CRITICAL CARE TRANSPORT/FLIGHT PARAMEDIC EXAM
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔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
✔✔2,3-DPG (Diphosphoglycerate) - ✔✔isomer made by red blood cells in normal
amounts during homeostasis; acts as a crowbar to offload oxygen from the hemoglobin;
will increase or decrease production according to body conditions; when increased,
there is less ability for hemoglobin to hold onto oxygen and more ability to release it into
tissues; when decreased, there is more ability for hemoglobin to hold onto oxygen and
less ability to release it into tissues
✔✔4 - ✔✔How many oxygen carrying sites are on each hemoglobin molecule?
✔✔oxyhemoglobin dissociation curve - ✔✔Relationship between available oxygen and
amount of oxygen carried by hemoglobin; The first part of the graph is relatively flat,
indicating the difficulty of attaching the first oxygen molecule to the heme subunit of the
hemoglobin; The middle of the graph is steep, a result of the increased ease of oxygen
binding as the second, third, and fourth oxygen molecules are bound to the heme
subunits; The lower portion of the curve represents the condition found in metabolically
active tissue; The upper portion of the curve represents the condition in the pulmonary
vasculature at the alveolar-capillary membrane.
✔✔right shift - ✔✔the direction in which the oxyhemoglobin dissociation curve is shifted
when more oxygen is released from the hemoglobin, resulting in greater oxygen
delivery to the tissues; caused by increased PCO2, increased temperature, increased
2,3-DPG (less ability for hemoglobin to hold onto oxygen), and decreased pH (acidosis);
Ex: SpO2 of 80 (low) with a paO2 of 80 (normal)
- raised PCO2
- raised temperature
- raised 2,3-DPG
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔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
✔✔2,3-DPG (Diphosphoglycerate) - ✔✔isomer made by red blood cells in normal
amounts during homeostasis; acts as a crowbar to offload oxygen from the hemoglobin;
will increase or decrease production according to body conditions; when increased,
there is less ability for hemoglobin to hold onto oxygen and more ability to release it into
tissues; when decreased, there is more ability for hemoglobin to hold onto oxygen and
less ability to release it into tissues
✔✔4 - ✔✔How many oxygen carrying sites are on each hemoglobin molecule?
✔✔oxyhemoglobin dissociation curve - ✔✔Relationship between available oxygen and
amount of oxygen carried by hemoglobin; The first part of the graph is relatively flat,
indicating the difficulty of attaching the first oxygen molecule to the heme subunit of the
hemoglobin; The middle of the graph is steep, a result of the increased ease of oxygen
binding as the second, third, and fourth oxygen molecules are bound to the heme
subunits; The lower portion of the curve represents the condition found in metabolically
active tissue; The upper portion of the curve represents the condition in the pulmonary
vasculature at the alveolar-capillary membrane.
✔✔right shift - ✔✔the direction in which the oxyhemoglobin dissociation curve is shifted
when more oxygen is released from the hemoglobin, resulting in greater oxygen
delivery to the tissues; caused by increased PCO2, increased temperature, increased
2,3-DPG (less ability for hemoglobin to hold onto oxygen), and decreased pH (acidosis);
Ex: SpO2 of 80 (low) with a paO2 of 80 (normal)
- raised PCO2
- raised temperature
- raised 2,3-DPG
