Critical Care Transport/Flight Paramedic
Exam with Questions and 100% Correct
Answers
hypoxic hypoxia - ✔✔one of the four types of hypoxia; inadequate oxygenation secondary to
reduced partial pressures of oxygen in inspired air; caused by reduced PaO2, impaired gas exchange
across the alveolar-capillary membrane, or impaired ventilation
anemic (hypemic) hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation
secondary to reduced to reduced oxygen-carrying capacity (from either inadequate availability of
oxygen molecules or obstructive pathology that prevents oxygen from diffusing across alveolar
membranes); caused by CO poisoning, anemia, blood loss, drugs causing methemoglobinemia, alcohol
use or abuse, COPD, pneumonia, pulmonary edema, or pulmonary embolism
stagnant hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation secondary to
reduced cardiac output, pooling of blood, reduced blood flow to tissues, or restriction of blood flow; cause
by heart failure, shock, gravitational forces, positive pressure ventilation, or pulmonary embolism
histotoxic hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation secondary
to metabolic disorder or poisoning of the cytochrome oxidase enzyme system resulting in cellular
inability to utilize oxygen; caused by toxic gas poisoning, alcohol or narcotic abuse, or cyanide poisoning
temperature - ✔✔the "vital sign" should be monitored on ALL patients during flight,
especially pediatric patients
30 degrees - ✔✔angle at which the patient's head should be raised on the stretcher in most
cases, especially intubated patients and patients with head injuries
rotor-wing aircraft - ✔✔type of aircraft typically used for transports less than 150 nautical
miles; operates at sustained speeds of 100-200 mph and at altitudes less than 10,000 ft
,fixed-wing aircraft - ✔✔type of aircraft typically used for transports over 150 nautical miles;
operates at speed ranges from 300-600 mph and at altitudes up to 38,000 ft
Part 91 - ✔✔the section of Title 14 of the Code of Federal Regulations that governs the operation
of all aircraft within the U.S., including the waters within 12 nautical miles of the U.S. coast; can only
be used when NO medical crew is on board
Part 135 - ✔✔the section of Title 14 of the Code of Federal Regulations that governs all commuter
or on-demand commercial flight operations; contains strict weather minimums and duty times;
requires that pilots have no more than 14 hours of duty time followed by at least 10 hours of rest; must
be used when a medical crew is on board
Crew Resource Management (CRM) - ✔✔one solution that has been implemented to reduce the
number of air medical accidents defined as using all available resources (information, equipment, and
people) to achieve safe and efficient flight operations; focuses on the cognitive and interpersonal skills
needed to successfully complete the flight
therapeutic misadventure - ✔✔implies death that occurs as a result of unexpected complications
of medical procedures; a "nice" term for a medical mistake
dialysis fistula - ✔✔a dialysis site that is formed by surgically connecting the walls of an artery to
the walls of a vein; takes three to six months to mature
dialysis graft - ✔✔a dialysis site that is created by connecting the artery and the vein with a
synthetic tube; takes two to six weeks to mature
PICC (peripherally inserted central catheter) - ✔✔non-tunneled CVAC (central venous access
catheter) that is popular in patients who require intermediate to long-term, as well as short-term,
venous access; the most popular form of vascular access in NICU patients; commonly composed
of biocompatible materials and come in a variety of sizes; can have multiple lumina; used for TPN,
chemotherapy, blood products, blood sampling, fluid and drug administration, and measuring CVP
(central venous pressure)
,Hickman Catheter - ✔✔tunneled CVAC (central venous access catheter) used for long-term use in
the cephalic, subclavian, internal jugular, or external jugular vein; has thromboresistant lumina made of
polymeric silicone and are available in double and triple catheters; frequent heparin flushes required
Broviac Catheter - ✔✔tunneled CVAC (central venous access catheter) that is typically used for
pediatric patients for long-term use of TPN, IV fluids, and medications; lumina made of polymeric
silicone and are available in double and triple catheters; needs to be flushed once daily to once weekly
when not in use and must be heparinized; injection cap should be changed every seven days or after
18 needle insertions, after the cap has been removed, if it appears damaged, or after a blood draw
Groshong Catheter - ✔✔tunneled CVAC (central venous access catheter) that has a long, hollow
lumen made of soft silicone, and has a closed, rounded tip and a three-position valve placed in the side
of the catheter near the tip, which allows fluid to flow in or out, but remain closed when not in use;
inserted into the jugular vein and advanced into the superior vena cava; heparin not required; daily
flushing required
SVAD (subcutaneous vascular access device) - ✔✔tunneled CVAC (central venous access device)
that has an injection port, wherein the port itself includes a self-closing septum for repeated injections;
also known as a port-a-cath; requires a special non-coring injection needle called a Huber needle; used
for long-term IV antibiotic or anti fungal treatment, chemotherapy, TPN, repeated blood samples, and
hemodialysis
arterial line - ✔✔central line placed for continuous beat-by-beat blood pressure measurement and
frequent arterial blood gas analysis; waveform should be displayed and monitored at all times; 25%
incidence rate of occlusion, in which 3% of these result in permanent occlusion; 20 gauge catheter
used in adults, 22 gauge catheter used in children, and 24 gauge catheter used in infants
dampening - ✔✔distortion of an arterial line waveform, which can lead to inaccurate systolic and
diastolic blood pressures (typically lower than they actually are); caused by any restriction in
transmission of the arterial pressure to the transducer; can occur as a result of blood clots in the system,
kinking of the tubing, compression of air bubbles, viscous drag of saline in the line, or patient may
actually be hypotensive
Type and Cross - ✔✔test in which the patient's blood is mixed with a potential donor's blood under
a microscope to test for compatibility (if blood is not compatible, it will agglutinate [clump together]);
takes up to 45 minutes to complete
, Type and Screen - ✔✔test that assesses a patient's blood type and antibodies; takes
approximately 15 minutes to complete
normal saline - ✔✔What is the only solution that blood products can be administered with?
