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Flight Test > Flight Test 1 > Flashcards

Flight Test 1 Flashcards

1
Q

Le Forte I Fracture

A

Horizontal across the maxilla, the maxilla and maxillary teeth are moveable.

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2
Q

Le Forte II Fracture

A

Bridge of Nose and around mouth

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3
Q

Le Forte III Fracture

A

Transverse Fracture “Carniofacial Disassociation”

Goes theough the orbits

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4
Q

Pediatric Dose for Adenosin

A
  1. 1 mg/kg initial
  2. 2 mg/kg second
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5
Q

HHNK (Hyperglycemic Hyperosmolar Non Ketosis)

A

Common with diabetes type II

Extremely elevated glucose (>600 mg/dL)

Normal ketones (non-ketotic)

Non-Acidotic

First line treatment is fluids, then insulin

Administer regular insulin IV (Humilin or Novolin)

Do not lower glucose > 100 mgdL per hour or less than 250 mgdL total

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6
Q

Spinal Shock

A

Due to swelling of spinal cord post trauma

Decreased SVR < 800

Hypotension

Treatment IV fluids and vasopressors

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7
Q

Neurogenic Shock (distributive)

A

Causes a decrease in sympathetic nervous system outflow

Unable to vasoconstrict and increase HR

Decreased systemic vascular resistance (SVR) and normal HR, SVR < 800

Hypotension

Warm red skin

No tachycardia

Treat with IV fluids and vasopressors

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8
Q

Central Cord Injury

A

Motor weakness in upper extremities is greater than lower extremities

This is below the level of injury

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9
Q

Anterior Cord Syndrome

A

Loss of pain and temp sensation everywhere below level of injury

Worst prognosis

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10
Q

Important Dermatomes

A

T4 nipples

T10 umbilicus

C3-C5 innervates the diaphragm

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11
Q

Autonomic Dysreflexia/Hypereflexia

A

Common in the paralyzed pt without foley catheter

Bladder becomes extremely distended

Increases B/P, HR, ICP

Insert and drain foley catheter slowly

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12
Q

Subarachnoid Hemorrhage

A

Life Threatning

Starfish pattern on CT

Keep systolic B/P below 140 mmHg

Treat with Nimodepine (Nimotop) (helps prevent cerebral vasospasm)

Persistent HTN, treat with Nipride

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13
Q

Epidural Hematoma

A

Arterial bleed (middle meningeal artery/MMA)

LOC followed by lucid interval and then second LOC

Pupil dilation after occulomotor nerve injury (CN III) due to loss of parasympathetic tone

Cheyne-Stokes Respirations common

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14
Q

Subdural Hematoma

A

Results from tearing of the bridging veins to the subdural space

Slow onset

Often in the elderly and kids

More common and lethal than epidural hemotoma

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15
Q

Normal ICP

A

0 - 10 mmHg

ICP > 20 mmHg has high mortality (Monroe-Kellie)

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16
Q

CCP

A

MAP - ICP

Normal 60 - 80 mmHg

Keep above 60 mmHg

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17
Q

MAP

A

Diastolic B/P x 2 + systolic B/P /3

Normal 80 - 100 mmHg

ideally 90 mmHg

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18
Q

Tetrology of Fallot

A

Right to Left Shunt

Consists of ; pulmonic stenosis, aortic coarctation, transposition of great vessels

ventricular septal defect

“Tet Spells” characterized by sudden cyanosis ans syncope

Treat with knees to chest , morphine

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19
Q

Patent Ductus Arteriosis (PDA)

A

Blood vessel connecting the pulmonary artery to the aortic arch

Allows most of the blood from the right ventricle to bypass fetus lungs

PGE1 (prostaglandin) is what keeps the PDA open (can cause apnea)

Indocin (indomethacin) drug of choice for closing PDA

Oxygen also closes PDA

If femoral pulses are absent, possible coarctation of the aorta, pt likely requires PDA to survive.

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20
Q

HELLP (hemolysis/Elevated Liver Enzymes/Low Platelets)

A

Common with PreEclampsia and Eclampsia

Right Upper Quadrant Pain (liver) Jaundice, Malaise

Platelet count < 100,000 mm3

> Liver serum billirubin >/= 1.2 mgdL

Give Mag-sulfate 4 - 6 g over 30 min

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21
Q

Terbutaline (tocolytic)

A

Stops tetanic contractions immediately

0.25 SQ every 15 min

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22
Q

Pregnancy Induced Hypertension (PIH)

A

New onset HTN with pregnancy

Labetolol (beta blocker)

Hydralazine

Methyldopa

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23
Q

Rh Negative Mothers

A

Rhogam prevents mothers immune response from attacking the baby

If mother is Rh negative, ALWATS give Rhogam

Majority of the population is Rh positive

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24
Q

Cardiogenic Shock

A

Obstructive signs of shock due to heart failure

PAWP > 18-20

SB/P < 80 mmHg

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25
Q

IABP Late Deflation

A

MOST DANGEROUS

Increases Afterload

Late Deflation = “Lethal Dose”

