Shared Flashcard Set

Details

CCEMTP
CCEMTP HACC class 2010
171
Medical
Not Applicable
10/03/2010

Additional Medical Flashcards

 


 

Cards

Term
Mechanical treatments  for cardiogenic shock include ________ _________ ________ and _________ _________ ____________
Definition
Ventricular assist device, intra-aortic balloon pump
Term
After rapid decompression the crrew is placed on high flow O2, they then become dizzy. This condition is known as.
Definition
Oxygen paradox
Term

 

When a patient experiences an adverse condition that is inadvertently induced as a result of appropriate treatment, it is referred to as being:

 

Definition

 

iatrogenic.

 

Term

 

A _______-minute ground transport is considered the minimum for which air medical transport may be faster than ground transport.

 

Definition

 

30

 

Term

 

The most common form of diabetes is:

 

Definition

 

type 2 diabetes.

 

Term

 

You are caring for a seriously injured patient. During your patient assessment, you find that the patient has a decreased level of consciousness, an absent gag reflex, and a GCS of 6. Based on this information, you anticipate that this patient will require which of the following interventions?

 

Definition

 

endotracheal intubation

 

Term

 

_______ is defined as wear and tear the body experiences during adjustment to daily life and the environment.

 

Definition

 

Stress

 

Term

 

 

Which of the following patients is most at risk for dislodging the IAPB catheter due to movement?

A) 40 year old male

B) 86 year old female

C) 52 year old female

D) 61 year old male

Definition

 

86-year-old female

 

Term

 

_______ occurs when one or more of the components of the immune system is damaged or nonfunctioning

 

Definition

 

Immunodeficiency

 

Term

 

Compared with the pregnant mother, the oxygen content of the fetus is:

 

Definition

 

lower.

 

Term

 

The first Army Medical Corps was established by: 

A)Dominique Jean Larrey in 1792.
B)Jonathan Letterman in 1862.
C)Michael Reese in 1899.
D)Francis Pantridge in 1966.

Definition

 

Dominique Jean Larrey in 1792

 

Term

Which of the following nonphysiologic conditions doesNOT elevate cortisol production?

 

A) alcohol withdrawal syndrome

 

B) chronic alcoholism

 

C) intense aerobic exercise

 

D) poorly controlled diabetes mellitus

Definition

 

intense aerobic exercise

 

Term

Glucagon can be utilized as an antidote for cases of beta-blocker or calcium channel blocker overdose or toxicity. Which of the following statements best describes the mechanism of action for this?

 
 
A)  Glucagon is converted to glucose, and the highly polar glucose molecule competes with beta receptors to effect a reversal.

 
 
B) Glucagon stimulates the metabolic pathway to increase metabolism of the overdosed agent.

 
 
C) Glucagon increases cAMP, and subsequently inotropy and chronotropy, to increase cardiac output.

 

D) Glucagon dissolves into its inactive metabolite, which partially binds with beta-blockers and calcium channel blockers.

 

Definition

 

Glucagon increases cAMP, and subsequently inotropy and chronotropy, to increase cardiac output.

 

Term
The MOST common site for intraosseous (IO) insertion in children is the:
Definition
anterior tibia.
Term

Hypothermia may be a result of any of the following EXCEPT:
A) impaired thermogenesis.


B) excessive thermolysis.


C) excessive environmental cold stress.


D) hyperdynamic cardiac states.

Definition
hyperdynamic cardiac states.
Term
A patient found unresponsive and seizing would consent for treatment and transport under _______ consent.
Definition
implied
Term

Any part of the gastrointestinal (GI) tract may have congenital anomalies, including:
A) colitis.


B) dysplastic bowel

.
C) mesenteric adhesions.


D) atresias.

Definition
atresias.
Term

Nasotracheal intubation requires a spontaneously breathing patient.

 

True or False

Definition
True
Term
Hydrofluoric acid is treated topically, after irrigation, by the use of:
Definition
calcium gluconate.
Term

The preflight aircraft walk-around is performed in order to:

Definition

A) ensure that all doors, blots, and hatches are closed.
B) clear the helipad of any foreign object debris (FOD).

