Shared Flashcard Set

Details

CCP-C Prep
CCP-C Prep
132
Medical
Professional
04/22/2011

Additional Medical Flashcards

 


 

Cards

Term
CLINICAL SIGNS:

Kehr's
Definition
Referred left shoulder pain - possible splenic injury or ectopic pregnancy
Term
CLINICAL SIGNS:

Kernig's
Definition
Back, leg pain on knee extension - possible bacterial meningitis
Term
CLINICAL SIGNS:

Brudzinski's
Definition
Back, leg pain on neck flexion - possible bacterial meningitis or subarachnoid bleed
Term
CLINICAL SIGNS:

Hamman's
Definition
crunching sound heard with auscultation over the anterior chest synchronized with heartbeat - tracheobronchial injury
Term
X-RAY FNDINGS

Steeple sign
Definition
Possible croup (laryngotracheaobonchitis) A/P neck view
Term
X-RAY FINDINGS

Thumbprint sign
Definition
Possible epiglottitis lateral neck view
Term
ABG VALUES
Definition
pCO2 high = pH low (acidosis)
pCO2 low = pH high (alkalosis)
pH low = HCO3 low (acidosis)
pH high = HCO3 high (alkolosis)
pCO2 = 35-45 respiratory
pH = 7.35-7.45 metabolic
HCO3 = 22-26 metabolic
Term
DRUGS FOR AAA
Definition
Nipride and beta-blockers
Term
FIRST ADJUSTMET ON VENTILATOR
Definition
TV first, not rate
Term
TRAUMA

1. Most common dislocation
2. Most common spontaneous recurrence
Definition
1. Hip
2. Anterior shoulder
Term
BRAIN NATRIURETIC PEPTIDE
(BNP)
Definition
Heart failure marker that measures BNP released by an overdistension of the heart

Below 100 = normal
Above 500-700 = heart failure
Term
ROTOR-WING PILOT REQUIRED HOURS
Definition
2000 hours
1000 PIC
100 hours at night
Term
"BOTTLE-TO-THROTTLE" TIME
Definition
At least 8 hours
Term
CVP
MEASURES NORMAL PARAMETER
WHICH PORT TO USE
Definition
Measures: preload (right atrial pressure)
Norm: 2-6 mmHg
Port: proximal port
Term
SPINAL CORD SYNDROMES
(ABC)"A"
ANTERIOR CORD
Definition
Anterior: complete motor, pain and temperature loss below the lesion
Term
SPINAL CORD SYNDROMES
(ABC)"B"
BROWN-SEQUARD
Definition
Brown: ipsilateral loss of motor, position and vibration sense;contralateral loss of pain and temperature perception
Term
SPINAL CORD SYNDROMES
(ABC)"C"

CENTRAL CORD SYNDROME
Definition
Central: great motor weakness in UE than LE with varying degrees of sensory loss
Term
SPINAL CORD SYNDROMES
(ABC)

AUTONOMIC DYSREFLEXIA
Definition
Auronomic: Urinary retention, massive increase in sympathetic tone which can cause HTN, treated by insertion of foley
Term
NORMAL URINARY OUTPUT
Definition
UO: 30-50 mL/hr (adult)
UO: 1-2 mL/hr (peds)
Term
NORMAL BLOOD VOLUME
Definition
Blood volume: 70 mL/kg (adult)
Blood volume: 80 mL/kg (peds)
Term
NORMAL TEMPERATURE
MILD HYPOTHERMIA
MODERATE HYPOTHERMIA
SEVERE HYPOTHERMIA
Definition
Normal: 37.6/98.6
Mild 32-36 (decreasing HR)
Moderate: 29-32 (loss of shivering, ALOC)
Severe: 20-28 (coma, VF common)
Term
TWO MAJOR CAUSES OF HEAT LOSS?
THERMOREGULATION CEASES AT?
Definition
Radiation, evaporation
28 degrees
Term
RULES OF FLIGHT FOLLOWING
Definition
Sterile cockpit during critical phase of flight
15 minutes maximum between communication center during flight
45 minutes maximum while on the ground
Term
ROTOR WING SHUT-OFF SEQUENCE
Definition
Remember "TFB"
throttle
fuel
battery

