AIR METHODS CC PARAMEDIC NEW EDITION

AIR METHODS CC PARAMEDIC NEW EDITION ABG - PH - CORRECT ANSWER-7.35-7.45 mm HG ABG - PaCO2 range - CORRECT ANSWER-35-45 mm HG ABG - PA02 - CORRECT ANSWER-80-100mm HG ABG - BE - CORRECT ANSWER--2 - 3 MeQ/L CBC: Hemoglobin (Hgb) - what is the normal range? - CORRECT ANSWER-Normal Value: 14-17.5 G /DL CBC: Hemoglobin (Hgb) - what do high and low values indicate? - CORRECT ANSWER-High value = smoking? Low value = anemia or blood loss? CBC: Hematocrit - what is the normal range? - CORRECT ANSWER-Normal value = 41-50% CBC: Hematocrit - what do high and low values indicate? - CORRECT ANSWER-High value = dehydrated? Low value = anemia or blood loss? CBC: WBC - what is the normal range? - CORRECT ANSWER-Normal value = 4500- 11000 CBC: WBC - what do high and low values indicate? - CORRECT ANSWER-High value = infection, anemia, steroid use Low value = viral infection or immunodeficiency CBC: RBC - what is the normal range? - CORRECT ANSWER-Normal value = 3.9-5.5 million mm3 CBC: RBC - what do high and low values indicate? - CORRECT ANSWER-High value = polycythemia or high altitude Low value = cancer or bone marrow suppression Coags: PT - what does it measure & how long? - CORRECT ANSWER-Coumadin anticoagulation 10-13 second Coags: PT - what do high values indicate? - CORRECT ANSWER-High values can indicate liver cirrohsis, vitamin K deficiency or DIC Coags: INR - CORRECT ANSWER-International normalized ratio. Normal INR = 1.0. Coags: aPTT - what does it measure & how long? - CORRECT ANSWER-Measures Heparin 25-40 second OB: What are some physiological changes which occur in pregnancy? - CORRECT ANSWER--Blood volume increases 40% -Plasma increases, showing false anemia on labs -BP decreases in 2nd trimester, but returns to normal -Cardiac output increases, up to 50% -HR increases 10-15 bpm -SBP increases -Body becomes more insulin resistant -Uterus enlarges 20x OB: Physical assessment of pregnant patient - CORRECT ANSWER-Palpate / Check vitals / Check FHT / Ask GP-PAL OB: What is GP-PAL - CORRECT ANSWER-Gravida, Para, Preterms, Abortion, Living children OB: Tx for distressed fetus? - CORRECT ANSWER-100% O2 via NRB on mother; place in LLR; give fluids for hypotension and perform external vaginal exam OB: Vaginal bleeding - caused by? - CORRECT ANSWER-Ovarian cysts, spotting, fetal loss, ectopic pregnancy or uterine rupture OB: Vaginal bleeding - TX? - CORRECT ANSWER-O2/IV/Monitor Manage blood loss Blood products Tx for shock Monitor FHT OB: Gestational hypertension - TX? - CORRECT ANSWER-Treat with: -Beta Blockers like Labetalol -Arterial vasodilators like Hydrolozine -Consider seizure prophylaxis like 4G Mag over 20 min OB: Pre-eclampsia - S/S & TX? - CORRECT ANSWER-S/S = HTN with edema, neuro changes and clonus TX = -Beta Blockers like Labetalol -Arterial vasodilators like Hydrolozine -Consider seizure prophylaxis like 4G Mag over 20 min (Delivery is only option to stop condition) OB: Pre-eclampsia - severe S/S? - CORRECT ANSWER-BP >160/100 Pulmonary edema Platelets under 100k Headache/ vision changes RUQ pain Proteins in urine OB: Eclampsia - S/S & TX? - CORRECT ANSWER-S/S - HTN with seizures TX - Magnesium -4G bolus over 2 minutes; 2G Mag bolus if already administered. Consider Midazolam (2-5mg IM) if seizure continues OB: Placenta Previa - S/S? - CORRECT ANSWER-Painless, bright red bleeding No significant findings on abdomen exam OB: Abruptio Placentae - S/S & TX? - CORRECT ANSWER-Caused by Trauma, HTN, ETOH/drugs S/S = tearing, abdominal pain, vaginal bleeding. In severe cases, hemorrhagic shock and rigid abdomen TX = 100% O2 NRB, 2 IV's with volume replacement. Consider 4G Mag or steroid OB: Uterine Rupture - S/S and TX? - CORRECT ANSWER-S/S = sharp pain, hypovolemic chock, distention and possible bleeding TX = LLR, 100% O2, IV's and 4G Mag bolus OB: Prolapsed cord - TX - CORRECT ANSWER-Knees to chest, don't push, 100% O2, Keep cord moist, consider manual displacement if needed. Consider Nitro infusion of 2ug/min or 4G Mag bolus OB: Name the delivery presentations - CORRECT ANSWER-Cephalic, vertex - normal presentation Cephalic, face - head down, posterior, head not flexed Complete breech - feet first, indian style Incomplete breech - one foot presenting Transverse - (non deliverable) Butt first or sideways OB: Vitals at birth? - CORRECT ANSWER-RR - 30-60 HR - 100-160 SBP - 50-70 BGC - over 70 OB: Post delivery hemmorhage - caused by? - CORRECT ANSWER-Tissue Trauma Tone Thrombin OB: Amniotic Fluid Embolism - S/S and TX? - CORRECT ANSWER-S/S = HX, trauma, coughing, AMS, Coughing, chest pain, restlessness, CVA symptoms, hypoxic TX = Aggressive airway management with PEEP, Manage ABC's, Fluid replacement, consider Epi or SoluMedrol OB: Magnesium - CORRECT ANSWER-SMOOTH MUSCLE RELAXANT -Neuro protection for baby -seizure prophylaxis Dose - 4G in 100ml D5W over 15 minutes, followed by 2G/hr infusion. OB: Nifedipine - CORRECT ANSWER-UTERINE SMOOTH MUSCLE RELAXANT Dose - 10mg PO *May cause hypotension OB: Terbutaline - CORRECT ANSWER-SMOOTH MUSCLE RELAXANT /STOPS CONTRACTIONS/ VASODIALATOR Dose - 0.25mg IM OB: Indomethacin - CORRECT ANSWER-NSAID Dose - 25-50mg PO *Contraindicated in 3rd trimester OB: Labetalol - CORRECT ANSWER-Beta blocker / smooth muscle relaxant / antihypertensive Dose - 20-40mg (300mg max) OB: Betamethasone - CORRECT ANSWER-Steroid Dose - 12mg IM x2, 24 hours apart OB: Dexamethasone - CORRECT ANSWER-Steroid