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Flight Paramedic Study Cards
Flight Paramedic Certification (FP-C) Study Cards
275
Medical
Graduate
08/23/2012

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Term
Kernig's Sign
Definition
Back, leg pain on knee extension. Possible bacterial meningitis.
Term
Kehr's Sign
Definition
Referred left shoulder pain. Possible splenic injury.
Term
Brudzinski's Sign
Definition
Back, leg pain on neck flexion. Possible bacterial meningitis or subarachnoid bleed.
Term
Hamman's Sign
Definition
Crunching sound heard over anterior chest synced with heartbeat- tracheobronchial injury.
Term
Steeple Sign
Definition
Possible croup
A/P neck view
Term
Thumbprint Sign
Definition
Possible epiglottitis.
Lateral neck view.
Term
Lactate Level
Definition
0.1 mmol/L +- 0.5
>2.0 in critically ill indicates significant lactic acidosis
Term
ATP
Definition
Adenosine Triphosphate
Term
FiO2
Definition
Fraction of inspired oxygen
Term
PaO2
Definition
Partial pressure of arterial oxygen
Term
PAO2
Definition
Partial pressure of alveolar oxygen
Term
PvO2
Definition
Partial pressure of venous oxygen
Term
SaO2
Definition
Arterial saturation of oxygen
Term
Pressure at sea level
Definition
760 torr
Term
Partial pressure of oxygen at sea level
Definition
103 torr
Term
What is the fastest way to increase the partial pressure of oxygen in the blood stream (PaO2)?
Definition
Increase FiO2.
Term
What is the percentage of O2 that is attached to HgB?
Definition
98%
Term
What is the percentage of O2 that is attached to plasma?
Definition
2%
Term
Respiratory Acidosis
Definition
pCO2 high=pH low
Term
Respiratory Alkalosis
Definition
pCO2 low=pH high
Term
Metabolic Acidosis
Definition
pH low=HCO3 low
Term
Metabolic Alkalosis
Definition
pH high=HCO3 high
Term
Normal pCO2
Definition
35-45
Term
Normal pH
Definition
7.35 to 7.45
Term
Drugs for AAA
Definition
Nipride and beta blockers
Term
First adjustment on ventilator
Definition
Tidal volume first, not rate
Term
Most common dislocation
Definition
Hip
Term
Most common spontaneous dislocation recurrence
Definition
Anterior Shoulder
Term
What is Brain natriuretic peptide (BNP)?
Definition
Heart failure marker that measures BNP released by an overdistension of the heart. Below 100 is normal, above 500 is heart failure.
Term
Rotor wing pilot required hours
Definition
2000 hours, 1000 as PIC, 100 hours at night
Term
Bottle to throttle time
Definition
8 hours
Term
Define Central Venous Pressure (CVP).
Definition
Measures preload which is right atrial pressure. Normal is 2-6mmHg. Port is proximal on an arterial line. Catheter placement outside line markers: RA/CVP=25-30cm
RV=35-45cm
PA=50-55cm
Term
Define Anterior Cord Syndrome.
Definition
Complete motor, pain, and temperature loss below the lesion.
Term
Define Brown-Sequard Syndrome.
Definition
Ipsilateral loss of motor, position, and vibration sense; contralateral loss of pain and temperature perception.
Term
Define Central Cord Syndrome.
Definition
Central: Greater motor weakness in upper extremities than lower extremities with varying degrees of sensory loss.
Autonomic: Urinary retention, massive increase in sympathetic tone which can cause HTN, treated by foley cath.
Term
What is normal urinary output?
Definition
UO: 30-50ml/hr adult
UO: 1-2mlkg/hr peds
Term
What is normal blood volume?
Definition
70ml/kg adult
80ml/kg peds
Term
What is normal body temperature?
Definition
37.6C/98.6F
Term
What is mild hypothermia?
Definition
32-36C (decreasing heart rate)
Term
What is moderate hypothermia?
Definition
29-32C (loss of shivering, altered)
Term
What is severe hypothermia?
Definition
20-28C (coma, VF common)
Term
What are the two major types of heat loss?
Definition
Radiation and evaporation
Term
When does thermoregulation cease?
Definition
28C
Term
When is sterile cockpit in effect?
Definition
In all critical phases of flight.
Term
What is the time that a crew must report during flight?
Definition
Every 15 minutes.
Term
What is the time that a crew must report while on the ground?
Definition
Every 45 minutes.
Term
What is the sequence of rotor wing shut down in case of an emergency?
Definition
TFB, Throttle, Fuel, Battery
Term
What is the crew to do after exiting a downed aircraft?
Definition
Take survival bag and meet at 12 o'clock position.
Term
What are the priorities in order for survival?
Definition
Shelter, fire, water, food
Term
In what order is the abdomen to be assessed?
Definition
Inspect, auscultate, palpate, percuss.
Term
What are the contraindications for thrombolytics?
Definition
History of hemorrhagic stroke, CVA in last 12 months, SBP over 180, pregnancy or 1 month postpartum
Term
What are the FARs that govern flight programs?
