Exam (elaborations)
AIR METHODS CRITICAL CARE EXAM |225 QUESTIONS AND ANSWERS
- Module
- AIR METHODS
- Institution
- Oxford University (OX)
AIR METHODS CRITICAL CARE EXAM |225 QUESTIONS AND ANSWERS
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AIR METHODS CRITICAL CARE EXAM225 QUESTIONS AND ANSWERS
Coopernail's Sign - answer bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign - answer Marbled abdomen- bleeding
Cullen's sign - answer ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign - answer pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being - answer 1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure) - answer -Causes increased pulmonary vascular
resistance
-Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
steps in resuscitation of the neonate - answer Dry, warm, position to open airway, suction
mouth then nose
Tactile stimulation (HR<100 or apnea/IR breath rub back and put)
,Oxygen near the face
Bag valve mask - unresponsive to tactile stim within a few sec (40-60bpm)
reposition head, reapply mask, suction again prn, if no response in 30 sec
Intubate - if HR < 60 after PPV for 30 sec, then
Chest compressions - 3:1 ratio (90 compressions / 30 breaths)
Drugs - epinephrine 0.1-0.3ml/kg of 1:10,000, through et tube or (preferably) through umbilical
venous line, volume loss give 10ml/kg NS
pulmonary contusion - answer Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
ruptured diaphragm - answer abd contents herniate into the thoracic cavity compressing the
lung
s/s: dyspnea, dysphagia, abd pain, sharp epigastric or chest pain radiating to L shoulder (Kehr
sign), bowel sounds heard in the lung fields on injured side, decreased breath sounds on injured
side.
Tracheobronchial injury - answer 1. hemoptysis
2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDIASTINUM even after chest tube placement***
- advance ETT below level of injury into Right mainstem
,esophageal perforation - answer -fever
-hematemesis
Fat embolus - answer can form when a long bone is fractured and fat cells from yellow bone
marrow are released into the blood
-fever
-rash after fracture
Blood loss from humerus fracture - answer 750 ml
blood loss from femur fracture - answer 1500 ml
PAWP (pulmonary artery wedge pressure) - answer - Looks at the left side of the heart
- If elevated can indicate pulmonary congestion, CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient cough forcefully
-Normal: 8-12
Adult ETT depth - answer 3 x ETT size or average 19.23 cm
Peds ETT depth - answer 10 + age in years (cm)
Neonate ETT depth - answer 6 + wt in kg (cm)
Adjust vent to change Co2 - answer adjust rate and tidal volume
, Adjust vent to change oxygenation - answer adjust PEEP, PAP
infant rule of nines - answer Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate - answer -acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
Digoxin - answer -cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress - answer -Left lateral recumbent position
-O2
-Correct contributing factors
-keep reassessing
CHF considerations - answer -many are relatively hypovolemic
-be careful with diuretics
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