C) ensure that there are no bystanders within the danger zone.

Term
A left axis deviation is normally seen:
Definition
in pregnant women.
Term
The laboratory values for BUN should remain between:
Definition
8 and 23 mg/dL.
Term
End diastolic pressure is synonymous with:
Definition
preload.
Term
Ambulance crews with a driver and patient care provider did not evolve until the:
Definition
early 1900s.
Term
The sensing device that connects directly to the skin to receive an ECG signal is known as a(n):
Definition
electrode.
Term
The immature bones of children are more porous than those of adults and tend to respond to trauma by:
Definition
buckling rather than fracturing.
Term

Croup (laryngotracheobronchitis) is commonly associated with a High fever.

 

True or False

Definition
False
Term
During CPR on a patient with active counterpulsation therapy, the CCTP should:
Definition
turn the IABP to pressure-sensing mode.
Term
The normal range for a VBG PCO2 is:
Definition
38 to 50 mm Hg.
Term
Cabin humidity will _______ during a long-range, high-altitude fixed-wing flight lasting more than 4 hours.
Definition
decrease
Term
Pulmonary overpressurization syndrome (POPS) occurs:
Definition
on ascent.
Term
What is the normal pressure in the pulmonary artery?
Definition
25/10 mm Hg
Term
Continuous positive airway pressure (CPAP) primarily works by:
Definition
increasing the patient's expiratory pressure.
Term
During the follicular phase of the normal female menstrual cycle, the first hormone that is released is:
Definition
follicle-stimulating hormone (FSH).
Term
Cranial nerves IX and X are both indicators of:
Definition
swallowing and gag reflexes.
Term
"Mortality" refers to:
Definition
the number of patient deaths due to an injury or illness.
Term

A diastolic murmur may be a normal finding in an elderly patient.

True or False

Definition
True
Term
Class II antiarrhythmic medications:
Definition
competitively bind to beta receptors to inhibit stimulation.
Term
When caring for a patient with cardiac concerns or issues, the CCTP should focus on three areas of concern with regard to cardiac pharmacology. These areas are:
Definition
chronotropic, inotropic, and dromotropic.
Term

Succinylcholine (Anectine) is used during RSI as a neuromuscular blocker may cause transient muscle fasciculation.


True or False

Definition
True
Term
The majority of oxygen found in the arterial blood is bound to:
Definition
hemoglobin.
Term
You are caring for a 50-year-old male who has presented with an acute onset of chest pain. After completing the assessment, you consider that this patient may be experiencing an acute myocardial infarction, an aortic dissection, a pneumothorax, or a pulmonary embolism. The list of these for disease states is called a:
Definition
differential diagnosis.
Term
Should family members be permitted to stay in the room during treatment and assessment of a patient?
Definition
Yes.
Term
According to the Federal Drug Administration (FDA) categorization of medications for use in pregnancy, which category represents medications that have known fetal risks but are used in some situations?
Definition
Class D
Term

Ultrasonography is is contraindicated in pregnancy.

True or False

Definition
False
Term
The time of useful consciousness (TUC) after explosive decompression at 35,000' (10.7 km) is _______ seconds.
Definition
30 to 60
Term
EMTALA is also known as the:
Definition
antidumping act.
Term
Your patient has ingested a large amount of a caustic substance, causing a large GI bleed. This bleed would be categorized as _______ gastritis.
Definition
reactive
Term
While caring for a critical patient with profound hypoxia, you recall that changes in the V/Q ratio is one of the most common causes of hypoxemia. Which of the following best describes the V/Q ratio?
Definition
a measurement of how much blood flow must be present at the alveolar capillary membrane for perfusion to take place
Term
Indications for insertion of an IABP
Definition

impending myocardial infarction,


septic shock,


weaning from cardiopulmonary bypass

Term
Shrugging the shoulders and turning the head are motor functions of the _______ nerve
Definition
Spinal Accessory
Term
In ascending order, the loss of airway protective reflexes?
Definition
swallowing, coughing, gag, corneal
Term
If, during transport, a 60-mL/kg bolus fails to improve a hypovolemic patient's physiologic status, blood replacement and/or inotropes should be considered depending on the underlying condition. Blood replacement is calculated as _______ of body weight.
Definition
10 mL/kg
Term
The normal range for potassium is:
Definition
3.5 to 5.1 mmol/L.
Term
In chemical burns, blisters should always be:
Definition
broken.
Term
The ability of a test to detect a particular condition is referred to as its:
Definition
sensitivity.
Term

Preeclampsia may transition to eclampsia, even up to 10 days after delivery.

