AIR METHODS CRITICAL CARE UPDATED EXAM SCRIPT
QUESTIONS AND ANSWERS SURE A+
✔✔Blood loss from humerus fracture - ✔✔750 ml
✔✔blood loss from femur fracture - ✔✔1500 ml
✔✔PAWP (pulmonary artery wedge pressure) - ✔✔- Looks at the left side of the heart
- If elevated can indicate pulmonary congestion, CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient cough forcefully
-Normal: 8-12
✔✔Adult ETT depth - ✔✔3 x ETT size or average 19.23 cm
✔✔Peds ETT depth - ✔✔10 + age in years (cm)
✔✔Neonate ETT depth - ✔✔6 + wt in kg (cm)
✔✔Adjust vent to change Co2 - ✔✔adjust rate and tidal volume
✔✔Adjust vent to change oxygenation - ✔✔adjust PEEP, PAP
✔✔infant rule of nines - ✔✔Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
✔✔Sodium Bicarbonate - ✔✔-acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
✔✔Digoxin - ✔✔-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
✔✔treatment for fetal distress - ✔✔-Left lateral recumbent position
-O2
-Correct contributing factors
-keep reassessing
,✔✔CHF considerations - ✔✔-many are relatively hypovolemic
-be careful with diuretics
✔✔CVP catheter placement outside line markers - ✔✔RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
✔✔Central Cord Syndrome - ✔✔-loss of function in upper extremities caused by injury
to the middle portion of the spinal cord
-varying degrees of sensory loss
✔✔Brown-Sequard Syndrome - ✔✔Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
✔✔Anterior Cord - ✔✔-loss of motor function, pain, pinprick, and temp bilaterally below
lesion
-proprioception and light touch are preserved
✔✔Autonomic Dysreflexia - ✔✔-urinary retention, massive increase in sympathetic tone
which can cause HTN
-treated by foley
✔✔Adult urine output per hour - ✔✔30-50 ml
✔✔Peds Urine output per hour - ✔✔1-2 ml/kg/hr
✔✔Normal adult blood volume - ✔✔70 ml/kg
✔✔Peds blood volume - ✔✔80 ml/kg
✔✔Mild Hypothermia - ✔✔-32-36 degrees Celcius
-decreased HR
✔✔CVP (central venous pressure) - ✔✔-Measures preload (right atrial pressure)
-Norm: 2-6 mmHg
- Use proximal port
✔✔Basic natriuretic peptide (BNP) - ✔✔-heart failure marker that measures this level by
an over distention of the heart
->500 = HF
✔✔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
QUESTIONS AND ANSWERS SURE A+
✔✔Blood loss from humerus fracture - ✔✔750 ml
✔✔blood loss from femur fracture - ✔✔1500 ml
✔✔PAWP (pulmonary artery wedge pressure) - ✔✔- Looks at the left side of the heart
- If elevated can indicate pulmonary congestion, CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient cough forcefully
-Normal: 8-12
✔✔Adult ETT depth - ✔✔3 x ETT size or average 19.23 cm
✔✔Peds ETT depth - ✔✔10 + age in years (cm)
✔✔Neonate ETT depth - ✔✔6 + wt in kg (cm)
✔✔Adjust vent to change Co2 - ✔✔adjust rate and tidal volume
✔✔Adjust vent to change oxygenation - ✔✔adjust PEEP, PAP
✔✔infant rule of nines - ✔✔Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
✔✔Sodium Bicarbonate - ✔✔-acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
✔✔Digoxin - ✔✔-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
✔✔treatment for fetal distress - ✔✔-Left lateral recumbent position
-O2
-Correct contributing factors
-keep reassessing
,✔✔CHF considerations - ✔✔-many are relatively hypovolemic
-be careful with diuretics
✔✔CVP catheter placement outside line markers - ✔✔RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
✔✔Central Cord Syndrome - ✔✔-loss of function in upper extremities caused by injury
to the middle portion of the spinal cord
-varying degrees of sensory loss
✔✔Brown-Sequard Syndrome - ✔✔Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
✔✔Anterior Cord - ✔✔-loss of motor function, pain, pinprick, and temp bilaterally below
lesion
-proprioception and light touch are preserved
✔✔Autonomic Dysreflexia - ✔✔-urinary retention, massive increase in sympathetic tone
which can cause HTN
-treated by foley
✔✔Adult urine output per hour - ✔✔30-50 ml
✔✔Peds Urine output per hour - ✔✔1-2 ml/kg/hr
✔✔Normal adult blood volume - ✔✔70 ml/kg
✔✔Peds blood volume - ✔✔80 ml/kg
✔✔Mild Hypothermia - ✔✔-32-36 degrees Celcius
-decreased HR
✔✔CVP (central venous pressure) - ✔✔-Measures preload (right atrial pressure)
-Norm: 2-6 mmHg
- Use proximal port
✔✔Basic natriuretic peptide (BNP) - ✔✔-heart failure marker that measures this level by
an over distention of the heart
->500 = HF
✔✔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
