Critical Care Transport/Flight Paramedic
Questions & Answers 100% Correct
Sickled cells - ANSWER-Red blood cells that are less deformable and do not pass
through microcirculation as easily, cause an increase in blood viscosity, and are
sequestered and destroyed by the liver and spleen
Acute chest syndrome - ANSWER-Condition that accounts for 25% of premature deaths
in patients with sickle cell disease; the leading cause of hospitalization and death of
sickle cell patients; symptoms include fever, cough, chest pain, dyspnea, new infiltrates
on chest x-ray; no definitive therapy, only supportive care
Integrilin, ReoPro, and Aggrastat - ANSWER-The three glycoprotein IIb/IIa inhibitors
that bind to a platelet receptor glycoprotein and inhibit platelet aggregation
760 mmHg/1 atm - ANSWER-Barometric pressure at sea level
Physiologic zone - ANSWER-Atmospheric zone; sea level-10,000 ft; human body is well
adapted; adequate pressure to allow for oxygen exchange, impairments are frequently
due to changes in pressure (ascent or descent)
Physiologically deficient zone - ANSWER-Atmospheric zone; 10,000-50,000 ft;
noticeable deficits to humans; reduced barometric pressure results in poor oxygen
exchange; most noticeable impairment is hypoxia (trapped gases can also cause
hypoxia)
Space equivalent zone - ANSWER-Atmospheric zone; 50,000-250,000 ft; environment
incompatible with human life; pressurized suits and sealed cabins required; impairments
include hypoxia, trapped gas, and emboli
Boyle's Law - ANSWER-Gas law; When temperature remains constant, the volume of a
gas is inversely proportional to its pressure; As a gas bubble ascends, it expands. As it
descends, it gets smaller; P1(V1) = P2(V2)
Charles' Law - ANSWER-Gas law; At a constant pressure, the volume of gas is directly
proportional to its temperature; For every 1,000 ft (333 meters) of altitude increase,
temperature decreases 2 degrees Celsius; V1/T1 = V2/T2
Ideal Gas Law - ANSWER-Gas law; created to explain Boyle's Law vs. Charles Law; It
takes a large amount of temperature change to affect a small amount of volume; pV =
nRT (absolute pressure of gas x volume = amount of substance x gas constant x
absolute temperature)
,Dalton's Law - ANSWER-Gas law; The total pressure of a gas mixture is the sum of the
individual partial pressure of all the gas in the mixture; As altitude increases, the amount
of oxygen molecules decreases, but the percentage of molecules remains the same; Pt
= P1 + P2 + P3... (Pt = total pressure of a gas)
Henry's Law - ANSWER-Gas law; The amount of gas in a solution is proportional to the
partial pressure of gas in contact with the liquid; decompression sickness: increased
nitrogen absorbed into the blood at depth, nitrogen "bubbles" exit the blood with rapid
change in air pressure; soda bottle: CO2 held in suspension by pressure, lid is removed
and CO2 exits to equalize with atmospheric pressure; P = KHC
Graham's Law - ANSWER-Gas law; With temperature and pressure held constant, the
relative rate of diffusion of a gas is inversely proportional to the square roots of the
density of those gases; The less dense the gas, the more rapidly the gas will diffuse
through the air; Lighter gases diffuse more rapidly in narrowed peripheral airways
(heliox); CO2 has a solubility factor 19 times greater than O2 and will more rapidly
diffuse across a membrane
15 PSI/1 atm - ANSWER-Amount of pressure at 33 ft of ocean depth
indifferent stage - ANSWER-first of the four stages of hypoxia; sea level to 10,000 ft in
altitude; 33,000-39,000 ft if breathing 100% oxygen; SpO2 of 90-95%; night vision lost
5,000 ft; slight increase in heart rate and respiratory rate
compensatory stage - ANSWER-second of the four stages of hypoxia; 10,000-15,000 ft
in altitude; 39,000-42,000 ft if breathing 100% oxygen; SpO2 80-90%; signs and
symptoms include deceased alertness, subtle errors in judgement, fatigue, irritability,
headache, tachycardia, tachypnea, increased blood pressure, increased tidal volume,
altered mental status
disturbance stage - ANSWER-third of the four stages of hypoxia, 15,000-20,000 ft in
altitude; 42,000-45,200 ft if breathing 100% oxygen; SpO2 70-80%; signs and
symptoms include fatigue, dizziness, cyanosis, impairment, tachypnea, altered mental
status, impaired central and peripheral vision, and personality changes; period of useful
consciousness is 15-20 minutes
critical stage - ANSWER-last of the four stages of hypoxia; 20,000-23,000 ft in altitude,
45,200-46,800 ft if breathing 100% oxygen; SpO2 60-70%; signs and symptoms include
severe altered mental status, seizures, impairment, unconsciousness, severe mental
and physical capacitation, and death
hypoxic hypoxia - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-the "vital sign" should be monitored on ALL patients during
flight, especially pediatric patients
30 degrees - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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) - ANSWER-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