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26
Q

Aortic Dissection

A

“Ripping or Tearing” sensation between shoulder blades

Can also have pain in abdomen with same description

Ascending Aorta most common

A difference of 20 mmHg SB/P in the arms common

Treat first with Beta blocker (labetalol) then vasodilators (Nipride)

DO NOT use Nipride first due to Reflex Tachycardia

Pain meds - Morphine, Fentanyl, Ketamine

Restrict fluids unless hypotensive

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27
Q

ASA Poisoning

A

Respiratory Alkalosis followed by Metabolic Acidosis

Can lead to Reye’s Syndrome (liver and brain damage)

Treat with bicarb

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28
Q

Dilantin Overdose

A

Overdose can cause SVT and Ventricular dysrhythmias

Coma, confusion, tremors

Can cause Diabetes Insipidus like symptoms

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29
Q

Coagulation Panel

A

PT 10 - 13 sec

PTT 25 - 40 sec

INR 09 - 1.3

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30
Q

Right Heart Failure

A

CVP elevated (2-6)

PAP decreased (15-25s/8-15d)

PCWP decreased (8-12)

SVR elevated (800-1200)

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31
Q

Administering 1 Unit PRBC’s will

A

Increase

Hct 3%

Hgb 1gdL

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32
Q

Chest Tube Location

A

Between 4th and 5th intercostal space mid-axillary

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33
Q

Head Injury with Dilated and Fixed Pupils

A

Cranial Nerve III

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34
Q

Black and Blue Bruising Around Umbilicus

A

Cullens Sign

Acute Pancretitis

Blount Trauma

Ruptured AAA

Ruptured Eptopic Pregnancy

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35
Q

What Does Boyle’s Law Affect in Flight

A

ETT cuff’s

Mast Trousers, Air Splints (increases air)

IV Drip Rates (increases rate)

“Turn IV bag Upside Down”

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36
Q

What does Boyle’s Law state

A

The pressure of a gas is inveresely proportional to the volume of gas at a sonstant temperature.

“Boyle’s = Balloon = Barotrauma”

37
Q

Daltons Law

A

Total pressure of a gas mixture is the sum of the partial pressures of all the gases in the mixture.

“Dalton’s Gang”

38
Q

Charles’ Law

A

Absolute temperature of the gas

“charging an oxygen tank, the tank gets hot”

39
Q

Gay-Lussac’s Law

A

Directly proportional relationship between temperature and pressure.

O2 tank reading lower in cool temp and higher in warm temp.

40
Q

Hypoxic Hypoxia

A

Cardiovascular/Pneumothorax pt’s are moresusceptible to this type of hypoxia.

41
Q

Effects of Altitude

A

Every 1,000 foot increase in elevation causes temp to drop 2 degrees C

42
Q

Air Transport Team Members

A

Flight Nurse

Flight Paramedic / EMT

Respiratory Therapist

Flight Physician

43
Q

Sterile Cockpit

A

Only essential communication during all phases of flight except straight and level flight.

Critical phases of flight: Takeoff, Landing (short final), Refueling, and taxi (ground or air)

44
Q

CAMTS- How many live intubations are required?

A

5 live intubations before begining missions

Quarterly intubations thereafter

45
Q

The only time you don’t need to wear your seatbelt

A

During straight and level flight

Or when the PIC directs you to

(PIC has ultimate authority of the mission)

46
Q

What is the pre-crash sequence

A

Lay the patient flat

Turn off any oxygen

Assume the crash position

(knees together, feet 6” apart flat on the floor)

47
Q

What is the post-crash sequence

A

Turn off in order

Throttle

Fuel

Battery

Assembel at the 12 o’clock position

48
Q

Indications for Intubation

A

pH < 7.2, CO2 > 55, PaO2 < 60

Only ONE value needs to be off to indicate the need for intubation

49
Q

Mallampati III

A

Only the base of the uvula can be seen

Moderate difficulty

50
Q

When inflating the distal cuff on an ETT the pressure should be?

A

Between 20-30 mmHg

(only use the ammount of air required to make a good seal)

51
Q

Succinycholine

A

Depolarizing Neuromuscualr blocking agent

Dose: 1-2 mg/kg

52
Q

Rocuronium

A

Non-Depolarizing Neuromuscular Agent

Zemeron

53
Q

Etomidate

A

Induction agent, preferred for awake sedation

(fast onset, short half-life)

0.3 mg/kg

54
Q

Synchronized Intermittent Mandatory Ventilation

(SIMV)

A

Assisted mechanical ventilation synchronized with the pt’s breathing

Spontaneous breathin by the patient occurs between the assisted mechanical breaths, which occur at preset intervals

55
Q

With ARDS, Focus on oxygenation with:

A

Increased PEEP (> 10)

High Tidal Volumes (> 10 cc/kg)