endotoxemia - ✔✔potentially fatal reaction caused by gram-positive or gram-negative
bacterial contamination during a transfusion of blood products due to poor aseptic technique or
subacute bacteremia at the time of donation; symptoms are identical to septic shock
TRALI (transfusion-related acute lung injury) - ✔✔non-cariogenic pulmonary edema secondary to a
blood transfusion; occurs in one out of every 5,000 transfusions; most frequent in multiparous females
or multi-transfused patients; unpredictable and unpreventable; more frequent with plasma and platelet
administration than other blood products; most patient recover with 48 hours of appropriate ventilator
therapy and hemodynamic support
TACO (transfusion-related circulatory overload) - ✔✔volume overload and pulmonary edema
secondary to a blood transfusion; patients with decreased ejection fraction or renal disease at
greater risk; prevented by good assessment, limiting number of units administered per day if not
actively hemorrhaging, decreasing infusion rate, and furosemide administration between units
massive transfusion - ✔✔a blood transfusion in which ten or more units are administered in a 24
hour period; hyperkalemia is a probable side effect due to shelved blood becoming acidic; hypocalcemia
is a probably side effect due to added citrate in the donor blood, which binds to calcium; patients with
impaired kidneys will benefit from "fresher" blood; other complications include ammonia intoxication,
DIC, thrombocytopenia, hypothermia, ARDS, etc.
diaphragm - ✔✔structure in the body responsible for 75% of tidal volume during normal,
quiet breathing
PaO2 (partial pressure of oxygen) - ✔✔the measurement of the amount of oxygen in the blood
available for use by the body; normal level is 80-100; should be approximately five times the
percentage of oxygen a person is inhaling
Exam with Questions and 100% Correct
Answers
hypoxic hypoxia - ✔✔one of the four types of hypoxia; inadequate oxygenation secondary to
reduced partial pressures of oxygen in inspired air; caused by reduced PaO2, impaired gas exchange
across the alveolar-capillary membrane, or impaired ventilation
anemic (hypemic) hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation
secondary to reduced to reduced oxygen-carrying capacity (from either inadequate availability of
oxygen molecules or obstructive pathology that prevents oxygen from diffusing across alveolar
membranes); caused by CO poisoning, anemia, blood loss, drugs causing methemoglobinemia, alcohol
use or abuse, COPD, pneumonia, pulmonary edema, or pulmonary embolism
stagnant hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation secondary to
reduced cardiac output, pooling of blood, reduced blood flow to tissues, or restriction of blood flow; cause
by heart failure, shock, gravitational forces, positive pressure ventilation, or pulmonary embolism
histotoxic hypoxia - ✔✔one of the four types of hypoxia; inadequate tissue oxygenation secondary
to metabolic disorder or poisoning of the cytochrome oxidase enzyme system resulting in cellular
inability to utilize oxygen; caused by toxic gas poisoning, alcohol or narcotic abuse, or cyanide poisoning
temperature - ✔✔the "vital sign" should be monitored on ALL patients during flight,
especially pediatric patients
30 degrees - ✔✔angle at which the patient's head should be raised on the stretcher in most
cases, especially intubated patients and patients with head injuries
rotor-wing aircraft - ✔✔type of aircraft typically used for transports less than 150 nautical
miles; operates at sustained speeds of 100-200 mph and at altitudes less than 10,000 ft
,fixed-wing aircraft - ✔✔type of aircraft typically used for transports over 150 nautical miles;
operates at speed ranges from 300-600 mph and at altitudes up to 38,000 ft
Part 91 - ✔✔the section of Title 14 of the Code of Federal Regulations that governs the operation
of all aircraft within the U.S., including the waters within 12 nautical miles of the U.S. coast; can only
be used when NO medical crew is on board
Part 135 - ✔✔the section of Title 14 of the Code of Federal Regulations that governs all commuter
or on-demand commercial flight operations; contains strict weather minimums and duty times;
requires that pilots have no more than 14 hours of duty time followed by at least 10 hours of rest; must
be used when a medical crew is on board
Crew Resource Management (CRM) - ✔✔one solution that has been implemented to reduce the
number of air medical accidents defined as using all available resources (information, equipment, and
people) to achieve safe and efficient flight operations; focuses on the cognitive and interpersonal skills
needed to successfully complete the flight
therapeutic misadventure - ✔✔implies death that occurs as a result of unexpected complications
of medical procedures; a "nice" term for a medical mistake
dialysis fistula - ✔✔a dialysis site that is formed by surgically connecting the walls of an artery to
the walls of a vein; takes three to six months to mature
dialysis graft - ✔✔a dialysis site that is created by connecting the artery and the vein with a
synthetic tube; takes two to six weeks to mature
