Air Methods Critical Care Exam
1. Coopernail's Sign bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
2. Halstead's Sign Marbled abdomen- bleeding
3. Cullen's sign ecchymosis in umbilical area, seen with pancreatitis
4. Murphy's Sign pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
5. Factors fetal well-be- 1.) Viability (most important)
ing 2.) Fetal Heart rate
3.) Fetal movement
6. PEEP (positive end -Causes increased pulmonary vascular resistance
expiratory pressure) -Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
7. steps in resuscitation Dry, warm, position to open airway, suction mouth
of the neonate 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 ve-
nous line, volume loss give 10ml/kg NS
8. pulmonary contusion Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
, Air Methods Critical Care Exam
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
9. ruptured diaphragm abd contents herniate into the thoracic cavity com-
pressing 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.
10. Tracheobronchial in- 1. hemoptysis
jury 2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDI-
ASTINUM even after chest tube placement***
- advance ETT below level of injury into Right main-
stem
11. esophageal perfora- -fever
tion -hematemesis
12. Fat embolus can form when a long bone is fractured and fat cells
from yellow bone marrow are released into the blood
-fever
-rash after fracture
13. Blood loss from 750 ml
humerus fracture
14. blood loss from femur 1500 ml
fracture
15. PAWP (pulmonary - Looks at the left side of the heart
artery wedge pres- - If elevated can indicate pulmonary congestion,
sure) CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient
, Air Methods Critical Care Exam
cough forcefully
-Normal: 8-12
16. Adult ETT depth 3 x ETT size or average 19.23 cm
17. Peds ETT depth 10 + age in years (cm)
18. Neonate ETT depth 6 + wt in kg (cm)
19. Adjust vent to change adjust rate and tidal volume
Co2
20. Adjust vent to change adjust PEEP, PAP
oxygenation
21. infant rule of nines Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
22. Sodium Bicarbonate -acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
23. Digoxin -cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
24. treatment for fetal dis- -Left lateral recumbent position
tress -O2
-Correct contributing factors
-keep reassessing
25. CHF considerations -many are relatively hypovolemic
-be careful with diuretics
1. Coopernail's Sign bruising of the scrotum or labia
-indicating pelvic bleeding/ abdominal bleeding
-pelvic fx
2. Halstead's Sign Marbled abdomen- bleeding
3. Cullen's sign ecchymosis in umbilical area, seen with pancreatitis
4. Murphy's Sign pain with palpation of the RUQ during inspiration
-indicative of cholecystitis
5. Factors fetal well-be- 1.) Viability (most important)
ing 2.) Fetal Heart rate
3.) Fetal movement
6. PEEP (positive end -Causes increased pulmonary vascular resistance
expiratory pressure) -Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
7. steps in resuscitation Dry, warm, position to open airway, suction mouth
of the neonate 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 ve-
nous line, volume loss give 10ml/kg NS
8. pulmonary contusion Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
, Air Methods Critical Care Exam
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
9. ruptured diaphragm abd contents herniate into the thoracic cavity com-
pressing 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.
10. Tracheobronchial in- 1. hemoptysis
jury 2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDI-
ASTINUM even after chest tube placement***
- advance ETT below level of injury into Right main-
stem
11. esophageal perfora- -fever
tion -hematemesis
12. Fat embolus can form when a long bone is fractured and fat cells
from yellow bone marrow are released into the blood
-fever
-rash after fracture
13. Blood loss from 750 ml
humerus fracture
14. blood loss from femur 1500 ml
fracture
15. PAWP (pulmonary - Looks at the left side of the heart
artery wedge pres- - If elevated can indicate pulmonary congestion,
sure) CHF, cardiogenic shock
- Do not keep wedged for more than 30 seconds
- Make sure balloon is deflated and have patient
, Air Methods Critical Care Exam
cough forcefully
-Normal: 8-12
16. Adult ETT depth 3 x ETT size or average 19.23 cm
17. Peds ETT depth 10 + age in years (cm)
18. Neonate ETT depth 6 + wt in kg (cm)
19. Adjust vent to change adjust rate and tidal volume
Co2
20. Adjust vent to change adjust PEEP, PAP
oxygenation
21. infant rule of nines Head and neck - 21%
Each arm - 10%
chest/stomach - 13%
back - 13%
butt/genitals - 6%
each leg - 13.5%
22. Sodium Bicarbonate -acidosis
-drug choice for cyclic antidepressant OD
-KG/4 x base deficit = mEq needed
23. Digoxin -cardiac glycoside
-can cause hypokalemia
-inotropes
-pediatric dose: 0.1 mg/ml
-adult 0.25 mg/ml
24. treatment for fetal dis- -Left lateral recumbent position
tress -O2
-Correct contributing factors
-keep reassessing
25. CHF considerations -many are relatively hypovolemic
-be careful with diuretics
