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Critical Care > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

System most responsible for Spatial Disorientation

A

Visual System

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2
Q

Visual Illusoins caused by Spatial Disorientation

A

Confusing cloud formations with horizon/water, objects appearing to move further away when they’re moving closer, water appearing to be further from the ground

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3
Q

Methods to equalize the middle ear

A

Moving the lower jaw, swelling, yawning, Valsalva

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4
Q

Reduction in medical errors in a teaching hospital after implementing a standardized handoff bundle

A

25%

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5
Q

FARs that pertain to medical servies

A

Part 91 and Part 135

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6
Q

Process where the clinician identifies, prioritizes, establishes plans, and evaluates date to provide patient care

A

Clinical Judgement

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7
Q

Care Commensurate with the scope of practice of an EMT-B

A

BLS

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8
Q

Medical direction should be delivered to the transport crew in this manner

A

Directly between the physician and the crew

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9
Q

SBAR

A

Situation, Background, Assessment, Recommendation

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10
Q

Sterile cockpit should be practiced during these times

A

Critical Modes of Flight/ Landing and Takeoff

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11
Q

Term used to describe aircraft position reporting

A

Flight Following

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12
Q

The first need in a survival situation

A

Shelter

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13
Q

The amount of space between the flight suit and undergarments

A

0.25 inches

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14
Q

This is who Dr. Wu refers to as a Second Victim

A

The Provider performing the medical error

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15
Q

These are the parts of the effective communication cycle

A

Encoder, Message Medium, Decoder, Feedback

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16
Q

How to combat human error

A

Recognize errors that are going to occur and plan mitigation strategies

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17
Q

Care commensurate with the scope of practice of a physician or RN

A

Critical Care

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18
Q

The Four Variables affecting Gas Relationships

A

Pressure, Temperature, Volume, Relative Mass

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19
Q

Required when a HEMS certificate holder operates more than 10 helicopters

A

Operations Control Center

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20
Q

The average time of useful consciousness at or below 18000 feet

A

30 minutes

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21
Q

This information helps to determine the members of the medical transport team

A

The patient and the patient’s needs

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22
Q

This individual can work as a member of the critical care team, or indirectly via medical direction, clinical oversight, or as a medical liaison

A

Physician

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23
Q

This agency developed the diamond sign designation the different types of severity of hazards

A

National Fire Protection Agency

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24
Q

An Incidence taxing the assets of responding rescuers

A

Mass Casualty Incident

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25
Q

This accreditation program requires minimum ceiling and visibility limits under VFR conditions

A

CAMTS

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26
Q

Percent of lung volume that can be lost on a patient when placed supine

A

50%

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27
Q

The most accurate and easily available method to monitor ETT position and ventilator circuit integrity

A

EtCO2

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28
Q

The possible effect of damage to the C3, C4,C5 vertebrae

A

Diaphragmatic Paralysis

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29
Q

Diffusion of pulmonary gases is affected by 3 things

A

Alveolar surface area, thickness of alveolar capillaries, and driving pressure

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30
Q

Difficulty ventilating with a BVM can occur with patients with a BMI greater than:

A

26kg/m2

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31
Q

Medication that can produce dissociative anesthesia

A

Ketamine

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32
Q

Significance of the Oxyhemoglobin Dissociation Curve

A

Relationship between hemoglobin and the saturation of oxygen

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33
Q

Begins with an initially high V/Q ratio and later transitions to a decreased V/Q ratio as a result of alveolar atelectasis

A

Pulmonary Embolism

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34
Q

This can cause chest wall rigidity

A

Rapid Fentanyl Administration

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35
Q

What is the oxygen saturation goal?

