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CCP Semester 1 > CCP 105 - Fundamentals of AeroMedical Transport > Flashcards

CCP 105 - Fundamentals of AeroMedical Transport Flashcards

1
Q

What are the components of the atmosphere and the % they make up?

A

Nitrogen - 78%
Oxygen - 21%
Argon - 0.9%
Trace elements - 0.1% (hydrogen, carbon dioxide, etc)

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2
Q

Definition of barometric pressure

A

the weight per unit area of all the molecules of the gas above the point at which the measurement was taken
769 mmHg at sea level

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3
Q

What is Avogadro’s Law?

A

The volume of a gas is directly proportional to the amount of gas

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4
Q

What is the effect of humidity on the density of air?

A

Humid air is less dense than dry air

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5
Q

What is the effect of cloud on temperature?

A

Cloud holds more heat than clear air

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6
Q

What is the Alveolar Gas Equation?

A

PAO2=(P(ATM)−PH2O)FiO2−(PaCO2÷R)

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7
Q

What is the useful function of the alveolar gas equation?

A

allows you to calculate the partial pressure of O2 at the altitude that you are flying at

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8
Q

What does PAO2 stand for

A

Partial pressure of alveolar oxygen

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9
Q

What does FiO2 stand for?

A

Fraction of inspired oxygen

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10
Q

what does P(ATM) stand for?

A

Pressure of atmosphere (barometric pressure)

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11
Q

what does P(H20) stand for?

A

The pressure that water vapour exerts. Always 47 mmHg

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12
Q

What does PaCO2 stand for?

A

Partial pressure of arterial CO2

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13
Q

What does RQ stand for and what is it?

A

Respiratory quotient.
Based on metabolic activity of organism.
In humans, generally 0.8)

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14
Q

What is the oxygen binding capacity of hemoglobin?

A

the amount of oxygen in millilitres carried by each gram of hemoglobin

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15
Q

What 2 factors most influence the oxygen carrying capacity of blood?

A

Amount of hemoglobin and saturation of that hemoglobin

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16
Q

How do we mitigate the changes in physiology that are due to flight?

A

Supplemental O2, Pressurized cabins, protective equipment.

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17
Q

What are the factors of flight that affect physiology?

A

Partial pressure of O2, barometric pressure, gravity, G forces, linear acceleration, buffeting, clear air turbulence, light intensity, temperature.

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18
Q

What is the blood oxygen content equation?

A

CaO2 = (SaO2xHbx1.34) + 0.003(PaO2)

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19
Q

What is the definition of hypoxia?

A

A condition where the oxygen supply is inadequate to either the body as a whole (general hypoxia) or to a specific region (tissue hypoxia)

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20
Q

What are the 4 types of hypoxia?

A

Hypoxic hypoxia
Hypemic hypoxia
Stagnant hypoxia
Histotoxic hypoxia

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21
Q

Define hypoxic hypoxia

A

Low PaO2. Insufficient oxygen supply.

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22
Q

Define hypemic hypoxia

A

Inability of the blood to carry oxygen to the tissues.

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23
Q

Define stagnant hypoxia

A

Inability of blood volume to get to the tissues.

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24
Q

Define histotoxic hypoxia

A

inability of the cells to take up oxygen. Related to oxygen extraction

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25
Q

What are the 4 stages of hypoxia?

A
  1. Indifferent Stage
  2. Compensatory stage
  3. Disturbance stage
  4. Critical stage
26
Q

Define and characterize the Indifferent stage of hypoxia

A

Up to 10,000 ft
SPO2 90-98%
MInor physiological effects
Loss of night vision above 5000 ft

27
Q

Define and characterize the Compensatory stage of hypoxia

A

10,000-15,000ft
Minute ventilation and cardiac output increase
Nausea, dizziness, fatigue, lethargy, poor judgement, impaired coordination and increased irritability
SPO2 80-90%

28
Q

Define and characterize the Disturbance stage of hypoxia

A

SPO2 70-80%
Impairment of senses, mental processes, personality, psychomotor function

29
Q

Define and characterize the Critical stage of hypoxia

A

SPO2 60-70%
Incapacitation, unconsciousness and death

30
Q

What does SMEAC stand for?

A

Situation
Mission
Equipment
Additional Personnel
Communication

31
Q

How often do you need to do
1) detailed safety training
2) safety briefing

A

1) annually
2) daily/pre-trip

32
Q

What are the unique layers to the earth’s atmosphere

A

1) troposphere (26k ft at poles, 52k ft at equator) *physiologic zone is <10k ft
2) tropopause (30-60k ft)- physiologically deficient zone
3) space equivalent (stratosphere, stratopause, mesosphere, thermosphere, exosphere)

33
Q

Altitude of rotor wing

A

<2000ft

34
Q

Disadvantages of rotor wing vs fixed

A

Weather limitations, generally cannot fly under instrument flight rules (IFR) unless min. Cloud clearance and visibility requirements are met, interior space limit, weight restrictions, distance

35
Q

Disadvantages of fixed wing vs rotor

A

Cost, landing fields, restrictions on runway length

36
Q

What is the ceiling for a commercial nonpressurized air craft

A

10,000 ft

37
Q

What are the altitudes of BCEHS RW and FW

A

Helicopter- 2-5k ft
Turboprop- 18-22k ft (can go as high as 30k)
Jet- <40k ft

38
Q

Discuss the effects on normal physiology of slow cabin decompression

A

Insidious onset and loss of o2, ICDC

39
Q

Discuss the effects on normal physiology of rapid can decompression

A

Loud explosion and warning horns. Immediate exposure to hypoxia, decompression sickness, GI expansion, hypothermia

