Air Methods Critical Care Exam
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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-being: 1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
6. PEEP (positive end expiratory pressure): -Causes increased pulmonary vas-
cular resistance
-Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
7. steps in resuscitation of the neonate: 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
8. pulmonary contusion: Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
9. ruptured diaphragm: 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.
, Air Methods Critical Care Exam
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10. Tracheobronchial injury: 1. hemoptysis
2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDIASTINUM even after chest tube
placement***
- advance ETT below level of injury into Right mainstem
11. esophageal perforation: -fever
-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 humerus fracture: 750 ml
14. blood loss from femur fracture: 1500 ml
15. PAWP (pulmonary artery wedge pressure): - 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
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 Co2: adjust rate and tidal volume
20. Adjust vent to change oxygenation: adjust PEEP, PAP
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 distress: -Left lateral recumbent position
-O2
, Air Methods Critical Care Exam
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-Correct contributing factors
-keep reassessing
25. CHF considerations: -many are relatively hypovolemic
-be careful with diuretics
26. CVP catheter placement outside line markers: RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
27. Central Cord Syndrome: -loss of function in upper extremities caused by injury
to the middle portion of the spinal cord
-varying degrees of sensory loss
28. Brown-Sequard Syndrome: Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
29. Anterior Cord: -loss of motor function, pain, pinprick, and temp bilaterally below
lesion
-proprioception and light touch are preserved
30. Autonomic Dysreflexia: -urinary retention, massive increase in sympathetic
tone which can cause HTN
-treated by foley
31. Adult urine output per hour: 30-50 ml
32. Peds Urine output per hour: 1-2 ml/kg/hr
33. Normal adult blood volume: 70 ml/kg
34. Peds blood volume: 80 ml/kg
35. Mild Hypothermia: -32-36 degrees Celcius
-decreased HR
36. CVP (central venous pressure): -Measures preload (right atrial pressure)
-Norm: 2-6 mmHg
- Use proximal port
37. Basic natriuretic peptide (BNP): -heart failure marker that measures this level
by an over distention of the heart
->500 = HF
38. Most common spontaneous recurrance: anterior shoulder
39. Most common dislocation: hip
40. First adjustment on ventilator: TV first, not rate
41. drugs for AAA: Nipride and Beta Blockers
42. Kehr's sign: -Referred pain down the left shoulder
-indicative of a ruptured spleen or ectopic pregnancy
43. Kernig's sign: -Sign of bacterial meningitis
-positive with back, leg pain on knee extension
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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-being: 1.) Viability (most important)
2.) Fetal Heart rate
3.) Fetal movement
6. PEEP (positive end expiratory pressure): -Causes increased pulmonary vas-
cular resistance
-Can cause hypotension over 15 cmH2O
-Normal: 5 cmH2O
- lowest pressure the lungs will see
7. steps in resuscitation of the neonate: 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
8. pulmonary contusion: Chest pain
bruising over sternum
Progressive dyspnea
decreased breath sounds on one side
rales
low sats despite being on o2
hemoptysis
irregular pulse-dysrthymia
9. ruptured diaphragm: 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.
, Air Methods Critical Care Exam
Study online at https://quizlet.com/_c0u55s
10. Tracheobronchial injury: 1. hemoptysis
2. subcutaneous emphysema
3. air leak (PNEUMOTHORAX) + PNEUMEDIASTINUM even after chest tube
placement***
- advance ETT below level of injury into Right mainstem
11. esophageal perforation: -fever
-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 humerus fracture: 750 ml
14. blood loss from femur fracture: 1500 ml
15. PAWP (pulmonary artery wedge pressure): - 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
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 Co2: adjust rate and tidal volume
20. Adjust vent to change oxygenation: adjust PEEP, PAP
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 distress: -Left lateral recumbent position
-O2
, Air Methods Critical Care Exam
Study online at https://quizlet.com/_c0u55s
-Correct contributing factors
-keep reassessing
25. CHF considerations: -many are relatively hypovolemic
-be careful with diuretics
26. CVP catheter placement outside line markers: RA/CVP: 25-30 cm
RV: 35-45 cm
PA: 50-55 cm
27. Central Cord Syndrome: -loss of function in upper extremities caused by injury
to the middle portion of the spinal cord
-varying degrees of sensory loss
28. Brown-Sequard Syndrome: Hemi-section of the cord
- ipsilateral (same side) spastic paralysis and loss of position sense
- contralateral (opposite side) loss of pain and thermal sense
29. Anterior Cord: -loss of motor function, pain, pinprick, and temp bilaterally below
lesion
-proprioception and light touch are preserved
30. Autonomic Dysreflexia: -urinary retention, massive increase in sympathetic
tone which can cause HTN
-treated by foley
31. Adult urine output per hour: 30-50 ml
32. Peds Urine output per hour: 1-2 ml/kg/hr
33. Normal adult blood volume: 70 ml/kg
34. Peds blood volume: 80 ml/kg
35. Mild Hypothermia: -32-36 degrees Celcius
-decreased HR
36. CVP (central venous pressure): -Measures preload (right atrial pressure)
-Norm: 2-6 mmHg
- Use proximal port
37. Basic natriuretic peptide (BNP): -heart failure marker that measures this level
by an over distention of the heart
->500 = HF
38. Most common spontaneous recurrance: anterior shoulder
39. Most common dislocation: hip
40. First adjustment on ventilator: TV first, not rate
41. drugs for AAA: Nipride and Beta Blockers
42. Kehr's sign: -Referred pain down the left shoulder
-indicative of a ruptured spleen or ectopic pregnancy
43. Kernig's sign: -Sign of bacterial meningitis
-positive with back, leg pain on knee extension