True or False

Definition
True
Term

During your neurologic assessment of a critical stroke patient, you find that the patient's pupils are unequal. Which of the following is the correct terminology for this finding?



strabismus

anisocoria

hyphema

disconjugate gaze

Definition
anisocoria
Term
The average basal metabolic rate (BMR) of a 70-kg adult is around _______ kcal/h.
Definition
60 to 70
Term
The five Ps of compartment syndrome are: pain, pallor, paralysis, _______, and pulselessness.
Definition
paresthesias
Term
Charles' Law states that:
Definition
a volume of a gas is directly proportional to the temperature of a gas.
Term
What is considered the respiratory component of the ABG values?
Definition
PaCO2
Term
Cell death begins to occur when the pH falls below _______ or above ______.
Definition
6.8; 7.8
Term

You are caring for a patient with a confirmed coronary thrombus (a clot). A staffed cath lab is not readily available, and the ECG indicates an evolving infarction pattern. The care team is considering ordering a thrombolytic/fibrinolytic medication to reduce the thrombus. Based on your understanding of the mechanism of action for these medications, which of the following from the patient history would indicate a contraindication to its administration?


A) The patient had a gallbladder removal (choleycystectomy) 8 months ago.


B) The patient has a history of bleeding hemorrhoids diagnosed by colonoscopy 3 months ago.


C) The patient suffered a traumatic crush injury to the right leg 2 weeks ago


D) The patient's blood pressure is 88/54 mm Hg.

 

Definition
The patient suffered a traumatic crush injury to the right leg 2 weeks ago
Term
Your patient is suffering from profound liver failure. When reviewing the patient's laboratory values, you note that the direct bilirubin level is 2.2 mg/dL. Based on this information, you would anticipate what physical findings?
Definition
anemia
Term
You are transporting a patient following a near drowning/submersion injury. The most recent serum magnesium level is 1.0 mEq/L. Based on this, you suspect what?
Definition
The patient sustained the submersion injury in sea water and aspirated.
Term
Distributive shock includes which three types of shock?
Definition
neurogenic, septic, and anaphylactic
Term
_______ are diseases caused by normally nonpathogenic agents in patients with an abnormally functioning immune system.
Definition
Opportunistic infections
Term
Signs and symptoms of diaphragmatic rupture
Definition

bowel sounds in the chest cavity.


subcutaneous emphysema.


acute respiratory distress.

Term
IABP therapy assists the cardiogenic shock patient by:
Definition
increasing coronary perfusion pressures.

decreasing left ventricular workload.

increasing myocardial oxygen supply.
Term
Studies have shown a definite increase in patient survivability with an air medical crew configuration of:
Definition
No definite crew configurations increase survivability.
Term
The addition of the nonstandard V7, V8, and V9 leads would look for a possible:
Definition
posterior MI
Term
When placing an arterial line in the radial artery, the wrist should be:
Definition
hyperextended.
Term
Stimulation of sympathetic nerves without parasympathetic input can cause sympathetic overdrive, resulting in _______.
Definition
Autonomic dysreflexia
Term
What are complications of endotracheal intubation in the neonate?
Definition

esophageal intubation

hypoxia

pneumothorax

Term
A referring physician has opted to place an IABP in a patient with known significant peripheral artery disease. The CCTP knows to continually monitor the:
Definition
blood flow distal to the insertion site for circulatory compromise.
Term

To select the correctly sized OPA, measure from the central incisors to the angle of the jaw.


