Air Methods Critical Care Exam Questions And Answers Latest Updated 2023/2024

Air Methods Critical Care Exam Questions And Answers Latest Updated 2023/2024. 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 (HR100 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 CVP catheter placement outside line markers - ANSWER-RA/CVP: 25-30 cm RV: 35-45 cm PA: 50-55 cm Central Cord Syndrome - ANSWER--loss of function in upper extremities caused by injury to the middle portion of the spinal cord -varying degrees of sensory loss Brown-Sequard Syndrome - ANSWER-Hemi-section of the cord - ipsilateral (same side) spastic paralysis and loss of position sense - contralateral (opposite side) loss of pain and thermal sense Anterior Cord - ANSWER--loss of motor function, pain, pinprick, and temp bilaterally below lesion -proprioception and light touch are preserved Autonomic Dysreflexia - ANSWER--urinary retention, massive increase in sympathetic tone which can cause HTN -treated by foley Adult urine output per hour - ANSWER-30-50 ml Peds Urine output per hour - ANSWER-1-2 ml/kg/hr Normal adult blood volume - ANSWER-70 ml/kg Peds blood volume - ANSWER-80 ml/kg Mild Hypothermia - ANSWER--32-36 degrees Celcius -decreased HR CVP (central venous pressure) - ANSWER--Measures preload (right atrial pressure) -Norm: 2-6 mmHg - Use proximal port Basic natriuretic peptide (BNP) - ANSWER--heart failure marker that measures this level by an over distention of the heart -500 = HF Most common spontaneous recurrance - ANSWER-anterior shoulder Most common dislocation - ANSWER-hip First adjustment on ventilator - ANSWER-TV first, not rate drugs for AAA - ANSWER-Nipride and Beta Blockers Kehr's sign - ANSWER--Referred pain down the left shoulder -indicative of a ruptured spleen or ectopic pregnancy Kernig's sign - ANSWER--Sign of bacterial meningitis -positive with back, leg pain on knee extension Brudzinski's sign - ANSWER--Back, leg pain on neck flexion -Possible Bacterial Meningitis or subarachnoid bleed Hamman's sign - ANSWER-- Crunching sound heard with auscultation over the anterior chest synchronized with heartbeat - tracheobronchial injury Steeple sign - ANSWER-- Possible croup (laryngotracheobronchitis) -found on A/P xray neck view Thumbprint sign - ANSWER-Radiographic appearance on lateral x-ray that signifies epiglottitis Acidosis - ANSWER-- pCo2 up = pH down - pH down = HCO3 down - pCo2 45 - pH 7.35 - HCO3 22 Alkalosis - ANSWER-- pCo2 down = pH up - pH up = HCO3 up - pCo2 35 - pH 7.45 - HCO3 22 Primary cause of death with ventilator dependent patients - ANSWER-Ventilator acquired pneumonia Mannitol (Osmitrol) - ANSWER-- 1-2 g/kg -reduce ICP -reduce IOP -promote diuresis for ARF -remove (excrete) toxic substances Ativan - ANSWER--seizures - 1-2 mg - max 4mg Ketamine - ANSWER-- Induction agent of choice with bronchospastic patient -RSI - 1 - 2 mg/kg - 40-60 second onset - 10 - 20 minute duration - combative: 5mg/kg IM or IN - pain: 0.1 - 0.2 mg/kg IV - increase oral secretions - caution with HTN - may cause laryngospasms