Take survival bag and meet at twelve o'clock position
Term
SURVIVAL SEQUENCE
Definition
Shelter
Fire
Water
Food
Term
ORDER OF HOW TO ASSESS THE ABDOMEN
Definition
Inspect
Auscultation
Palpation
Percussion
Term
CONTRAINDICATIONS FOR THROMBOLYTICS
Definition
History of hemorrhagic stroke
CVA last 12 months
SBP over 180
Pregnancy or 1 month postpartum
Term
FARs
LOCAL FLYING AREA
DETERMINED BY CELL PHONES PROHIBITED
Definition
Part 91: no passengers
Part 135: passengers (14 hours max for pilots)
Certificate holder
While airborne
Term
PaO2
SaO2
BARIOBARIATRAUMA
Definition
PaO2: plasma-measured as preasure
SaO2: hemoglobin-measured as percentage
Nitrogen release in obese patients, administer high flow O2 15 minutes to lift off to wash out nitrogen
Term
NORMAL PEDIATRIC SBP?
WHEN DOES IT DROP?
Definition
"BP last to go"

SBP: 90+(2 x age)
After loss of 25%

DBP: 2/3 the SBP
Term
THREE KILLERS OF VENTILATOR PATIENTS DURING FLIGHT
Definition
Pericardial tamponade
Tension pneumothorax
Hypovolemia
Term
DEATH FROM CRUSH INJURY DUE TO?
COMPLICATIONS OF CRUSH INJURY?
Definition
Death due to: renal failure
Complications: DIC, compartment syndrome, renal failure, hyperkalemia
Term
CAMTS
1. MEDICAL DIRECTORS NOT REQUIRED TO:
2: INTUBATION REQUIREMENT:
3. LIVE INTUBATION REQUIRED DURING TRAINING:
4. SPECIALTY TEAM RESPONSE TIME:
Definition
1. Live in same state
2. quarterly
3. Five
4. 45 minutes
Term
CAMTS
1. PILOT AREA ORIENTATION DAY/NIGHT
2. HELIPAD REQUIRED TO HAVE:
3. FIXED WING TWIN ENGINE TIME:
4. AMBULANCE FUEL REQUIREMENT:
ELT SET OFF AT:
UNIFORM FIT:
Definition
1. 5 hours day/2 hours night
2. 2 paths, security
3. 500 hours
4. 175 miles
5. 4g's
6. 1/4 space between body and uniform
Term
APPLIED GAS LAWS

THE BENDS, DECOMPRESSION, SODA CAN, CO2 IN BLOOD
Definition
Henry's Law
Term
APPLIED GAS LAWS
TISSUE SWELLING,HYPOXIC HYPOXIA, O2 AVAILABLE AT ALTITUDE
Definition
Dalton's Law
Term
APPLIED GAS LAWS

CELLULAR GAS EXCHANGE, DIFFUSION
Definition
Grahams's Law
Term
APPLIED GAS LAWS

OXYGEN TANK PRESSURE IN HEAT OR COLD
Definition
Gay-Lussac's Law
Term
APPLIED GAS LAWS

BP CUFF, ETT CUFF, MAST
Definition
Boyle's law IABP purges with ascent or descent
Term
APPLIED GAS LAWS

TRAUMA AND KINEMATICS
HIGH VELOCITY
MEDIUM VELOCITY
LOW VELOCITY
Definition
High = above 2000F FPS
Medium = 1000-2000 FPS
Low = under 1000 FPS
Term
TUMBLING YAW
Definition
Tumbling: rotation on 360 degree axis
Yaw: deviation up to 90 degrees from straight path
Term
NORMAL VALUES
CVP/RAP
CARDIAC OUTPUT
CARDIAC INDEX
PULMONARY ARTERY SYSTOLIC/DYSTOLIC
WEDGE (PAWP/PCWP)
SVR
Definition
CVP = 2-6
CO: SV x HR (4-8 L/min)
CI: 2.5-4.2
PAS/PAD: 15-25/8-15
PAWP/wedge: 8-12
SVR: 800-1200 dynes/sec/cm-5

When assessing CVP or PA, pressures on a mechanically ventilated patient, assess pressures at the end of exhalation
Term
CHEST/ABD TRAUMA