A

94% and above

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36
Q

This should be accomplished when you have unilateral rise and fall with absent breath sounds on one side

A

Pull the ETT back and re-evaluate lung sounds

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37
Q

The only absolute contraindication for nasal intubation

A

Apnea

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38
Q

This should be accomplished on a patient having had a pneumothorax decompressed more than once

A

Insert a chest tube

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39
Q

This is often improved when PEEP is increased for a ventilated patient

A

Oxygenation

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40
Q

Contraindication for Ketamine

A

Systolic Blood Pressure >180

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41
Q

Administration of Push Dose Pressors

A

During Peri-Intubation Period

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42
Q

This can be controlled with the wide flange of the curved laryngoscopes blade

A

The tongue

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43
Q

Maximum PIP when volume ventilating a patient

A

35 cmH2O

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44
Q

Indications for intubation and mechanical ventilation of a patient experiencing an asthma attack

A

Low pH, vital capacity similar to tidal volume, and decreased level of concsiousness

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45
Q

Term describing inadequate ventilation with a normal state of perfusion, as occurs with pneumonia

A

Pulmonary Shunting

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46
Q

This is the direction of shift on the oxygen dissociation curve for a patient with a pH of 7.25

A

Right Shift

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47
Q

Calculation for anatomical dead space

A

2mL/kg or 1mL/lb

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48
Q

SCOPE Mnemonic

A

Suction, Connection, Obstruction, Pneumothorax, Equipment

49
Q

The larynx of a normal adult is located between these vertebrae

A

C4-C6

50
Q

The expected variance of tidal volume per breath for a ventilated patient patient

A

No more than 50mL

51
Q

Role of the Pilot (PIC)

A

Responsible for safety of the aircraft, crew, passengers, and accountable for non medical aspects of flight

52
Q

Role of the Medical Director

A

Improve administrative medical oversight, medical quality management, improvement over transport

53
Q

What does blue on the hazard diamond identify?

A

Health Hazards

54
Q

What does red on the hazard diamond identify?

A

Flammability

55
Q

What does yellow on the hazard diamond identify?

A

Reactivity

56
Q

What does white on the hazard diamond identify?

A

Special Hazards

57
Q

Radio System that transmits in one direction at a time with a single frequency

A

Simplex

58
Q

Radio System that receives and transmits simultaneously with two frequencies

A

Duplex

59
Q

Radio System that transmits or receives in one direction at a time with two frequencies

A

Half Duplex

60
Q

Radio System that transmits from two or more sources over the same frequency

A

Multiplex

61
Q

Effects of Underload

A

Boredom, Fatigue, Frustration, Dissatisfaction

62
Q

Effects of Overload

A

Irrational, Exhaustion, Illness, Low self esteem, problem solving

63
Q

Order of survival needs

A

Oxygen, Shelter, Water, Food

64
Q

What allows the location of the aircraft to be identified in case of emergency landing in which a distress call was not made?

A

Flight Following

65
Q

Ways to purify water in a survival situation

A

Boiling, filtration or water purification tablets

66
Q

CAMTS requirements for minimum ceiling and visability

A

Ceiling: 3000’, AGL visibility: 5 m2

67
Q

Injuries likely to occur to a restrained driver of an MVC (Lap Restraint)

A

Pelvic, spleen, liver, pancreas injuries

68
Q

Injuries likely to occur to a restrained driver of an MVC (Shoulder Restraint)

A

Clavicle injuries, rupture of diaphragm or mitral valve

69
Q

What can happen in high doses of Ketamine?

A

Vocal cord closure

70
Q

LEMONS (Difficult Laryngoscopy)

A

Look externally, Evaluate 3-3-2, Mallampati, Obstructions, Neck Mobility, Saturation

71
Q

RODS (Difficult Extraglottic Device)

A

Restricted Mouth Opening, Obstructions/Obesity, Disrupters/Distorted Airway, Stiff Lungs (COPD, Asthma)

72
Q

SMART (Difficulty Cricothyrotomy)

A

Surgery, Mass, Access/Anatomy, Radiation, Tumor

73
Q

ROMAN (Difficult BVM)

A

Radiation/Restriction, Obesity/Obstruction, Mask Seal/Male Sex/Mallampati, Age, No Teeth

74
Q

Ability to identify the glottis opening during DL

A

Cormack-Lehane Scale

75
Q

Grade 1 Cormack-Lehane

A

Visualization of the entire glottic opening

76
Q

Grade 2 Cormack-Lehane

A

Visualization of the arytenoids cartilage or posterior glottic opening

77
Q

Grade 3 Cormack-Lehane

A

Visualization of only the epiglottis

78
Q

Grade 4 Cormack-Lehane

A

Visualization of only the tongue

79
Q

Estimated ETT Size for Neonates

A

Weeks in gestation divided by 10 and rounded

80
Q

Estimated ETT Size for Pediatric Patients (Cuffed)

