Monitoring & Ultrasound

Question 1

12 Lead ECG placement

Answer 1

Limb leads
Red - Right arm
Yellow - Left arm
Green - Left leg
Black - Right leg

Chest leads
V1 - 4th Intercostal Rt of sternum
V2 - 4th Intercostal Lt of sternum
V3 - Between V2 & V4
V4 - 5th Intercostal mid-clavicular line
V5 - 5th Intercostal, anterior axillary line
V6 - 5th Intercostal mid-axillary line.

Question 2

ECG small box time

Answer 2

0.04s

Question 3

ECG Large box

Answer 3

0.2s

Question 4

How many large boxes make 1 second?

Answer 4

5

Question 5

How to calculate BPM on a rhythm strip

Answer 5

Divide 300 by the number of large squares between R-R interval

300/R-R interval large squares

Question 6

Normal P-R Segment

Answer 6

0.12-0.2s
(3-5 small boxes)

Question 7

Normal QRS duration

Answer 7

70-100 ms
(0.07-0.1s) (2 small boxes)

Question 8

Hypothermia ECG changes

Answer 8

J Wave (Osborne Wave)
Atrial Fibrillation
Sinus bradycardia
AV Blocks

Question 9

Prolonged QTc (Male and female)

Answer 9

QTc is prolonged if
> 440ms in men (11 small boxes)
> 460ms in women

Question 10

Catecholamine surge from transport may increase HR by over what percentage?

Answer 10

10%

Question 11

Time lag between SPO2 measurement and reading

Answer 11

• 15-30 seconds
• Up to 2-3 minutes if shocked or hypothermic

Question 12

Normal ETCO2 range

Answer 12

4.0-5.7 KPA

35-45mmHg

Question 13

Best ECG leads to show ischemia

Answer 13

v4 & v5

Question 14

Best ECG lead to show rhythm

Answer 14

Lead II

Question 15

Paediatric/Infant GCS

Answer 15

Eye Opening

Open spontaneously+4
Open to verbal stimuli+3
Open to pain only+2
No response+1

Verbal Response

Coos, babbles+5
Irritable cries+4
Cries in response to pain+3
Moans in response to pain+2
No response+1

Motor Response

Moves spontaneously/purposefully+6
Withdraws to touch+5
Withdraws to pain+4
Flexor posturing to pain+3
Extensor posturing to pain+2
No response+1

Question 16

Frequency of US

Answer 16

2.5 - 12 mHz

Question 17

Higher frequency vs Low frequency

Answer 17

HF = clear image

LF = deeper view

Question 18

COACHRED

Answer 18

Continue compressions & Echo
Oxygen away
All else stand clear
Charge defibrillator
Hands off compressions
Rhythm check / Record Echo
Echo Off
Deliver shock or Dump charge

Question 19

3 signs of lung sliding in US

Answer 19

1) Pleural or lung sliding - pleural layers appear to shimmer

2) Baubles or Walking ants

3) B-lines or comet tails - vertical lines appearing from the pleura

Question 20

FAST

Answer 20

Focused Assessment with Sonography in Trauma