Questions & Answers 100% Correct
Sickled cells - ANSWER-Red blood cells that are less deformable and do not pass
through microcirculation as easily, cause an increase in blood viscosity, and are
sequestered and destroyed by the liver and spleen
Acute chest syndrome - ANSWER-Condition that accounts for 25% of premature deaths
in patients with sickle cell disease; the leading cause of hospitalization and death of
sickle cell patients; symptoms include fever, cough, chest pain, dyspnea, new infiltrates
on chest x-ray; no definitive therapy, only supportive care
Integrilin, ReoPro, and Aggrastat - ANSWER-The three glycoprotein IIb/IIa inhibitors
that bind to a platelet receptor glycoprotein and inhibit platelet aggregation
760 mmHg/1 atm - ANSWER-Barometric pressure at sea level
Physiologic zone - ANSWER-Atmospheric zone; sea level-10,000 ft; human body is well
adapted; adequate pressure to allow for oxygen exchange, impairments are frequently
due to changes in pressure (ascent or descent)
Physiologically deficient zone - ANSWER-Atmospheric zone; 10,000-50,000 ft;
noticeable deficits to humans; reduced barometric pressure results in poor oxygen
exchange; most noticeable impairment is hypoxia (trapped gases can also cause
hypoxia)
Space equivalent zone - ANSWER-Atmospheric zone; 50,000-250,000 ft; environment
incompatible with human life; pressurized suits and sealed cabins required; impairments
include hypoxia, trapped gas, and emboli
Boyle's Law - ANSWER-Gas law; When temperature remains constant, the volume of a
gas is inversely proportional to its pressure; As a gas bubble ascends, it expands. As it
descends, it gets smaller; P1(V1) = P2(V2)
Charles' Law - ANSWER-Gas law; At a constant pressure, the volume of gas is directly
proportional to its temperature; For every 1,000 ft (333 meters) of altitude increase,
temperature decreases 2 degrees Celsius; V1/T1 = V2/T2
Ideal Gas Law - ANSWER-Gas law; created to explain Boyle's Law vs. Charles Law; It
takes a large amount of temperature change to affect a small amount of volume; pV =
nRT (absolute pressure of gas x volume = amount of substance x gas constant x
absolute temperature)
,Dalton's Law - ANSWER-Gas law; The total pressure of a gas mixture is the sum of the
individual partial pressure of all the gas in the mixture; As altitude increases, the amount
of oxygen molecules decreases, but the percentage of molecules remains the same; Pt
= P1 + P2 + P3... (Pt = total pressure of a gas)
Henry's Law - ANSWER-Gas law; The amount of gas in a solution is proportional to the
partial pressure of gas in contact with the liquid; decompression sickness: increased
nitrogen absorbed into the blood at depth, nitrogen "bubbles" exit the blood with rapid
change in air pressure; soda bottle: CO2 held in suspension by pressure, lid is removed
and CO2 exits to equalize with atmospheric pressure; P = KHC
Graham's Law - ANSWER-Gas law; With temperature and pressure held constant, the
relative rate of diffusion of a gas is inversely proportional to the square roots of the
density of those gases; The less dense the gas, the more rapidly the gas will diffuse
through the air; Lighter gases diffuse more rapidly in narrowed peripheral airways
(heliox); CO2 has a solubility factor 19 times greater than O2 and will more rapidly
diffuse across a membrane
15 PSI/1 atm - ANSWER-Amount of pressure at 33 ft of ocean depth
indifferent stage - ANSWER-first of the four stages of hypoxia; sea level to 10,000 ft in
altitude; 33,000-39,000 ft if breathing 100% oxygen; SpO2 of 90-95%; night vision lost
5,000 ft; slight increase in heart rate and respiratory rate
compensatory stage - ANSWER-second of the four stages of hypoxia; 10,000-15,000 ft
in altitude; 39,000-42,000 ft if breathing 100% oxygen; SpO2 80-90%; signs and
symptoms include deceased alertness, subtle errors in judgement, fatigue, irritability,
headache, tachycardia, tachypnea, increased blood pressure, increased tidal volume,
altered mental status
disturbance stage - ANSWER-third of the four stages of hypoxia, 15,000-20,000 ft in
altitude; 42,000-45,200 ft if breathing 100% oxygen; SpO2 70-80%; signs and
symptoms include fatigue, dizziness, cyanosis, impairment, tachypnea, altered mental
status, impaired central and peripheral vision, and personality changes; period of useful
consciousness is 15-20 minutes
critical stage - ANSWER-last of the four stages of hypoxia; 20,000-23,000 ft in altitude,
45,200-46,800 ft if breathing 100% oxygen; SpO2 60-70%; signs and symptoms include
severe altered mental status, seizures, impairment, unconsciousness, severe mental
and physical capacitation, and death
hypoxic hypoxia - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-the "vital sign" should be monitored on ALL patients during
flight, especially pediatric patients
30 degrees - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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 - ANSWER-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) - ANSWER-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