A

(Age/4)+3.5

81
Q

Estimated ETT Size for Pediatric Patients (Uncuffed)

A

(Age/4)+4

82
Q

How to check ETT Depth

A

Tube size x3 = measurement at teeth

83
Q

Ideal Body Weight Calculation (Male)

A

50 + (2.3 x inches over 5’)

84
Q

Ideal Body Weight Calculation (Female)

A

45.5 + (2.3 x inches over 5’)

85
Q

Calculation for tidal volume

A

6-8 ml/kg

86
Q

Calculation for tidal volume for ARDS

A

4-6 ml/kg

87
Q

Ideal Minute Volume for Acidosis

A

9L

88
Q

Pediatric Ideal Body Weight Calculation

A

Age x2 + 8

89
Q

Neonate Ideal Body Weight Calculation

A

(Age in Months +9)/2

90
Q

V/Q Mismatch

A

Increased or Normal Ventilation without increase in Perfusion

91
Q

Low V/Q (Pulmonary Shunting)

A

Inadequate Ventilation with normal state of Perfusion

92
Q

Right Shift of Oxygen Disassociation Curve

A

Decreased oxygen affinity to hemoglobin

93
Q

Left Shift of Oxygen Disassociation Curve

A

Increased oxygen affinity to hemoglobin

94
Q

Physician role

A

Medical direction or clinical oversight responsible for all aspects of care provided

95
Q

ALS

A

Care commensurate with the scope of practice of a paramedic

96
Q

Specialty care

A

Team members with specific specialty added to the transport team(Neonate, Peds, IABP)

97
Q

Who can be added to a team for medical/clinical judgement, technical skills, clinical experience, and marketing value?

A

Physicians

98
Q

Components of a communication center

A

At least one dedicated phone line
A recording system w/90 day storage
Capability to notify team and online medical direction
Back up power
A status board w/ team info
local aircraft service area maps and nav charts
Road maps
Communication policy and procedures

99
Q

What should be on a base operations map?

A

-Normal area of operation
-Radial overaly with dark line marked off every 10 miles
-Street map of metropolitan area

100
Q

How should medical direction be given?

A

To the point and directly between the team and physician

101
Q

Issues with rank and experience

A

Higher ranking needs to encourage feedback and openness to questions

102
Q

Excessive professional courtesy

A

The hesitancy of lower-ranking teammates to challenge senior

103
Q

IPASS Study results

A

25% reduction in medical errors in a teaching hospital setting after implementation of a standardized handoff bundle

104
Q

How should your uniform fit?

A

With a .25” gap between undergarments

105
Q

Why do we use flight following?

A

If unable to send distress call information can be used to find a precise position of aircraft

106
Q

Ketamine too fast?

A

Vocal cord closure

107
Q

Etomidate

A

Barbiturate-like derivative without the adverse effects of the barbiturates. Acts rapidly producing hypnosis within 30s. Cardiovascular stability. Decreased cerebral blood flow and ICP. Does not suppress sympathetic response to laryngoscopy.
Bads: pain, muscle spasms, adrenocortical suppression.

108
Q

Goal of airway management

A

To improve oxygenation, hemodynamics, and physiologic status

109
Q

Barking cough or stridor

A

Upper airway problem

110
Q

Wheezing AND Grunting

A

Lower airway problem

111
Q

Goal of airway management interventions

A

To improve patient’s hemodynamic and physiologic status

112
Q

Muscles of expiration

A

Abdominal muscles and internal intercostal muscles

113
Q

Muscles of inspiration

A

Scalene, sternocleidomastoid, trapezius, pectoralis, external intercostal muscle

114
Q

Hypoxic hypoxia

A

A deficiency in alveolar oxygen exchange

115
Q

Hypemix hypoxia

A

A reduction in the oxygen carrying capacity of the blood

116
Q

Stagnant hypoxia

A

When conditions results in reduced cardiac output, pooling of the blood within certain regions of the body, a decreased blood flow to the tissues, or restriction of blood flow

117
Q

Histotoxic hypoxia

A

When metabolic disorders or poisoning of cytochrome oxidase enzyme system results in a cell’s inability to use molecular oxygen

118
Q
A

Critical Care (4 decks)

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