Air Methods Critical Care Review
Airway Anesthesia and Analgesics
well answered
You are transporting a traumatic patient who has been in the Trauma ICU with significant
injuries for 1 week. He has not developed sepsis with the following VS:
BP: 88/55
P: 120 Sinus tach without ectopy
RR: 10
SpO2: 100%
Temperature: 102.1F
ABGs
pH: 7.1
PaCO2: 50mmHg
PaO2: 340 mmHg
HCO3: 30mEq/L
What would you expect with this patient's O2 Hemoglobin dissociation curve? - ANS ✔✔The
curve will be shifted right
You are intubating a 54 year old female who is 5'2" and weighs 235lbs. While preforming a
mallampati assessment, you notice her soft palate and major part of uvula present. You could
classify her as a class: - ANS ✔✔II
,Structures seen with Class I Mallampati assessment - ANS ✔✔Soft palete, uvula, fauces, pillars
visible
Structures seen with Class II Mallampati assessment - ANS ✔✔Soft Palate, major part of uvula,
fauces visible
Structures seen with Class III Mallampati assessment - ANS ✔✔Soft palate, base of uvula visible
Structures seen with Class IV Mallampati assessment - ANS ✔✔Only hard palate visible
What can cause a left shift in the oxyhemoglobin dissociation curve?
ARDS
A pt. who received mass transfusion
Respiratory Acidosis
Sepsis - ANS ✔✔A patient who received mass transfusion
Would shift left due to increased oxygen carrying. ARDS, Respiratory acidosis, and sepsis all are
associated with acidosis, lower pH, higher levels of CO2, which would cause a right shift
When it comes to making ATP during aerobic respiration, why is oxygen necessary? - ANS
✔✔Oxygen is the final electron acceptor in the electron transport chain
High-energy electrons go through the electron transport chain in a series of exe3rgonic redox
reactions. Ultimately used to produce ATP.
Which of the following methods is the least effective way to confirm endotracheal tube
placement?
End Tidal CO2 capnometry
, Fogging in the tube
Direct visualization between the vocal cords
Bilateral equal lung sounds - ANS ✔✔Fogging in the tube
What is the gold-standard to confirm ETT placement? - ANS ✔✔End Tidal CO2 capnometry
What is Graham's law? - ANS ✔✔Gas will diffuse from high pressure to low pressure
Higher O2 concentration in alveoli will diffuse to capillaries, which has lower concentrations of
O2
Acronym to consider for surgical cric considerations - ANS ✔✔SMART
Surgery of Neck
Mass
Access to the neck - obesity, Limited ROM
Radiation
Tumor
Acronym to consider when predicting a difficult airway - ANS ✔✔HEAVEN
Hypoxemia
Extremes of size - obese pt, petite pt.
Anatomic disruption/obstruction
Vomit/blood/fluid
Exsanguination- bled out so much they can't keep SpO2 up
Neck mobility/neuro injury
Airway Anesthesia and Analgesics
well answered
You are transporting a traumatic patient who has been in the Trauma ICU with significant
injuries for 1 week. He has not developed sepsis with the following VS:
BP: 88/55
P: 120 Sinus tach without ectopy
RR: 10
SpO2: 100%
Temperature: 102.1F
ABGs
pH: 7.1
PaCO2: 50mmHg
PaO2: 340 mmHg
HCO3: 30mEq/L
What would you expect with this patient's O2 Hemoglobin dissociation curve? - ANS ✔✔The
curve will be shifted right
You are intubating a 54 year old female who is 5'2" and weighs 235lbs. While preforming a
mallampati assessment, you notice her soft palate and major part of uvula present. You could
classify her as a class: - ANS ✔✔II
,Structures seen with Class I Mallampati assessment - ANS ✔✔Soft palete, uvula, fauces, pillars
visible
Structures seen with Class II Mallampati assessment - ANS ✔✔Soft Palate, major part of uvula,
fauces visible
Structures seen with Class III Mallampati assessment - ANS ✔✔Soft palate, base of uvula visible
Structures seen with Class IV Mallampati assessment - ANS ✔✔Only hard palate visible
What can cause a left shift in the oxyhemoglobin dissociation curve?
ARDS
A pt. who received mass transfusion
Respiratory Acidosis
Sepsis - ANS ✔✔A patient who received mass transfusion
Would shift left due to increased oxygen carrying. ARDS, Respiratory acidosis, and sepsis all are
associated with acidosis, lower pH, higher levels of CO2, which would cause a right shift
When it comes to making ATP during aerobic respiration, why is oxygen necessary? - ANS
✔✔Oxygen is the final electron acceptor in the electron transport chain
High-energy electrons go through the electron transport chain in a series of exe3rgonic redox
reactions. Ultimately used to produce ATP.
Which of the following methods is the least effective way to confirm endotracheal tube
placement?
End Tidal CO2 capnometry
, Fogging in the tube
Direct visualization between the vocal cords
Bilateral equal lung sounds - ANS ✔✔Fogging in the tube
What is the gold-standard to confirm ETT placement? - ANS ✔✔End Tidal CO2 capnometry
What is Graham's law? - ANS ✔✔Gas will diffuse from high pressure to low pressure
Higher O2 concentration in alveoli will diffuse to capillaries, which has lower concentrations of
O2
Acronym to consider for surgical cric considerations - ANS ✔✔SMART
Surgery of Neck
Mass
Access to the neck - obesity, Limited ROM
Radiation
Tumor
Acronym to consider when predicting a difficult airway - ANS ✔✔HEAVEN
Hypoxemia
Extremes of size - obese pt, petite pt.
Anatomic disruption/obstruction
Vomit/blood/fluid
Exsanguination- bled out so much they can't keep SpO2 up
Neck mobility/neuro injury
