Air Methods Critical Care Review | Medical
Emergencies UPDATED ACTUAL Exam
Questions and CORRECT Answers
What type of shock is septic shock considered? - CORRECT ANSWER - Distributive
3 types of distributive shock: Septic shock, neurogenic shock, and anaphylactic shock.
Sepsis occurs when there is a circulatory and cellular/metabolic abnormality severe enough to
increase mortality in the tissue that could potentially cause multi-organ failure
While at bedside of your adult ICU patient, you elect to perform an RSI prior to transport due to
decreasing mentation and airway protection. Your patient presents with the following pulmonary
artery catheter readings:
CVP 1
SVR 400
PCWP 9
CI 5.6
PAP 17/11
What induction agent would you utilize?
Etomidate
Ketamine
Versed
Fentanyl - CORRECT ANSWER - Ketamine
This is a septic shock patient as displayed by decreased CVP, decreased SVR and increased CI
Etomidate should be avoided in patients with septic shock r/t it causing adrenal insufficiency and
cortisol production, which is already present in septic shock states. Preferred induction agent
,would be ketamine because Versed may further worsen hemodynamic stability. Fentanyl is not
an RSI sedation induction agent to be utilized but can be used as pre-treatment medication to RSI
A 54 year old male presents to the hospital with hypotension and AMS. There is no medical
history.
A Pulmonary Artery Catheter is placed in the patient and shows the following:
CVP: 13
PAP: 28/12
PAOP: 18
CI: 1.8
SVR: 2,200
What type of shock do you suspect this patient is in? - CORRECT ANSWER - Cardiogenic
Shock
This patient has a high CVP, high PAOP, low CI, and high SVR which is indicative of
cardiogenic shock.
Hypovolemic shock may have a high SVR and low CI but would not have a high CVP and
PAOP.
Septic shock is defined as - CORRECT ANSWER - Multiorgan dysfunction caused by a host
response to infection
Septic shock is a type of shock that affects capillary beds and profusion to tissue with a MAP 2
with a mortality rate exceeding 40% that manifests from an infection
A patient pressents with a wound, that is hot to touch and red. The patient is also tachycardic and
hypotensive. What type of shock do you assume the patient is suffering from? - CORRECT
ANSWER - Septic shock
, Septic shock s/s upon physical assessment without diagnostics include hypotension, confusion,
fever, tachycardia, increased RR, decreased UO and source of infection to cause it
A patient presents with confusion, is hot to the touch, and has a rapid pulse. Upon assessment,
you see their BP is 60/45.
Which treatment would you start immediately?
10mL/kg crystalloid fluids and antibiotics
20mL/kg packed RBCs
30mL/kg Crystalloid fluids and antibiotics
Epinephrine drip - CORRECT ANSWER - 30mL/kg crystalloid fluids and antibiotics
PRBCs are not indicated unless a patient is anemic or losing blood. Tissue perfusion is
predominantly achieved by the aggressive administration of IVF, usually crystalloids, given at
30mL/kg. Started within one hour and completed within the first 3 hours following presentation,
in conjunction with broad spectrum antibiotics in the first hour of symptoms. 30mL/kg
crytsalloid fluids and antiobiotics can significantly decrease mortality. Epinephrine may increase
serum lactate and is not the first line choice for vasopressor for sepsis.
The transport clinician arrives to the patient and hears in report that the patie4nt is receiving
chemotherapy for lung cancer. What lab value would be most concerning?
WBC 0.4
RBC 5.0
WBC 11.2
hbg 15 - CORRECT ANSWER - WBC 0.4
What would you expect your patient's calcium to be with a positive Chvostek sign? - CORRECT
ANSWER - Low calcium
Normal calcium: 8.5-10.3
Emergencies UPDATED ACTUAL Exam
Questions and CORRECT Answers
What type of shock is septic shock considered? - CORRECT ANSWER - Distributive
3 types of distributive shock: Septic shock, neurogenic shock, and anaphylactic shock.
Sepsis occurs when there is a circulatory and cellular/metabolic abnormality severe enough to
increase mortality in the tissue that could potentially cause multi-organ failure
While at bedside of your adult ICU patient, you elect to perform an RSI prior to transport due to
decreasing mentation and airway protection. Your patient presents with the following pulmonary
artery catheter readings:
CVP 1
SVR 400
PCWP 9
CI 5.6
PAP 17/11
What induction agent would you utilize?
Etomidate
Ketamine
Versed
Fentanyl - CORRECT ANSWER - Ketamine
This is a septic shock patient as displayed by decreased CVP, decreased SVR and increased CI
Etomidate should be avoided in patients with septic shock r/t it causing adrenal insufficiency and
cortisol production, which is already present in septic shock states. Preferred induction agent
,would be ketamine because Versed may further worsen hemodynamic stability. Fentanyl is not
an RSI sedation induction agent to be utilized but can be used as pre-treatment medication to RSI
A 54 year old male presents to the hospital with hypotension and AMS. There is no medical
history.
A Pulmonary Artery Catheter is placed in the patient and shows the following:
CVP: 13
PAP: 28/12
PAOP: 18
CI: 1.8
SVR: 2,200
What type of shock do you suspect this patient is in? - CORRECT ANSWER - Cardiogenic
Shock
This patient has a high CVP, high PAOP, low CI, and high SVR which is indicative of
cardiogenic shock.
Hypovolemic shock may have a high SVR and low CI but would not have a high CVP and
PAOP.
Septic shock is defined as - CORRECT ANSWER - Multiorgan dysfunction caused by a host
response to infection
Septic shock is a type of shock that affects capillary beds and profusion to tissue with a MAP 2
with a mortality rate exceeding 40% that manifests from an infection
A patient pressents with a wound, that is hot to touch and red. The patient is also tachycardic and
hypotensive. What type of shock do you assume the patient is suffering from? - CORRECT
ANSWER - Septic shock
, Septic shock s/s upon physical assessment without diagnostics include hypotension, confusion,
fever, tachycardia, increased RR, decreased UO and source of infection to cause it
A patient presents with confusion, is hot to the touch, and has a rapid pulse. Upon assessment,
you see their BP is 60/45.
Which treatment would you start immediately?
10mL/kg crystalloid fluids and antibiotics
20mL/kg packed RBCs
30mL/kg Crystalloid fluids and antibiotics
Epinephrine drip - CORRECT ANSWER - 30mL/kg crystalloid fluids and antibiotics
PRBCs are not indicated unless a patient is anemic or losing blood. Tissue perfusion is
predominantly achieved by the aggressive administration of IVF, usually crystalloids, given at
30mL/kg. Started within one hour and completed within the first 3 hours following presentation,
in conjunction with broad spectrum antibiotics in the first hour of symptoms. 30mL/kg
crytsalloid fluids and antiobiotics can significantly decrease mortality. Epinephrine may increase
serum lactate and is not the first line choice for vasopressor for sepsis.
The transport clinician arrives to the patient and hears in report that the patie4nt is receiving
chemotherapy for lung cancer. What lab value would be most concerning?
WBC 0.4
RBC 5.0
WBC 11.2
hbg 15 - CORRECT ANSWER - WBC 0.4
What would you expect your patient's calcium to be with a positive Chvostek sign? - CORRECT
ANSWER - Low calcium
Normal calcium: 8.5-10.3