40
Q

Define boyle’s law

A

As altitude increases, atmospheric pressure decreases and gases inside the body expand

41
Q

Define Charles’ law

A

Volume of a gas is directly proportional to the temperature, with the pressure remaining constant

Exp. Hot day/air= volume increase= molecules spread out= less dense= less lift of rotor wing

*Humid air is less dense than dry air because h2o displaces other heavier gases

42
Q

Define gay-Lussac’s law

A

As pressure decreases, temperature decreases

43
Q

Define Dalton’s law

A

Total pressure of a gas mixture is the sum of the individual pressures

Context: increasing altitude/decreasing barometric pressure causes proportional decrease in partial pressure of gases.

44
Q

Define fick’s law

A

Diffusion rate of gas is affected by atmospheric pressure, surface area of membrane and thickness of membrane

45
Q

Define Henry’s law

A

As the partial pressure of a gas over liquid decreases, the amount of gas dissolved in liquid decreases (and escapes

Exp. Decompression sickness- as barometric pressure decreases, the partial pressure of nitrogen in the atmosphere decreases and the body attempts to establish equilibrium with nitrogen coming out of solution (blood) in the form of gas bubble

46
Q

Define universal gas law

A

Aka ideal gas law. States how a hypothetical gas should act with no variables— a change in density is directly related to a change in temp and pressure

47
Q

Define graham’s law

A

The rate of effusion of a gas is inversely proportional to the square root of the density of the gas

Effusion= escape through small hole

More dense = larger= slower moving

48
Q

You observe the medical post of the nitrous oxide cylinder is frozen, which gas law is this?

A

Charles’ law: as liquid gas under pressure expands, it cools and freezes the moisture in the air around and on the medical post.

? Volume goes down as liquid becomes gas, temp goes down?

49
Q

O2 tank was at 1500psi, but overnight in freezing temps, it’s now 1300psi. Because of which gas law and why

A

Gay lussac’s: compressed gas is at a constant volume, but as temp of gas decreases it exerts less pressure.

50
Q

Mid-flight, sanguineous fluid collected in first chamber of pleurevac is working its way back up chest tube. Because of what gas law

A

Boyle’s law. “Pleur-Evac drain likely not vented to atmosphere and there is a pressure build up within the device chambers”

?atmospheric pressure decreasing so volume of gas inside non-vented pleurevac increased, forcing fluid back into chest tube?

51
Q

How would you figure out what to set FiO2 at to compensate for altitude/barometric pressure and what has law is it based on

A

Henry’s law

Adjusted FiO2=
(Initial FiO2 x initial barometric pressure)/barometric pressure at cruising altitude

52
Q

After hearing a whistling sound from the door and completing a rapid ascent to 25,000 ft, your grossly obese pt with a shoulder dislocation starts to complain his shoulder pain is much worse with new onset headache and itching around ears and neck. What is happening and what has law applies

A

Altitude decompression sickness, Henry’s law

53
Q

In the helicopter, the pilots advise we have to fly at 4500ft over the weather. NSTEMI pt is not on supplemental o2 and has no SOB, but at that altitude will require >25%fio2 and thus is put on NC 2LPM. What is the reasoning for this tx and what gas law supports this most

A

In an unpressurized aircraft, at this altitude, the partial pressure of o2 in the atmosphere is reduced. Dalton’s law- total pressure of a mixture of gas is equal to the sum of the partial pressure of each gas in the mixture

?why not Henry’s?

54
Q

You bring your CO poisoning pt to the hyperbaric chamber with set and measured flow rate of gas from ventilator delivering similar values. At a depth of 2.5atm the measured flow rate of delivered gas has dropped. Why has this happened and which gas law applies

A

Under higher bariatric pressure, the density of gas in the breathing circuit has increased (daltons)

Graham’s law: The rate of effusion of a gas is inversely proportional to the square root of the density of the gas. (More dense=moves slower)

55
Q

Pt with pneumonia has pronounced atelectasis and consolidation on CXR. Labs show elevated A-a gradient. What is the patho behind A-a gradient and what gas law applies

A

Pneumonia is causing physical barrier with the alveoli, limiting diffusion of o2 into capillaries.

Fick’s law- diffusion rate is proportional to the difference in partial pressure across membrane, proportional to area of membrane, and inversely proportional to the thickness of the membrane

56
Q

Define dysbarism

A

Syndrome resulting from a difference between barometric pressure and the pressure of gases within the body

57
Q

Examples of dysbarism and tx

A

Barotitis media- pilot should ascdnd until pain is relieved and then very slowly descend

Barosinusitis- pain mgmt and decongestants

Barodontalgia- usually resolves around sea level

58
Q

Clinical manifestation of hypoxic hypoxia

A

Reduction in PO2

59
Q

Clinical manifestation of histotoxic hypoxia

A

SvO2 higher than normal because o2 is not unloading into cell

60
Q

Clinical manifestations of hypemic hypoxia

A

Too few functional Hgb from CO, sickle cell disease, anemia, hemorrhage.

Manifestation per disease process?

CCP Semester 1 (10 decks)

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