Exam (elaborations)
Critical Care Paramedic Exam – Q&A Verified
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Critical Care
Critical Care Paramedic Exam – Q&A Verified
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Critical Care Paramedic Exam – Q&A Verified
Normal pH - ✔️ 7.35-7.45
Normal CO2 - ✔️ 35-45
Normal HCO3 - ✔️ 22-26 (good dating age)
Normal PaO2 - ✔️ 80-100
Normal SaO2 - ✔️ > 95%
Base (deficit/excess) - ✔️ (-2) - (+2)
Buffer systems: Bicarb reaction time - ✔️ seconds
Buffer systems: Lungs reaction time - ✔️ minutes
Buffer systems: Kidneys reaction time - ✔️ hours to days
Minute volume calculation - ✔️ Tidal volume x respiratory rate
pCO2 >45 - ✔️ acidotic
pCO2 <35 - ✔️ alkalotic
HCO3 <22 - ✔️ acidotic
HCO3 >26 - ✔️ alkalotic
base deficit of < -4 - ✔️ indicator for the potential need for blood
transfusion
base deficit of < -19 - ✔️ indicates poor outcome (death likely)
base deficit replacement formula - ✔️ 0.1 x (-BE) x patient weight in kg =
bicarb needed
,PO2 of 60 is roughly equivalent to a SaO2 of - ✔️ 90%
critical pH for intubation - ✔️ < 7.2
critical pCO2 for intubation - ✔️ > 55
critical pO2 for intubation - ✔️ < 60
number one cause of metabolic acidosis - ✔️ lactic acidosis (lactate > 4)
CO2 is a byproduct of - ✔️ metabolism
for every __ change in ETCO2, you should expect the pH to change __ in the
___________ direction. - ✔️ 10, 0.08, opposite
for every __ change in pH, you should expect the HCO3 to change __ in the
___________ direction. - ✔️ 0.15, 10, same
for every __ change in pH, you should expect the potassium to change __ in the
___________ direction. - ✔️ 0.10, 0.6, opposite
LEMON - ✔️ difficult intubation
look, evaluate (3-3-2), mallampati, obstructions, neck mobility
HEAVEN - ✔️ difficult intubation
Hypoxia, extremes of size, anatomic challenges, vomit/blood/fluid,
exsanguination, neck mobility issues
ramping - ✔️ ear to sternal notch
without ramping during intubation or transport causes a potential for - ✔️
decrease in functional reserve capacity, tidal volume, and preload
Sellick's maneuver and BURP - ✔️ no longer recommended
External laryngeal manipulation (ELM) - ✔️ current standard of practice
bougie adult size - ✔️ 15 Fr
,bougie pediatric size - ✔️ 10 Fr
bougie neonatal size - ✔️ 6 Fr
supraglottic devices - ✔️ provide little protection against aspiration
ETT cuff pressure - ✔️ 20-30 mmHg (25 is standard)
gold standard of confirming ET placement - ✔️ chest X-Ray
distal tip of ET - ✔️ 2-3 cm (1 inch) above carina, at T3 or T4
7 p's for RSI success - ✔️ preparation, preoxygenation, pretreatment,
paralysis with induction, protect/position, placement (with proof), post
intubation management
LOAD - ✔️ pretreatment for RSI
lidocaine, opiates, atropine (infants), defasiculating dose
fentanyl adult dose - ✔️ 1 mcg/kg
fentanyl onset - ✔️ 3-5 mins
fentanyl post intubation management - ✔️ 0.5 - 1.5 mcg/kg every 5 minutes
fentanyl post intubation management infusion - ✔️ 1-3 mcg/kg/hour
fentanyl reversal agent - ✔️ narcan
etomidate adult dose - ✔️ 0.3 mg/kg
etomidate onset time - ✔️ 15-45 seconds
etomidate duration - ✔️ 3-12 minutes
etomidate cautions/contraindications - ✔️ hemodynamically unstable
patients, adrenal suppression, shock patients, COPD/asthmatic
ketamine adult dose - ✔️ 1-2 mg/kg
, ketamine onset - ✔️ 40-60 seconds
ketamine duration - ✔️ 10-20 minutes
ketamine is preferred for - ✔️ asthmatic patients
ketamine post intubation management - ✔️ 0.5 - 1 mg/kg
ketamine post intubation management infusion - ✔️ 1-2 mg/kg/hour
versed adult dose - ✔️ 2.5-5 mg
versed onset - ✔️ 30-60 seconds
versed duration - ✔️ 15-30 minute duration
versed post intubation management - ✔️ 2-5 mg
versed post intubation management infusion - ✔️ 0.05 - 0.1 mg/kg/hour
versed reversal agent - ✔️ flumazenil (romazicon) 0.2 mg
propofol (diprivan) adult RSI dose - ✔️ 1-2 mg/kg
propofol (diprivan) adult maintenance dose - ✔️ 25-50 mcg/kg/min
propofol (diprivan) onset - ✔️ 15-45 seconds
propofol (diprivan) duration - ✔️ 5-10 minutes
propofol (diprivan) cautions - ✔️ hemodynamically unstable patients
succinylcholine (anectine) - ✔️ depolarizing neuromuscular blocker agent
succinylcholine (anectine) can cause - ✔️ fasciculations
hyperkalemia
succinylcholine (anectine) requires - ✔️ refrigeration