True or False

Definition
True
Term
You are dispatched to transport a patient to a tertiary care facility from a medium-size facility's ICU. On arrival, your patient is found paralyzed, sedated, intubated, and ventilated, with an initial presentation of pulmonary edema. The patient's CVP is 6 mm Hg, PCWP is 24 mm Hg, and PVR is measured at 1,500 dyne-sec/cm-5. The CCTP suspects that the etiology of the pulmonary edema is:
Definition
left ventricular failure.
Term

A patient has the right to terminate treatment after transport has been initiated.


True or False

Definition
True
Term
What are the three steps of a quality assurance and improvement program?
Definition


Collect and analyze data.


Define what "quality" means to the stakeholders.

Focus on improving quality.

Term
The network of endothelial cells and astrocytes that envelop delicate cerebral capillaries is the _______.
Definition
Blood-Brain Barrier
Term

The primary role of  Fetal hemoglobin is to address hypoxia in utero

 

True or False

Definition
True
Term
What are the 3 "P's" that must be assessed before and after any manipulation of musculoskeletal injuries?
Definition

paresthesia

paralysis

pulses

Term
During the neurologic assessment, special attention is paid to those findings that may be early indicators of a serious problem. In the patient with significant head trauma and who is at risk for brain herniation, which cranial nerve would be the most important to assess?
Definition
III
Term
The mortality of bloodstream infections in critically ill patients approaches:
Definition
20%.
Term
Organs of equilibrium in the ear provide _______ information.
Definition
vestibular sensory
Term
The first line of protection against legal problems is:
Definition
maintaining a professional and compassionate demeanor.
Term
The placenta, not the lungs, acts as the organ of _______ during fetal gestation
Definition
respiration
Term
Abdominal trauma is classified as either _______ or _______.
Definition
Blunt/ Penetrating
Term
The immune response can be extremely harmful to the host when it is:
Definition
exaggerated.
Term
The first value to consider when interpreting an arterial blood gas (ABG) is:
Definition
pH.
Term
Arterial blood gas (ABG) studies of a patient in the compensatory stage of shock generally show a low pH, which is indicative of _______.
Definition
Acidosis
Term
The tip of a central venous line should reside:
Definition
just outside of the right atrium.
Term
The peripheral nervous system (PNS) consists of the _______ and _______ nerves.
Definition
Spinal/Cranial
Term
Trauma is generally classified into one of two categories:
Definition
blunt or penetrating.
Term
_______ is a group of symptoms that together may lead to coronary artery disease, stroke, and type 2 diabetes.
Definition
Metabolic syndrome
Term
Classic clinical signs and symptoms of a pericardial tamponade are called Beck's triad. Beck's triad is best described as:
Definition
muffled heart tones, JVD, and narrowed pulse pressure.
Term
Anaerobic metabolism represents the breakdown of _______ to create adenosine triphosphate (ATP) for energy.
Definition
glucose
Term

While performing the physical assessment over the chest, the CCTP uses the skill of percussion. Which of the following statements is TRUE regarding the assessment findings during percussion?



Percussion over normal lung fields will produce hyperresonance.


Percussion over bone will produce flatness.
Percussion over the stomach will produce dullness.

Percussion over the liver will produce resonance.

 

Definition
Percussion over bone will produce flatness.
Term
A patient is being transferred on a medication that is not carried by your transport service and that is not covered under your protocols. You should:
Definition
ensure that orders for use of the medication is in the transfer orders.
Term
The first use of helicopters for air medical transport occurred as a result of
Definition
The Korean conflict of 1950
Term
The preferred qualifications of a Critical Care Professional include
Definition

A minimum of 1 year experience in an ALS system

Term

Which of the following is not considered routine equipment on-board a Critical Care Transport unit?

IV infusion pumps

 

 Portable ABG machine

 

 Neonatal isolette

 

            Central venous line ki

 

Definition
Neonatal isolette
Term

Which of the following trauma patients is a candidate for Critical Care Transport?

        40 year old who has fallen from a height greater than 10 feet

        16 year old with partial and full thickness burns of the arms,        affecting 15% body surface area

      33 year old with a Revised Trauma Score of 12

       22 year old who has been ejected from a vehicle

 

 

Definition

22 year old who has been ejected from a vehicle

Term

The law requiring that patients are provided written information on the right to make medical decisions is the:

Definition

Patient Self Determination Act

Term

Three areas  that are often cited in litigation involving malpractice?

