AIR METHODS CRITICAL CARE EXAM UPDATED
ACTUAL QUESTIONS AND CORRECT ANSWERS
◉ 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%
ACTUAL QUESTIONS AND CORRECT ANSWERS
◉ 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%