CHEST TUBE LOCATION?
NEEDLE THORACOSTOMY?
SUSPECT WITH FRACTURE OF FIRST 3 RIBS?
SCAPHOID ABDOMEN INDICATES?
Definition
Fourth IC space, anterior-axillary
(chest tube)
Second ICS midclavicular or the fifth ICS anterior
mid-axillary line (needle thoracostomy)
Aortic Disruption
Diaphragmatic rupture
Term
HIGH RISK OB
ABRUPTIO PLACENTA
PLACENTA PREVIA
TERBUTALINE DOSE
DEFINE POSTPARTUM
HEMORRHAGE
UTERINE RUPTURE
Definition
Abruptio: dark red, painful
Placenta previa: red, painless
Terbutaline: 0.25 SQ
PP hemorrhage: over 500 mL
Fetal parts can be palpated over abdomen
Term
EFFECTS OF ALTITUDE WORSEN WITH:
Definition
Cold upper latitudes
Term
GAY-LUSSAC'S LAW
TWO COMPONENTS
Definition
Temperature increases and pressure increases

Temperature decreases and pressure decreases

EXAMPLE:
oxygen tank pressure at 2200 in the afternoon, pressure drops to 1800 in the evening (temperature declined in the evening, pressure decreased)
Term
UNIVERSAL LAW
Definition
Combines Boyle's and Charlie's laws
Term
GRAHAM'S LAW
DEFINITION
EFFECTS
Definition
Gas moves from high to low concentration

EXAMPLES
gas through liquid, cellular gas exchange
Term
HENRY'S LAW
Definition
gas in liquid proportional to gas above liquid

EXAMPLES:
"the bends" CO2 in blood, decompression
Term
VOLUME OF GAS IN GI EXPANDS THRICE AT WHAT ALTITUDE?

WHAT LAW EFFECTS THE GI THE MOST?
Definition
25,000 feet

Boyle's law
Term
CARDIOGENIC SHOCK
CVP
CARDIAC OUTPUT
CARDIAC INPUT
PAS/PAD
PAWP
SVR
HEART RATE
Definition
CVP: high
CO: low
CI: low
PAS/PAD: high
PCWP: high
SVR: high
Heart rate initially fast, then slows down
Term
BOYLES LAW
TWO COMPARTMENTS EFFECTS
Definition
increased volume = decreased pressure

Examples:
cuffs, MAST, GI, ETT, IABP
Term
CHARLES' LAW
TWO COMPONENTS EFFECTS
Definition
Temperature and volume proportional (increased temperature = increased volume)

Up 100 meters = down 1 degree C
Term
ENVIRONMENTAL
1. PASSIVE REWARMING?
2. ACTIVE REWARMING?
3. WARM AND DEAD?
4. HEAT STROKE
Definition
1. Mild hypothermia only. Up 1 degree C/hr with blankets, heater
2. apply heat to body
3. 32 degrees C
4. over 42 degrees C
Term
CLINICAL SIGNS
1. GREY TURNER'S SIGN
2. COOPERNAIL'S SIGN
3. HALSTEAD'S SIGN
4. CULLEN'S SIGN
5. mURPHY'S SIGN
6. LEVINE'S SIGN
Definition
1. Flank bruising (retroperitoneal bleeding)
2. scrotum/labia (abdominal/pelvic bleeding)
3. marbeled abdomen (bleeding)
4. Umbilical discoloration (pancreatitis)
5. RUQ pain with inspiration (gallbladder)
6. Fist to chest "cluthing" (cardiac)
Term
TYPES OF HYPOXIA
1. HYPOXIC HYPOXIA
2. HYPEMIC HYPOXIA
3. HISTOTOXIC HYPOXIA
4. STAGNANT HYPOXIA
Definition
1. Altitude hypoxia, decreased alveolar oxygen, tension pneumo (e.g., altitude)
2. Decreased 02 carrying capacity in blood
3. poisioning (e.g., nitrates)
4. decreased cardiac output, poor circulation (e.g., g-forces, CHF)
Term
High Risk OB
1. Normal FHR
2. factors fetal well-being
3. Most important factor
4. TX for fetal distress
Definition
1. 120-160
2. FHR, fetal movement, variability
3. variability
4. LOCK: Left lateral recumbent, 02, correct contributing factors, keep reassessing
Term
CHF considerations
preload
lab test
medications
Definition
many CHF patients are relatively hypovolemic. Careful with diuretics and mediations that can decrease preload

