CRITICAL CARE PARAMEDIC COMPLETE
STUDY GUIDE WITH CORRECT ANSWERS
◉ Fun Facts of Sepsis.
Answer: 1-raise HOB 30-45 degrees
2-CVPs goal=8-12mmHg
3-MAP goal= greater than 65
4-fluid challenges, 3l crystalloid over 45 mins
◉ Levels of hyperkalemia.
Answer: 1-Tall peaked T waves (6mEq/l)
2-Prolonged PR interval (6.5mEq/l)
3-Loss of p-wave (6.5-7)
4-Widening of qrs (7-7.5)
5-Sine wave, v-fib/tach (8-10)
◉ Hyperkalemia Treatment.
Answer: 1-CaCl 500mg IV over 3 mins (EKG changes or K+ greater
than 6.2),
2-NaHCO3 50meq/or 1meEq/kg over 5 mins (especially if acidotic)
3-Albuterol 5-20mg over 15 mins
,4-Glucose/Insulin: 10 units reg. insulin IV push, and 25 grams D50W
IV push (just give the 10U of insulin is BS more than 200)
◉ Significant Sepsis Prognostic.
Answer: Lactate greater than 4, ticking time bombs
◉ GI Hemorrhage.
Answer: -NG/OG
-Octreotide: decreases GI Motility/Acid Prod., decreases hepatic
portal pressures, relieves venous congestion, 25-50mcg IV Push, and
then 25-50 mcg/hr IV
-Could consider vasopressin (.2 to .8 U/min), caution with CAD,
decreases arterial pressures feeding hepatic portal system
◉ High Thyroid.
Answer: Aka-Graves disease, thyrotoxicosis, Thyroid storm
-Thyroid controls metabolic rate (o2, ch20, ATP)
-Presentation: dramatic wt loss, febrile, tachy, afib, chest pain,
palpitations, tremors
-New Tachy/Afib in otherwise healthy females
-Tx: Nsaid Antipyretic other than ASA, Anti-thyroid meds (respond to
reduce tachy), IV glucocorticoids (Decadron) inhibits t4-t3
-o2, fluids (correct electrolytes mg and k)
, ◉ Order of Heart Valves.
Answer: tricuspid, Pulmonic, mitral, aortic
◉ Hearts Sounds are:.
Answer: Closing valves due to pressure
◉ Coronary Arteries Arise from:.
Answer: Aortic ostium
◉ R. coronary artery turns into.
Answer: posterior descending artery
◉ Most anterior portion of the heart.
Answer: Right Ventricle, so most susceptible to blunt trauma
◉ Left Circumflex Artery feeds.
Answer: lateral wall
◉ Left Anterior Descending feeds.
Answer: anterior 2/3 septum, anterior wall
STUDY GUIDE WITH CORRECT ANSWERS
◉ Fun Facts of Sepsis.
Answer: 1-raise HOB 30-45 degrees
2-CVPs goal=8-12mmHg
3-MAP goal= greater than 65
4-fluid challenges, 3l crystalloid over 45 mins
◉ Levels of hyperkalemia.
Answer: 1-Tall peaked T waves (6mEq/l)
2-Prolonged PR interval (6.5mEq/l)
3-Loss of p-wave (6.5-7)
4-Widening of qrs (7-7.5)
5-Sine wave, v-fib/tach (8-10)
◉ Hyperkalemia Treatment.
Answer: 1-CaCl 500mg IV over 3 mins (EKG changes or K+ greater
than 6.2),
2-NaHCO3 50meq/or 1meEq/kg over 5 mins (especially if acidotic)
3-Albuterol 5-20mg over 15 mins
,4-Glucose/Insulin: 10 units reg. insulin IV push, and 25 grams D50W
IV push (just give the 10U of insulin is BS more than 200)
◉ Significant Sepsis Prognostic.
Answer: Lactate greater than 4, ticking time bombs
◉ GI Hemorrhage.
Answer: -NG/OG
-Octreotide: decreases GI Motility/Acid Prod., decreases hepatic
portal pressures, relieves venous congestion, 25-50mcg IV Push, and
then 25-50 mcg/hr IV
-Could consider vasopressin (.2 to .8 U/min), caution with CAD,
decreases arterial pressures feeding hepatic portal system
◉ High Thyroid.
Answer: Aka-Graves disease, thyrotoxicosis, Thyroid storm
-Thyroid controls metabolic rate (o2, ch20, ATP)
-Presentation: dramatic wt loss, febrile, tachy, afib, chest pain,
palpitations, tremors
-New Tachy/Afib in otherwise healthy females
-Tx: Nsaid Antipyretic other than ASA, Anti-thyroid meds (respond to
reduce tachy), IV glucocorticoids (Decadron) inhibits t4-t3
-o2, fluids (correct electrolytes mg and k)
, ◉ Order of Heart Valves.
Answer: tricuspid, Pulmonic, mitral, aortic
◉ Hearts Sounds are:.
Answer: Closing valves due to pressure
◉ Coronary Arteries Arise from:.
Answer: Aortic ostium
◉ R. coronary artery turns into.
Answer: posterior descending artery
◉ Most anterior portion of the heart.
Answer: Right Ventricle, so most susceptible to blunt trauma
◉ Left Circumflex Artery feeds.
Answer: lateral wall
◉ Left Anterior Descending feeds.
Answer: anterior 2/3 septum, anterior wall
