Air Methods Critical Care Exam
questions well answered graded A+
Coopernail's Sign - ANS ✔✔bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign - ANS ✔✔Marbled abdomen- bleeding
Cullen's sign - ANS ✔✔ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign - ANS ✔✔pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being - ANS ✔✔1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure) - ANS ✔✔-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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔-fever
-hematemesis
Fat embolus - ANS ✔✔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 - ANS ✔✔750 ml
blood loss from femur fracture - ANS ✔✔1500 ml
PAWP (pulmonary artery wedge pressure) - ANS ✔✔- 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 - ANS ✔✔3 x ETT size or average 19.23 cm
Peds ETT depth - ANS ✔✔10 + age in years (cm)
, Neonate ETT depth - ANS ✔✔6 + wt in kg (cm)
Adjust vent to change Co2 - ANS ✔✔adjust rate and tidal volume
Adjust vent to change oxygenation - ANS ✔✔adjust PEEP, PAP
infant rule of nines - ANS ✔✔Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate - ANS ✔✔-acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
Digoxin - ANS ✔✔-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress - ANS ✔✔-Left lateral recumbent position
-O2
-Correct contributing factors
questions well answered graded A+
Coopernail's Sign - ANS ✔✔bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
Halstead's Sign - ANS ✔✔Marbled abdomen- bleeding
Cullen's sign - ANS ✔✔ecchymosis in umbilical area, seen with pancreatitis
Murphy's Sign - ANS ✔✔pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
Factors fetal well-being - ANS ✔✔1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
PEEP (positive end expiratory pressure) - ANS ✔✔-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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔-fever
-hematemesis
Fat embolus - ANS ✔✔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 - ANS ✔✔750 ml
blood loss from femur fracture - ANS ✔✔1500 ml
PAWP (pulmonary artery wedge pressure) - ANS ✔✔- 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 - ANS ✔✔3 x ETT size or average 19.23 cm
Peds ETT depth - ANS ✔✔10 + age in years (cm)
, Neonate ETT depth - ANS ✔✔6 + wt in kg (cm)
Adjust vent to change Co2 - ANS ✔✔adjust rate and tidal volume
Adjust vent to change oxygenation - ANS ✔✔adjust PEEP, PAP
infant rule of nines - ANS ✔✔Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
Sodium Bicarbonate - ANS ✔✔-acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
Digoxin - ANS ✔✔-cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
treatment for fetal distress - ANS ✔✔-Left lateral recumbent position
-O2
-Correct contributing factors