BNP= lab test nonspecific >500
No beta-blockers, except for carvidolol (coreg)
natractor (neseritide)= synthetic version of BNP
Term
Primary cause of death with ventilator dependent patients
Definition
Ventilator acquired pneumonia
Term
Digoxin
class
causes what electrolyte imbalance
ECG changes
Definition
cardiac glycoside
hypokalcemia
ECG- "dig dip" ST depression
Term
ARDS
treatment CXR
Definition
PEEP
CXR reveals widespread pulmonary infiltrates; glass like appearance
Term
PEEP
effects of PEEP
normal physiological PEEP
Definition
PEEP
increased vascular resistance
Can cause hypotension over 15 cm H2O
Normal range: 3-5 cm H2O
Term
Treat HTN when BP?
Definition
Over 220 systolic
MAP over
Term
Dehydraion raises serum?
Definition
Sodium
Normal sodium 135-145
Term
Objective data?
Definition
ABCs, neurological assessment, Differential diagnosis for altered mental status: AEIOUTIPS
Term
A.E.I.O.U.T.I.P.S.
Definition
A= Alcohol
E= Electrolytes
Encephalopathy
Electrolytes
I: Insulin
O: 0-2
U: Uremia
T: Toxidromes
Trauma
Temperature
I: Infection
P: Psych
Pyphoria
Pharmacy
S. Space occupying lesions
Subarachnoid hemmorage
Stroke
Sepsis
Term
Bowel sounds in chest cavity?
Crunching sound heard over chest with auscultation, may be synchronized with heartbeat?
Definition
Bowel sounds heard
Diaphragmatic upture
most common in the left chest

Crunching sounds heard
associated with tracheobronchial injury and is called hamman's sign
Term
Preferred method for moving spinal injured patients
Definition
Scoop stretcher preffered rather then performing a log roll
Term
Differential diagnosis
1. Pulmonary contusion
2. Ruptued diaphragm
3. Tracheobronchial injury
4. Esophageal perforation
5. Fat embolus
Definition
1. low sats despite 02, rales
2. chest/abd pain radiated to left shoulder
3. Hemoptysis, sub-q air, air leak with chest tube, advanced ETT below level of injury into right mainstem
4. fever, hematamesis
5. fever, rash after fracture
Term
Blood Loss
Humerus
Femur
Definition
Humerus: 750 mL
Femur: 1500 mL
Term
PAWP/PCWP
Function
Normal
Definition
Pulmonary Artery Wedge Pressure
Pulmonary Capillary Wedge Pressure

Looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock

PAWP/PCWP: 8-12 mmHg

Do not keep wedged for more than 15 seconds, make sure that balloon is deflated and have patient cough forcefully
Term
ETT Depth
Definition
Adult: 3X ETT size or average is 19-23cm
Peds: 10 + age in years
Neonatal: 6 + age weight in kg
Term
Ventilator miscellaneous
1. To change CO2
2. To change oxygenation
Definition
1. adjust rate, TV
2. adjust PEEP, PAP
Term
Burns
Rules of nines for adult and pediatrics
Parkland Formula
Consensus Formula
Definition
Know your rules of nines for both adult and pediatric patients

Parkland: 4mL x kg x TBSA. 1/2 over 1st 8 hrs, rest over next 16

Consensus: 2-4 mL x kg x TBSA. 1/2 over first 8 hrs, rest over next 16
Term
Safety