“Pancreatitis and ARDS commonly occur together”

56
Q

Cardiac Enzymes

Troponin I

A

Specificity: High

Detectable at: 2 hours

Peak Levles: 12 hours

57
Q

Pericarditis

A

Substernal C/P when breathing or laying supine

Treat with NSAIDS (usually Indocin)

58
Q

Fetal HR Variability

A

1 cause of poor variability = fetal hypoxia

The single most important predictor of fetal wellbeing

10-15 bpm = normal variability

59
Q

Accelerations/Decelerations

A

Are in relation to uterine contraction

Early deceleration means the fetus hear rate decelerates early in the uterine contraction cycle

Accelerations are ALWAYS good

60
Q

Late Decelerations

A

ALWAYS indicates ureteroplacental insufficiency

Causing fetus to experience a hypoxic bradycardia

61
Q

Preterm Delivery

(< 38 weeks)

A

Terbutaline (fast acting, short half-life)

Stop tetanic contractions IMMEDIATELY

Subcutaneous 0.25 mg q 15 min

62
Q

“Mag Check”

A

Deep Tendon Reflexes

63
Q

Mauriceau’s Maneuver

A

Fingers relieving pressure off the baby’s nose so they can breath

Downward suprapubic pressure while the baby is rotated out of the birth canal

64
Q

HELLP Syndrome

A

Hemolysis/Elevated Liver Enzymes/Low Platelets

Common with PreEclampsia and Eclampsia

RUQ pain (liver), jaundice, malaise

Give Mag Sulfate (4-6g over 30 min)

Hypertension - use Labetalol, Hydralazine, or Methyldopa

65
Q

PreEclampsia

A

HTN / Proteinuria / Edema

NO SEIZURES

Risk factors - extremes of age, 1st pregnancy

66
Q

Placenta Abruption

A

Painful bleeding

Any MVA or blunt trauma is placental abrubtion until proven otherwise

EMERGENCY

67
Q

Uterine Rupture

A

1 cause of maternal death is trauma

Fetal parts presenting under mothers skin

“Stomach is as hard as a board”

68
Q

Infant Seizures

A

Lip smacking and tongue thrusting, eye fluttering and lowered SPO2

“Subtle Seizures”

Common causes: Hypoglycemia

69
Q

Ventriculoperitoneal Shunt

“VP Shunt”

A

Hydrocephalus

Fluid build up leading to increased ICP

Often presents with:

gastric distension, mental status changes

decreased LOC, vomiting and seizures

Give Mannitol

Raise head of bed 30 degrees (semi-fowlers)

70
Q

Pediatric Emergencies

ETT Diameter

A

(Age +16) /4 = tube size

If required ETT size is 5.5 or greater use a cuffed ETT

71
Q

Pediatric Fluid Resuscitation

A

Neonate/Infant = 10cc/kg (<1 y/o)

Toddler/Child = 20cc/kg (>1 y/o)

Average circulating blood volume 75-80mL/kg

72
Q

Pediatric Maintenance Fluids

“4, 2, 1 Rule”

A

1-10 kg = 4cc//kg/hr

10-20 kg = 2cc/kg/hr

>20 kg = 1cc/kg/hr

(8kg)

73
Q

CROUP

A

Steeple Sign on A/P neck XR

“Seal Like” Barking cough

Treat with racemic epi and steroids

(usually not life threatening)

74
Q

Epiglottitis

A

Sudden onset of DROOLING

Thumb Sign on lateral neck XR

Do not disturb child due to possible rapid airway loss

Treatment: Antibiotics, humidified O2

75
Q

ICP Transducer

A

Placed at the Foramen of Monro (level of the ear)

76
Q

Brainstem Herniation

A

Goal PaCo2 = 30-35mmHg

Treat seizures with a benzo and then either Phenytoin (Dilantin) or Fosphenytoin (Cerberyx)

DO NOT USE HYPOTONIC SOLUTIONS OR GLUCOSE!

(hyponatremia is associated with brain edema)

(hyperglycemia makes brain injuries worse)

77
Q

Acute Mountain Sickness (AMS)

A

Typically occurs to those not acclimatized and have recently traveled to altitude within 24 hours.

Symptoms: headache, nausea, vomiting, lassitude (feeling weak)

78
Q

Cardiac Tamponade

A

Early Tamponade: Give IV fluids (improve preload)

Late Tamponade (Beck’s Triad)

Pericardiocentesis

Beck’s Triad

Muffled Heart Tones

Hypovolemia (with narrowed pulse pressure)

JVD

80
Q

Oxygen Dissociation Curve

A

Right Shift (High)

Hyperthermia

Acidosis

Hypercapnia

Increased levles os 2, 3, DPG

(RELEASES OXYGEN)

81
Q

Pulmonary/Pleural Effusion

A

Buildup of fluid in the pleural space, an area between the layers of tissue that line the lungs and the chest wall.

Flight Test (1 decks)

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