Definition

Failure to adequately monitor the patient’s condition

Failure to adequately document findings

Failure to advise more highly trained individuals of abnormalities

 

 

 

 

Term

A common problem of specimen collection associated with the breakdown of red blood cells and subsequent release of hemoglobin is known as:

Definition

Hemolysis

Term

What is seen with a normal or increased hematocrit and

            hemoglobin?

Definition

Dehydration

COPD

Severe diarrhea

Term

A 16-year-old female presents with the following signs and symptoms: nervousness, anxiety, dizziness, with numbness and tingling of the extremities. The patient’s ABG analysis shows the following values.  Based on these values, what condition would you suspect? 

pH = 7.50

PO2 = 100

PCO2 = 30

HCO3 = 24

BE = -1

Definition

 Respiratory alkalosis

Term

The primary intracellular cation important for repolarization of cardiac cells is:

Definition

Potassium        

Term

The urine output of an average adult should be:

Definition

30-70 cc/ hr

Term

A ________ test is used to identify an organism, while a ________ test is used to determine the best antibiotic to use against the organism.

Definition
Culture; sensitivity
Term
General systemic response to inadequate tissue perfusion
Definition
Shock
Term

As a result of Neurogenic shock, what will occur?

Definition

Peripheral vasodilation

The absence of sympathetic cardiac stimulation

Term

A 31-year-old female is experiencing anaphylaxis. What is the CORRECT medication to give to promote vasoconstriction, bronchodilation, and inhibit further release of biochemical mediators?

Definition

Epinephrine

Term

 

Gram negative and gram positive bacteria have been implicated as the causative factors of:

Definition

 

Sepsis

Term

What abnormal lab values are indicative of DIC?

Definition

 

Clotting tests

Term

What is the proper infection control measures while caring for a tuberculosis patient?

Definition

Use of a micron filter face mask

Term
In which of the following would the blood oxygen saturation be high, yet the patient still dies from hypoxia?
Definition

Carbon monoxide poisoning

Term

The normal PaC02 for a healthy adult, breathing room air is:

Definition

35-45

Term

What is the  Fi02 of room air?

Definition
21%
Term

What do you need to know when changing a patient’s oxygen delivery system prior to obtaining an ABG sample?

Definition
May require 15 minutes for the patient to adapt
Term

After pleural decompression, assessment observations would include:

Definition

Hemoptysis


Signs of hypoxemia

 

Lung sounds

Term
What is the volume of gas inhaled or exhaled during a single respiratory cycle called?
Definition
Tidal volume
Term

What are complications of pleural decompression?

Definition

               Pneumothorax

Infection

 

Lung contusion

Term
The chest tube insertion site for air removal is the
Definition
4th or 5th intercostal space mid axillary
Term
Blood gas sequence that indicates the need for mechanical ventilation
Definition

Decreasing PO2, increasing PCO2, decreasing pH

Term

What are the indications for clamping a chest tube?

Definition

To locate the source of an water leak


Replacing the drainage unit


Suspicion that the tube has been accidently dislodged

Term

A dyspneic patient complains of sharp chest pain in the upper right chest. It becomes worse on deep inspiration. What condition would you suspect?

Definition
Pleuritic irritation
Term

Flow rate 80-100 lpm IS NOT a standard ventilator setting?

True or False

Definition
True
Term

Monitor tube position is an indication for ETT suctioning?

True or False

Definition
False
Term

By increasing ventilation what abnormality can be corrected?

Definition

Respiratory acidosis

Term

Sellick’s maneuver cannot be used on children.


True  or False

Definition
False
Term
Steps for rapid sequence intubation in chronological order:
Definition

Apply a cardiac monitor and pulse oximeter


Pre-oxygenate the patient

Medicate the patient with pancuronium or vecuronium if necessary

Medicate the patient with succinylcholine

Intubate the patient

Post intubation sedation/paralytic

Term

Why is a tracheostomy wound is not packed or surgically closed?

