Air Methods Critical Care exam with complete
solutions
What is the most reliable method of confirming and montioring correct placement of an ET tube?
Continuous waveform capnography
The upper airway consists of...
Nose, Mouth, Jaw, Oral Cavity, Pharynx, and Larynx
No gas exchange occurs here __________, it's called ____________.
Nose to terminal bronchioles, anatomical dead space. (2ml/kg of inspired tidal volume) They conduct
airflow towards gas exchange units.
Crycothyroid membrane
between thyroid and cricoid, avascular structure that connects the thyroid and cricoid cartilage. Site
of CRiCOTHYROTOMY- an emergency opening of the airway.
A PaCO2 greater than 45 mmHg indicates:
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis.
C. Respiratory acidosis
PaCO2 normal range
35-45 mm Hg Less than 35 likely means hyperventilation
Tracheal deviation AWAY from the affected side, decreased breath sounds, and hyperresonance...
What's happening?
Tension pneumothorax
In a tension pneumothorax tracheal deviation goes in what direction?
AWAY from affected side.
Normal mean pulmonary artery pressure
10-20 mmHg
Pulmonary hypertension is a mean PA pressure greater than...
(PAm) greater than 20
Primary pulmonary hypertension
Idiopathic genetic disorder caused by abnormal structure of the pulmonary blood vessels
Name three causes of secondary pulmonary hypertension..
1. Passive PH- the result of back pressure. Mitral Stenosis, LV systolic failure.
,2. Active PH- Constriction of the pulmonary circuit Increased volume in pulmonary circuit (i.e.
congenital heart disease)
3. Obstruction as in Chronic recurrent PE
TNP of the Pregnant patient
Resuscitation priorities are the same. The best way to take care of the baby is to take care of mama
Mechanisms of injury and biomechanics the most common cause of maternal injury is...
Blunt trauma caused by MVC. Second is BT caused by falls, 3rd is violence
fetal distress is an early sign of maternal distress... Why?
Catecholamine mediated vasoconstriction resulting from blood loss shunts blood away from the fetus
to the mom.
Fetal hypo perfusion is evidenced by....
Fetal tachycardia (140 to 160+) and fetal bradycardia
The FRC in a pregnant patient is....
Reduced by the gravid uterus lifting the diaphragm.
chest tube placement in a pregnant patient is 1-2 spaces higher
Because of the lifted diaphragm
What is the cause of physiological anemia in pregnant patients?
Hemodilitional anemia occurs. Plasma volume increases 30-50%.
Preterm Labor (PTL)
abruptio placentae
premature separation of the placenta from the uterine wall
On a pregnant patient...
Chest compressions must be higher on the sternum.
Any preg patient 20 weeks pregnant or more with a uterus above the umbilicus should have the
uterus left laterally displaced during compressions to avoid aortocaval compression. A 15 degree tilt
of the long board or lateral displacement.
What is the Maternal Fetal Triage Index?
A valid reliable 5 level triage tool that may assist in the triage of obstetric trauma patients.
Displacing the uterus off the vena cava can improve CO by
approximately 30%!
Continuous fetal monitoring is recommended...
, for all pregnant patients 20 or more weeks gestation... or (uterus above belly button).
Fundal height measurement
equals the approximate gestational age in weeks, until week 32.
Belly button is 20 weeks
Height of last rib is 26 weeks
costal margin is 36 weeks
Any fundal height indicating 23 or more weeks...
at the last rib and above is consistent with a viable fetus.
What type of blood should a pregnant trauma patient receive?
O-NEG baybay.
Initiate cardiotocography in any mother
20 or more weeks gestation, must be monitored for at least 6 hours.
What is the serum lab test that detects fetal red cells in the maternal circulation?
Kleinhauer Bette KB serum test. This lab is used to determine if hemorrhage of fetal blood through
the placenta and into maternal circulation. KB test is an important detector of abruptio placentae,
preterm labor and need to administer Rh negative globulin when mom is Rh negative and fetus is Rh
positive.
Continue fetal monitoring for a minimum of ---- hours for any viable pregnancy and up to _____ hours
if there is abdominal trauma
6..... 24
Sonography has __________ for diagnosis placental abruption,
POOR.... they miss 50-80% of abruptions.
In addition to routine labs a
Prothrombin (PT ) and PTT and serial coags should be drawn. Beta Human Chorionic gonadotropin
(BHCG)
Measure and record fundal height every
30 minutes.
Pediatric Mechanisms of injury and biomechanics
Blunt trauma MVC > suffocations > drownings > fires/burns. No. 1 cause of fatalities is TBI.
Primary Survey/ Resuscitation
Survival rates in pediatric emergency can be directly correlated with
1.RAPID AIRWAY MANAGEMENT,
2.INITIATION OF VENTILATORY SUPPORT, AND
solutions
What is the most reliable method of confirming and montioring correct placement of an ET tube?