1. ELT frequency
2. Confirm ELT working
3. Twin engine required offshore
Definition
1. 121.5
2. Tune it in and listen
3. Raft, vest
Term
Drugs
1.Induction agent of choice with bronchospastic patients
2.Ativan: indication dose, max
3. mannitol dose
4. Drug choice for cyclic antidepressant OD
5. Drug choice for beta-blocker OD
6. Fentanyl dose
7. Treatment for malignant hyperthermia
8. Drug for GI bleeds
Definition
1. Ketamine (ketalar)
2. Lorazepam, seizures, 1-2 mg, max 4 mg
3.1-2 g/kg
4. Sodium bicarbonate
5. Glucagon
6. Sublimaze (3ug/kg)
7. dantrium (dantrolene)
8. Sandostatin (octreotide)
Term
Neurogenic shock
CVP
Cardiac output
Cardiac index
PAWP/PCWP "wedge"
SVR
Heart rate
Definition
CVP: down
CO: down
CI: down
PCWP: down
SVR: down (distributive shock)
Heart rate can present as normal or slow
Term
Arterial line
Sites
Purpose
Definition
Radial, Femoral
Monitor pressure, blood draw,
ABG's
maintain pressure bag at 300 mmHg
Underdampening: caused by having air in the system, loose connection, a low pressure bag, and altitude changes
Overdampening: caused by kinking, increased bag pressure, and tip against the wall
Term
ECG
1. Most common reperfusion dysrhythmia
2. Most common hypothermia dysrhythmia
3. Hypokalemia on ECG
4. Hyperkalemia
Definition
1. Reperfusion: AIVR
2. Hypothermia: VF, (osborn wave)
3. Peaked P's, flat T's
4. Flat P's, Peaked T's (treat with calcium)
Term
MAP goal with CHI
CPP goal with increased ICP
Definition
MAP: 80-100
CPP: 70-90
Term
Normal ICP
Normal CPP (head)
Normal MAP
Normal for the other CPP (heart)
Definition
ICP: 0-10
CPP: 70-90
MAP: 80-100
Heart CPP: 50-60
"your head is higher
than your heart"
Term
GCS
Mild, Moderate, severe
Definition
GCS
Mild: 14-15
Moderate: 9-3
Severe: 3-8
Term
CPP (head) formula
MAP formula
CPP (heart) formula
Definition
CPP: MAP-ICP
MAP: x 2 + systolic/3
Heart CPP: DBP-wedge
Term
Rotor-wing minimums ceiling/visibilty
day/local
day/cross-country
night/local
night/cross-country
Definition
day/local: 500 ft (ceiling) and 1 mile (visibility)
day/x-country: 1000 foot Cceiling) and 1 mile (visibility)

Night/local: 500 foot (ceiling) and 2 mile (visibility)
Night/x-country: 1000 ft (ceiling) and 3 mile (visibility)
Term
Number one cause of air medical crashes
Definition
Controlled flight into terrain, pushing the weather
Term
lab values
1. Normal potassium
2. Normal sodium
3. normal chloride
4. normal calcium
5. metabolic acidoses elevates?
Definition
1. 3.5-5.5
2. 135-145
3. 95-105
4. 8.5- 10.5
5. potassium
Term
Time of useful conciousness with sudden decompression at:
30,000 ft
41,000 ft
Definition
30,000: 90 seconds
41,000: 15 seconds

least amount of time is your answer on the exam
Term
12 lead ECG
Inferior
Septal
Anterior
Lateral
Posterior
Definition
Inferior: II, III, aVf
Septal: V1, V2
Anterior: V3, V4
Lateral: I, aVL, V5, V6,
Posterior: ST segment depression or reciprical changes noted in V1-V4, ST elevation in V6
Term
Cardiac

Ischemia
Injury
Infarct
Definition
Ischemia: ST depression (1mm in 2 leads)
Injury: ST elevation (imm in 2 leads)
Infarct: Q-wave >25% the height of the R wave
Term
Pediatric age guidelines

ETT cuffed versus uncuffed
needle cricothyrotomy
Nasal Intubation
Definition
"10, 11, 12" rules
Uncuffed tube under 10
Needle cricothyrotomy only under 11
No nasal intubation under 12
Term
High risk OB

1.Primary cause of PTL
2. terbutaline contraindications
3. PIH triad signs
Definition
1. infection
2. IDDM, maternal HR over 120, vaginal bleeding
3. HTN, edema, proteinuria
Term
O2 adjustments calculation to maintain saturation at altitude
Definition
% oxygen patient is already on X pressure at departure (mmHg)Pressure at altitude

This equals percentage needed in flight

example:
patient on FIO2 of 0.40
Depart: 681 mmHg
altitude: 565 mmHg
Answer: patient needs 48% oxygen
Term
Ventilator modes

CMV
AC
IMV/SIMV
Definition
CMV: preset volume or PIP at set rate: patient cant initiate breath