PICC (peripherally inserted central catheter) - ✔✔non-tunneled CVAC (central venous access
catheter) that is popular in patients who require intermediate to long-term, as well as short-term,
venous access; the most popular form of vascular access in NICU patients; commonly composed
of biocompatible materials and come in a variety of sizes; can have multiple lumina; used for TPN,
chemotherapy, blood products, blood sampling, fluid and drug administration, and measuring CVP
(central venous pressure)
,Hickman Catheter - ✔✔tunneled CVAC (central venous access catheter) used for long-term use in
the cephalic, subclavian, internal jugular, or external jugular vein; has thromboresistant lumina made of
polymeric silicone and are available in double and triple catheters; frequent heparin flushes required
Broviac Catheter - ✔✔tunneled CVAC (central venous access catheter) that is typically used for
pediatric patients for long-term use of TPN, IV fluids, and medications; lumina made of polymeric
silicone and are available in double and triple catheters; needs to be flushed once daily to once weekly
when not in use and must be heparinized; injection cap should be changed every seven days or after
18 needle insertions, after the cap has been removed, if it appears damaged, or after a blood draw
Groshong Catheter - ✔✔tunneled CVAC (central venous access catheter) that has a long, hollow
lumen made of soft silicone, and has a closed, rounded tip and a three-position valve placed in the side
of the catheter near the tip, which allows fluid to flow in or out, but remain closed when not in use;
inserted into the jugular vein and advanced into the superior vena cava; heparin not required; daily
flushing required
SVAD (subcutaneous vascular access device) - ✔✔tunneled CVAC (central venous access device)
that has an injection port, wherein the port itself includes a self-closing septum for repeated injections;
also known as a port-a-cath; requires a special non-coring injection needle called a Huber needle; used
for long-term IV antibiotic or anti fungal treatment, chemotherapy, TPN, repeated blood samples, and
hemodialysis
arterial line - ✔✔central line placed for continuous beat-by-beat blood pressure measurement and
frequent arterial blood gas analysis; waveform should be displayed and monitored at all times; 25%
incidence rate of occlusion, in which 3% of these result in permanent occlusion; 20 gauge catheter
used in adults, 22 gauge catheter used in children, and 24 gauge catheter used in infants
dampening - ✔✔distortion of an arterial line waveform, which can lead to inaccurate systolic and
diastolic blood pressures (typically lower than they actually are); caused by any restriction in
transmission of the arterial pressure to the transducer; can occur as a result of blood clots in the system,
kinking of the tubing, compression of air bubbles, viscous drag of saline in the line, or patient may
actually be hypotensive
Type and Cross - ✔✔test in which the patient's blood is mixed with a potential donor's blood under
a microscope to test for compatibility (if blood is not compatible, it will agglutinate [clump together]);
takes up to 45 minutes to complete
, Type and Screen - ✔✔test that assesses a patient's blood type and antibodies; takes
approximately 15 minutes to complete
normal saline - ✔✔What is the only solution that blood products can be administered with?
endotoxemia - ✔✔potentially fatal reaction caused by gram-positive or gram-negative
bacterial contamination during a transfusion of blood products due to poor aseptic technique or
subacute bacteremia at the time of donation; symptoms are identical to septic shock
TRALI (transfusion-related acute lung injury) - ✔✔non-cariogenic pulmonary edema secondary to a
blood transfusion; occurs in one out of every 5,000 transfusions; most frequent in multiparous females
or multi-transfused patients; unpredictable and unpreventable; more frequent with plasma and platelet
administration than other blood products; most patient recover with 48 hours of appropriate ventilator
therapy and hemodynamic support
TACO (transfusion-related circulatory overload) - ✔✔volume overload and pulmonary edema
secondary to a blood transfusion; patients with decreased ejection fraction or renal disease at
greater risk; prevented by good assessment, limiting number of units administered per day if not
actively hemorrhaging, decreasing infusion rate, and furosemide administration between units
massive transfusion - ✔✔a blood transfusion in which ten or more units are administered in a 24
hour period; hyperkalemia is a probable side effect due to shelved blood becoming acidic; hypocalcemia
is a probably side effect due to added citrate in the donor blood, which binds to calcium; patients with
impaired kidneys will benefit from "fresher" blood; other complications include ammonia intoxication,
DIC, thrombocytopenia, hypothermia, ARDS, etc.
diaphragm - ✔✔structure in the body responsible for 75% of tidal volume during normal,
quiet breathing
PaO2 (partial pressure of oxygen) - ✔✔the measurement of the amount of oxygen in the blood
available for use by the body; normal level is 80-100; should be approximately five times the
percentage of oxygen a person is inhaling