Definition
To avoid subcutaneous emphysema
Term

What is the correct procedure for a crichothyrotomy incision?

Definition
A transverse incision is made through the superficial cricothyroid membrane
Term

Obstruction below the cricothyroid membrane

is an indication for needle cricothyrotomy:


True or False

Definition
False
Term

When the anterior neck is palpated from superior to inferior, the cricothyroid membrane

is:

Definition
Between the first and second prominent structures
Term
Which procedure allows rapid entrance into the airway by making a horizontal incision?
Definition

Surgical cricothyrotomy

Term
A stabbing incision is made at the ____________ to perform a surgical cricothyrotomy
Definition

Cricothyroid membrane

Term

Inability to fully open the patient’s mouth

an indication for retrograde intubation?


True or False

Definition
True
Term

 What are potential side effects or complications of retrograde intubation?

Definition

Bleeding

Hypoxemia

Term

 Infection of the  invasive line exit site requires dressing changes every 2 days


True or False

Definition
False
Term

CVP fluctuates with right ventricular compliance


True of False

Definition
True
Term
PCWP stands for:
Definition
 pulmonary capillary wedge pressure
Term
When trying to differentiate between a spontaneously wedged catheter to one that is occluded you would
Definition
Aspirate for blood return 
Term

Lack of an identifiable “wedge” waveform may possibly be due to:

Definition
Incorrect catheter position
Term
A disease that would increase the afterload of the heart would result in a/an
Definition

Decrease in the stroke volume

Term
What would the effect of positive pressure ventilation be on hemodynamic waveforms?
Definition

Hemodynamic pressure waves rise during positive pressure ventilation

Term

Rh factor is present in the blood plasma

True or False

Definition
False
Term

Which blood preparation contains the formed elements, clotting factors and antibodies?

Definition

Whole blood

Term
What test results would be the most helpful in assessing a patient with a bleeding disorder?
Definition

Platelet count

Term

Slowly infusing blood during the first 15 minutes  helps to decrease the danger of transfusion reactions?

True or False

Definition
True
Term
If a patient experienced a transfusion reaction, which of the following actions would be carried out initially?
Definition
Discontinue the transfusion
Term

It is a phase that is approximately twice as long as systole

Definition

diastole

Term
The term inotropic refers to the:
Definition
Contractile force
Term

A twelve-lead ECG is obtained by placing _______ electrodes on the body:

Definition

10

Term

The absolute refractory period is represented by the second half of the T wave


True or False

Definition
False
Term

Produces a 50-100 mV electrical signal

Marks the approximate beginning of mechanical systole

Definition
QRS complex
Term

The axis is abnormal if the QRS complex is upright in leads I and AVF

True or False

Definition
False
Term
QT interval measuring can help in the diagnosis of?
Definition

Hyperkalemia

Term

How to differentiate a right bundle branch block (RBBB) from a left bundle branch block?

Definition
RBBB has a characteristic RSR pattern in V1
Term

Which of the following statements is/are correct regarding right atrial hypertrophy?

a.  Is often associated with right ventricular hypertrophy

b. Is often associated with tall, wide P wave morphology

c. Results from congenital heart disease or pulmonary hypertension

d.    All of the above

Definition
All of the above
Term

To interpret the heart rhythm, the ICD:

Definition
Considers rate, onset of rate increase, and stability of the complex
Term

A critical care transport team can deactivate the device without a physician’s order

True or False

Definition
False
Term

What can cause failure of a pacemaker to achieve electrical capture?

Definition

         Lead dislodgement

        Battery depletion

       Loose pacemaker connections

Term
The proper positioning of the intra-aortic balloon
Definition
Requires balloon placement in the thoracic aorta, distal to the left subclavian artery
Term
For proper timing of the balloon pump a _______ ________ must be placed to insure proper timing?
Definition
arterial catheter
Term

What are complications associated with IABPs?

Definition

Arterial insufficiency

Infection

Gas embolism

Term
What are the therapeutic effects of IABP use?
Definition

 positively affect afterload,

preload,

contractility,

rate

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