Air Methods Critical Care Exam Questions
And Verifed Answers
Coopernail's Sign
bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign
Marbled abdomen- bleeding
Cullen's sign
ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign
pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being
1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure)
-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
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
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
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
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
-fever
-hematemesis
, Fat embolus
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
750 ml
blood loss from femur fracture
1500 ml
PAWP (pulmonary artery wedge pressure)
- 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
3 x ETT size or average 19.23 cm
Peds ETT depth
10 + age in years (cm)
Neonate ETT depth
6 + wt in kg (cm)
Adjust vent to change Co2
adjust rate and tidal volume
Adjust vent to change oxygenation
adjust PEEP, PAP
infant rule of nines
Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
And Verifed Answers
Coopernail's Sign
bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign
Marbled abdomen- bleeding
Cullen's sign
ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign
pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being
1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure)
-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
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
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
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
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
-fever
-hematemesis
, Fat embolus
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
750 ml
blood loss from femur fracture
1500 ml
PAWP (pulmonary artery wedge pressure)
- 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
3 x ETT size or average 19.23 cm
Peds ETT depth
10 + age in years (cm)
Neonate ETT depth
6 + wt in kg (cm)
Adjust vent to change Co2
adjust rate and tidal volume
Adjust vent to change oxygenation
adjust PEEP, PAP
infant rule of nines
Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