AC: preset volume or PIP with every breath. Can trigger breath, cant control TV

IMV: preset breaths, TV, PIP. patient breaths allowed

SIMV: allows variation of support
Term
IABP
1. Action
2. Deflates
3. Dicrotic Notch
Definition
1. Increases cardiac output, coronary artery perfusion
2. During ventricular systole
3. aortic valve closing, synchronizedwith aline or ECG(most common trigger)
Term
IABP
1. Action
2. Deflates
3. Dicrotic Notch
Definition
1. Increases cardiac output, coronary artery perfusion
2. During ventricular systole
3. aortic valve closing, synchronizedwith aline or ECG(most common trigger)
Term
IABP
1. Signs and symptoms of balloon leak
2. clot prevention
3. IABP increases CO by
4. Balloon rupture
5. Migration/dislodged
6. Lethal IABP timing cycles
Definition
1. blood specs in tubing, alarm
2.cycle manually every 30 minutes
3. 10-20%
4. rusty flakes in line or turn machine off
5. assess left radial pulse ine output
6. late deflation and early inflation
Term
Oxyhemoglobin disassociation curve
left curve
Definition
"L" stands for Alkalosis
Left shift = low
Hemaglobin holding oxygen Alkalosis

Low CO2
Low temperature
Loe DPG
Myxdema coma
Term
Oxyhemoglobin disassociation curve
Right Shift
Definition
"R" stands for raised
Right= raise/releases oxygen
Acidosis
Raised CO2

Raised temperature Raised DPG
Thyroid storm
Term
Phlebostatic axis
where?
what?
Definition
Where pressure measurements are made with an invasive line

Fourth intercostal space, level of atria
Term
Boyle's Law

Acent
Descent
Definition
Ascent
Barondontalgia toothache)
Barosinutis can occur on ascent
Bariobariatrauma (obese) = Nitrogen in the fat cells can expand causing the "bends" administer high flow oxygen for 15 minutes prior to lift-off to remove nitrogen

Descent
Barotitis media (middle ear) can effect the patient during decent
Term
Hypertension

mild
moderate
severe
Definition
Mild: 140-159/90-99
MOderate: 160-170/100-109
SEvere: 180/110
Term
Volume for RBC
administration
Volume for WBC
Definition
RBC: 10 mL/kg
WBC: 20 mL/kg
Term
ABG rules
1. CO2 and pH
2. Bicarb and pH
3. Bicarb replacement
4. PaO2 at altitude
Definition
1. CO2 up 10= pH down .08
(inverse)
2. HC03 up 10 = pH up 15
(proportional)
3. kg/4 x base deficit = meq of bicarb needed
4. PaO2 drops 5 for every 1000 feet elevation
Term
Stages of Hypoxia
Elevation
Signs or symptoms
Definition
Indifferent:(10,000 feet MSL):
increased HR and RR, decreased night vision

Compensatory: (10,000-15,000 feet MSL): HTN, task impairment

Disturance: (15,000-20,000 feet MSL): dizzy, sleepy, cyanosis

Critical: (20,000-30,000 feet MSL): ALOC, incapacitated
Term
Night vision lost at:
Definition
5,000' MSL
Term
PA Catheter
1. named?
2. Proximal port is for?
3. S/S of bad placement?
4. Procedure for bad placement?
5. Measures?
6. Which port is used?
Pressure bag set to?
Definition
1. Swan-Ganz
2. CVP, medications
3. VT, ventricular ectopy
4. Float forward to PA or pull back to RA
5. Right heart directly, left heart indirectly
6. Distal port
7. 300mmHg
Term
Normal cardiac index
Definition
CI:2.5-4.3
Term
Stressors of flight
Definition
1. third spacing
2. fatigue
3. g-forces
4. noise
5. vibration
6. hypoxia
7. dehydration
8. temp changes
9. barometric pressure changes
Term
Personal factors affecting stressors of flight?
Definition
Death
drugs
exhaustion
alcohol
tobacco
hypoglycemia
Term
Dalton's law
Definition
Sum total of partial pressures equal to total atmospheric pressures (Daltons gang)

examples:
tissues swelling, altitude hypoxia, hypoxic hypoxia

This is why 02 is needed at altitude
Term
Cardiac
Thrombolytics must be administered within?
Definition
Three hours of onset of chest pain
Term
Diving injuries
ATM
Definition
1 ATM for every 33 feet descent
and
Add 1 if asking for a total ATM versus water pressure
Term
Hypovolemic shock
CVP
CO
Cardiac index
Wedge
SVR
Heart rate
Definition
CVP: down
CO: down
CI: down
PAWP: down
SVR: high
Heart rate: fast
Term
Acute respiratory failure
Definition
pO2, below 60, pCO2 above 50
Term
Newton's Laws
Definition
First law: an object in motion tends to stay in motion...

