Air Methods Critical Care Exam Questions With
Accurate 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 post 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%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate
-acidosis
-drug of choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq required
Digoxin
-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress
-Left lateral recumbent position
-O2
-Correct contributing factors
-continued re-evaluation
CHF considerations
-many are relatively hypovolemic
-diuretics cautiously
CVP catheter placement outside line markers
RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
Accurate 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 post 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%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate
-acidosis
-drug of choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq required
Digoxin
-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress
-Left lateral recumbent position
-O2
-Correct contributing factors
-continued re-evaluation
CHF considerations
-many are relatively hypovolemic
-diuretics cautiously
CVP catheter placement outside line markers
RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