Continuous waveform capnography
The upper airway consists of...
Nose, Mouth, Jaw, Oral Cavity, Pharynx, and Larynx
No gas exchange occurs here __________, it's called ____________.
Nose to terminal bronchioles, anatomical dead space. (2ml/kg of inspired tidal volume) They conduct
airflow towards gas exchange units.
Crycothyroid membrane
between thyroid and cricoid, avascular structure that connects the thyroid and cricoid cartilage. Site
of CRiCOTHYROTOMY- an emergency opening of the airway.
A PaCO2 greater than 45 mmHg indicates:
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis.
C. Respiratory acidosis
PaCO2 normal range
35-45 mm Hg Less than 35 likely means hyperventilation
Tracheal deviation AWAY from the affected side, decreased breath sounds, and hyperresonance...
What's happening?
Tension pneumothorax
In a tension pneumothorax tracheal deviation goes in what direction?
AWAY from affected side.
Normal mean pulmonary artery pressure
10-20 mmHg
Pulmonary hypertension is a mean PA pressure greater than...
(PAm) greater than 20
Primary pulmonary hypertension
Idiopathic genetic disorder caused by abnormal structure of the pulmonary blood vessels
Name three causes of secondary pulmonary hypertension..
1. Passive PH- the result of back pressure. Mitral Stenosis, LV systolic failure.
,2. Active PH- Constriction of the pulmonary circuit Increased volume in pulmonary circuit (i.e.
congenital heart disease)
3. Obstruction as in Chronic recurrent PE
TNP of the Pregnant patient
Resuscitation priorities are the same. The best way to take care of the baby is to take care of mama
Mechanisms of injury and biomechanics the most common cause of maternal injury is...
Blunt trauma caused by MVC. Second is BT caused by falls, 3rd is violence
fetal distress is an early sign of maternal distress... Why?
Catecholamine mediated vasoconstriction resulting from blood loss shunts blood away from the fetus
to the mom.
Fetal hypo perfusion is evidenced by....
Fetal tachycardia (140 to 160+) and fetal bradycardia
The FRC in a pregnant patient is....
Reduced by the gravid uterus lifting the diaphragm.
chest tube placement in a pregnant patient is 1-2 spaces higher
Because of the lifted diaphragm
What is the cause of physiological anemia in pregnant patients?
Hemodilitional anemia occurs. Plasma volume increases 30-50%.
Preterm Labor (PTL)
abruptio placentae
premature separation of the placenta from the uterine wall
On a pregnant patient...
Chest compressions must be higher on the sternum.
Any preg patient 20 weeks pregnant or more with a uterus above the umbilicus should have the
uterus left laterally displaced during compressions to avoid aortocaval compression. A 15 degree tilt
of the long board or lateral displacement.
What is the Maternal Fetal Triage Index?
A valid reliable 5 level triage tool that may assist in the triage of obstetric trauma patients.
Displacing the uterus off the vena cava can improve CO by
approximately 30%!
Continuous fetal monitoring is recommended...
, for all pregnant patients 20 or more weeks gestation... or (uterus above belly button).
Fundal height measurement
equals the approximate gestational age in weeks, until week 32.
Belly button is 20 weeks
Height of last rib is 26 weeks
costal margin is 36 weeks
Any fundal height indicating 23 or more weeks...
at the last rib and above is consistent with a viable fetus.
What type of blood should a pregnant trauma patient receive?
O-NEG baybay.
Initiate cardiotocography in any mother
20 or more weeks gestation, must be monitored for at least 6 hours.
What is the serum lab test that detects fetal red cells in the maternal circulation?
Kleinhauer Bette KB serum test. This lab is used to determine if hemorrhage of fetal blood through
the placenta and into maternal circulation. KB test is an important detector of abruptio placentae,
preterm labor and need to administer Rh negative globulin when mom is Rh negative and fetus is Rh
positive.
Continue fetal monitoring for a minimum of ---- hours for any viable pregnancy and up to _____ hours
if there is abdominal trauma
6..... 24
Sonography has __________ for diagnosis placental abruption,
POOR.... they miss 50-80% of abruptions.
In addition to routine labs a
Prothrombin (PT ) and PTT and serial coags should be drawn. Beta Human Chorionic gonadotropin
(BHCG)
Measure and record fundal height every
30 minutes.
Pediatric Mechanisms of injury and biomechanics
Blunt trauma MVC > suffocations > drownings > fires/burns. No. 1 cause of fatalities is TBI.
Primary Survey/ Resuscitation
Survival rates in pediatric emergency can be directly correlated with
1.RAPID AIRWAY MANAGEMENT,
2.INITIATION OF VENTILATORY SUPPORT, AND