Second law: force= mass x acceleration

Third law: every action has = and opposite reaction
Term
Tetralogy of Fallot (TOF)
Definition
Remember PROV

P = pulmonary stenosis
R = right ventricular hypertrophy
O = overriding aorta
V = ventricular septal defect
Term
What is a tet spell?
Definition
During a "tet" spell, blood flow across the right ventricular outflow tract is significantly decreased, resulting in shunting right-to-left through the VSD out of the aorta, thus bypassing the lungs. Causes include: spasms, sudden decrease in systemic vascular resistance secondary to hypovolemia, dehydration, hot weather, or defecation. tet spells are usually seen in the neonatal period, and peak in incidence between two and four months of life.
Term
Atrial waveforms
Definition
"filling pressures"

right atrial pressure (CVP)

Left atrial pressure (PAWP/PCWP)
Term
Ventricular waveforms
Definition
ight ventricular pressure obtained upon insertion of PA catheter or if the catheter has been dislodged backward into the right ventricle resulting in a right ventricular waveform

Looks like VT, no dicrotic notch seen on the downslope of the right side of the waveform

left ventricular pressure measured during cardiac catheterization
Term
Arterial waveforms
Definition
Arterial lines


Pulmonary artery pressure (PAP)

Dictrotic notch seen n the downslope of the right side of the waveform
Term
Waves
Definition
"A" wave = rise in atrial pressure as a result of atrial contraction

"C" wave = not always visible on the tracing, rise in the atrial pressure which closure of the AV valves (tricuspid and mitral) buldge upward into the atriium following valve closure

"V" wave = rise in atrial pressure as it refills during ventricular contraction
Term
A Wave
Correlation to ECG
Definition
"A" wave generally coincides with the PR interval on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform
Term
C Wave
Correlation to ECG
Definition
C wave generally coincides with mid to late QRS on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform
Term
V Wave
Correlation to ECG
Definition
V wave generally seen immediately after the peak of the T wave on the ECG in a right atrial pressure waveform

It will be slightly delayed in a left atrial pressure waveform
Term
Wave descents
Definition
Decline in right atrial pressure during atrial relaxation (remember "X" in relaXation)

Decline in the right atrial pressure resulting from atrial emptying (remember "Y" in emptYing)
Term
Breathing and waveforms
Definition
Record pressure measurements at the end of exhalation

in a spontaneously breathing patient, inspiration is the fall in pressure, expiration is the rise in pressure. End-expiration occurs just prior to the respiratory drop in pressure

Positive pressure mechanical ventilated patients will cause vardiac pressure to rise upon inspiration
Term
Measuring waveforms
Definition
The end-diastolic pressure can be eatimated by identifying the "Z" point

A line is drawn from the end of the QRS to the hemodynamic tracing. The point where the line intersects with the waveform is the "Z" point. The "Z" point on the PAWP tracing will be delayed by 0.08-0.12 seconds from the QRS
Term
Cardiac output
Definition
Heart rate x stroke volume = CO
Term
Dicrotic notch
Definition
closure of the aortic valve
Term
Neonatal
Definition
Maintains the PDA open = prostaglandin (PGEI)

Closed the PDA = indomethacin and long term use of high oxygen delivery

32 weeks or less in gestation = surfactant

Common cause of seizures = hypoglycemia <40 mg/dL and hypoxia

Scaphoid abdomen = diapheretic hernia managed with orogastric tube and PPV
Term
CPK >20,000
Definition
CPK (muscle enzyme) levels greater than 20,000 is ominous and is an indication of later DIC, acute renal failure and is potentially dangerous hyperkalemia in the heatstroke patient
Term
Anion gap
Definition
Na - (CI + Bicarb/CO2)= AG
Normal 12 + or - 4
>16 indictes an underlying metabolic acidosis
Remember "MUDPILES"
Methanol
Uremia
DKA
Paraldehyde
Isoniazide/Iron
Lactate
Ethylene glycol
Salicylate
Supporting users have an ad free experience!