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AIR METHODS CRITICAL CARE REVIEW | MEDICAL EMERGENCIES QUESTIONS AND ANSWERS UPDATED
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AIR METHODS CRITICAL CARE REVIEW | MEDICAL EMERGENCIESQUESTIONS AND ANSWERS UPDATED 2024 - 2025
What,type,of,shock,is,septic,shock,considered?,,ANS,-,,Distributive
3,types,of,distributive,shock:,Septic,shock,,neurogenic,shock,,and,anaphylactic,shock.,
Sepsis,occurs,when,there,is,a,circulatory,and,cellular/metabolic,abnormality,severe,enough,to,increase,m
ortality,in,the,tissue,that,could,potentially,cause,multi-organ,failure
While,at,bedside,of,your,adult,ICU,patient,,you,elect,to,perform,an,RSI,prior,to,transport,due,to,decreasi
ng,mentation,and,airway,protection.,Your,patient,presents,with,the,following,pulmonary,artery,catheter,
readings:
CVP,1
SVR,400
PCWP,9
CI,5.6
PAP,17/11
What,induction,agent,would,you,utilize?
Etomidate
Ketamine
Versed
Fentanyl,,ANS,-,,Ketamine
This,is,a,septic,shock,patient,as,displayed,by,decreased,CVP,,decreased,SVR,and,increased,CI
Etomidate,should,be,avoided,in,patients,with,septic,shock,r/t,it,causing,adrenal,insufficiency,and,cortisol,
production,,which,is,already,present,in,septic,shock,states.,Preferred,induction,agent,would,be,ketamine,
because,Versed,may,further,worsen,hemodynamic,stability.,Fentanyl,is,not,an,RSI,sedation,induction,age
nt,to,be,utilized,but,can,be,used,as,pre-treatment,medication,to,RSI
,A,54,year,old,male,presents,to,the,hospital,with,hypotension,and,AMS.,There,is,no,medical,history.,
A,Pulmonary,Artery,Catheter,is,placed,in,the,patient,and,shows,the,following:
CVP:,13
PAP:,28/12
PAOP:,18
CI:,1.8
SVR:,2,200
What,type,of,shock,do,you,suspect,this,patient,is,in?,,ANS,-,,Cardiogenic,Shock
This,patient,has,a,high,CVP,,high,PAOP,,low,CI,,and,high,SVR,which,is,indicative,of,cardiogenic,shock.,
Hypovolemic,shock,may,have,a,high,SVR,and,low,CI,but,would,not,have,a,high,CVP,and,PAOP.
Septic,shock,is,defined,as,,ANS,-,,Multiorgan,dysfunction,caused,by,a,host,response,to,infection
Septic,shock,is,a,type,of,shock,that,affects,capillary,beds,and,profusion,to,tissue,with,a,MAP,2,with,a,mor
tality,rate,exceeding,40%,that,manifests,from,an,infection
A,patient,pressents,with,a,wound,,that,is,hot,to,touch,and,red.,The,patient,is,also,tachycardic,and,hypote
nsive.,What,type,of,shock,do,you,assume,the,patient,is,suffering,from?,,ANS,-,,Septic,shock
Septic,shock,s/s,upon,physical,assessment,without,diagnostics,include,hypotension,,confusion,,fever,,tac
hycardia,,increased,RR,,decreased,UO,and,source,of,infection,to,cause,it
A,patient,presents,with,confusion,,is,hot,to,the,touch,,and,has,a,rapid,pulse.,Upon,assessment,,you,see,t
heir,BP,is,60/45.
Which,treatment,would,you,start,immediately?
10mL/kg,crystalloid,fluids,and,antibiotics
, 20mL/kg,packed,RBCs
30mL/kg,Crystalloid,fluids,and,antibiotics
Epinephrine,drip,,ANS,-,,30mL/kg,crystalloid,fluids,and,antibiotics
PRBCs,are,not,indicated,unless,a,patient,is,anemic,or,losing,blood.,Tissue,perfusion,is,predominantly,achi
eved,by,the,aggressive,administration,of,IVF,,usually,crystalloids,,given,at,30mL/kg.,Started,within,one,ho
ur,and,completed,within,the,first,3,hours,following,presentation,,in,conjunction,with,broad,spectrum,ant
ibiotics,in,the,first,hour,of,symptoms.,30mL/kg,crytsalloid,fluids,and,antiobiotics,can,significantly,decreas
e,mortality.,Epinephrine,may,increase,serum,lactate,and,is,not,the,first,line,choice,for,vasopressor,for,se
psis.
The,transport,clinician,arrives,to,the,patient,and,hears,in,report,that,the,patie4nt,is,receiving,chemother
apy,for,lung,cancer.,What,lab,value,would,be,most,concerning?
WBC,0.4
RBC,5.0
WBC,11.2
hbg,15,,ANS,-,,WBC,0.4
What,would,you,expect,your,patient's,calcium,to,be,with,a,positive,Chvostek,sign?,,ANS,-,,Low,calcium
Normal,calcium:,8.5-10.3
The,transport,clinician,arrives,at,the,patient's,bedside,and,is,given,the,following,ABG:
pH,7.08
paCO2:,65
HCO3:,24
What,is,the,appropriate,interpretation?,,ANS,-,,Uncompensated,respiratory,acidosis
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