- increase oral secretions
- caution with HTN
- may cause laryngospasms

✔✔Consensus formula - ✔✔- LR/NS 2-4ml x kg x TBSA%
- give half over the first 8 hours from burn time
- give half over the next 16 hours

✔✔Parkland Formula - ✔✔- LR/NS 4ml x kg x TBSA%
- give half over the first 8 hours from burn time
- give other half over next 16 hrs
- use for >20% TBSA in adults and >10% in peds

✔✔Burn hypotension considerations - ✔✔-Hypotension is a late sign in burns
-If comes in with hypotension then consider other traumatic causes like hemothorax,
cardiac tamponade, neurogenic shock, internal abdominal or pelvic bleeding

✔✔Adult rule of nines - ✔✔- Head/neck: 9%
- each arm/hand: 9%
- chest: 9%
- abdomen: 9%
- back: 18%
- each leg: 18%
- genitals: 1%

✔✔Pediatric rule of nines - ✔✔- Head: 18%
- chest/abd: 18%

, - Back: 18%
- Full arm: 9%
- Full leg: 14%

✔✔Bowel sounds in chest cavity - ✔✔-Diaphragmatic rupture
-Most common in the left chest

✔✔Dehydration raises serum? - ✔✔Sodium
Normal sodium; 135-145

✔✔Treat HTN if blood pressure is over - ✔✔- 220 systolic
- MAP over 130

✔✔ARDS (acute respiratory distress syndrome) - ✔✔- PCWP <18
- CXR with bilateral pulmonary infiltrates
- PaCO2:FiO2 ratio <200
- increase PEEP

✔✔Normal FHR - ✔✔120 - 160

✔✔Passive Rewarming - ✔✔- Mild hypothermia only
- Up to 1 degree/ hr with blankets or heater

✔✔Active rewarming - ✔✔application of an external heat source to rewarm the body of
a hypothermic patient

✔✔Warm and dead temp - ✔✔32 degrees

✔✔Heat stroke - ✔✔over 42 degrees

✔✔Grey Turner's sign - ✔✔- Flank bruising
- Retroperitoneal bleeding

✔✔Moderate Hypothermia - ✔✔- 29-32 degrees
-loss of shivering
- ALOC

✔✔Severe hypothermia - ✔✔- 20-28 C
- Coma, VF Common

✔✔2 major causes of heat loss - ✔✔- radiation
- evaporation

✔✔Thermoregulation ceases at - ✔✔28 degrees C