Definition
Part 91: no passengers
Part 135: passengers (14 hours max for pilots)
Term
Who determines the local flying area?
Definition
The certificate holder
Term
Who and when are cell phones prohibited?
Definition
The FCC prohibits cell phone use while air borne.
Term
What is PaO2?
Definition
Plasma-measured as pressure
Term
What is SaO2?
Definition
Hemoglobin measured as percentage
Term
What is bariobariatrauma?
Definition
Nitrogen release in obese patients, administer high flow O2 15 minutes prior to lift off to wash out nitrogen.
Term
What is normal peds SBP?
Definition
SBP=90+(2 x age)
Term
When does SBP drop in peds?
Definition
After loss of 25% blood volume.
Term
What is normal peds DPB?
Definition
2/3 the SBP
Term
What are three killers of vented patients during flight?
Definition
Pericardial tamponade, tension pneumo, hypovolemia.
Term
What causes death in crush injuries?
Definition
Renal failure
Term
What are complications of crush injuries?
Definition
DIC, compartment syndrome, renal failure, hyperkalemia.
Term
What is the CAMTS requirement for intubations?
Definition
Quarterly
Term
What is the CAMTS requirement for live intubations during training?
Definition
Five
Term
What is the CAMTS requirement for specialty team response?
Definition
45 minutes.
Term
Under CAMTS is the medical director required to live in the same state?
Definition
No
Term
Under CAMTS how much orientation is a new pilot supposed to have?
Definition
5 hours day/2 hours night
Term
Under CAMTS what is a helipad required to have?
Definition
2 paths of egress, security.
Term
How much fixed wing twin engine time is a pilot required to have under CAMTS?
Definition
500 hours
Term
Under CAMTS what is the minimum fuel capacity for an ambulance?
Definition
Enough for 175 miles.
Term
What level of Gs has to set of an ELT?
Definition
4Gs
Term
Under CAMTS how are flight suits supposed to fit?
Definition
1/4 inch between body and suit.
Term
What gas law causes the bends?
Definition
Henry's Law. Soda can, CO2 in solution in blood.
Term
What gas law causes tissue swelling, hypoxic hypoxia, and reduces O2 available at altitude?
Definition
Dalton's Law. Dalton's gang, Pt=P1+P2+P3
Term
What gas law affects cellular gas exchange and diffusion?
Definition
Graham's Law.
Term
What gas law affects tank pressures in heat or cold?
Definition
Gay-Lussac's Law. P1/T1=P2/T2
Term
What gas law affects BP cuff, ETT cuff, MAST pants?
Definition
Boyle's Law. Boyle's balloon. P1V1=P2V2.
Term
What is considered a high velocity weapon?
Definition
Above 2000 FPS.
Term
What is considered a medium velocity weapon?
Definition
1000-2000 FPS.
Term
What is considered a low velocity weapon?
Definition
Under 1000 FPS.
Term
What is tumbling?
Definition
Rotation on a 360 degree axis.
Term
What is yaw?
Definition
Deviation up to 90 degrees from a straight path
Term
What is the normal value for CVP/RAP?
Definition
2-6mmHg
Term
What is cardiac output?
Definition
CO=HR X SV Normal is 4-8 L/min
Term
What is normal Cardiac Index (CI)?
Definition
2.5 to 4.2
Term
What are normal Pulmonary artery systolic/diastolic pressures?
Definition
PAS/PAD 15-25/8-15
Term
What are normal wedge pressures (PAWP/PCWP)?
Definition
8-12mmHg
Term
What is normal Systemic Vascular Resistance (SVR)?
Definition
800-1200 dynes/sec/cm-5
Term
When should CVP or PA be assessed on mechanically ventilated patients?
Definition
At the end of exhalation
Term
What is proper chest tube location?
Definition
Fourth intercostal space, anterior axillary line
Term
What is proper needle thoracostomy location?
Definition
Second intercostal space mid-clavicular, or fifth intercostal space anterior mid axillary line.
Term
What should you suspect with fracture of first three ribs?
Definition
Aortic disruption.
Term
In a trauma patient what does a scaphoid abdomen indicate?
Definition
Diaphragmatic rupture.
Term
What are the signs of an Abruptio placenta?
Definition
Dark red bleeding, pain
Term
What are the signs of a Placenta previa?
Definition
Red bleeding, painless
Term
What is the correct Terbutaline dose?
Definition
0.25mg SQ
Term
Define postpartum hemorrhage
Definition
Over 500ml
Term
What is the sign of uterine rupture?
Definition
Fetal parts can be palpated over the abdomen.
Term
What area worsens the effects of altitude?
Definition
Cold upper latitudes
Term
Define Gay-Lussac's Law
Definition
As temperature increases, so does pressure. P1T2=P2T1
Term
What is the Universal Gas Law?
Definition
It combines Boyle's Law and Charles'Laws.
P1V1/T1=P2V2/T2
Term
What is Graham's Law?
Definition
Gas moves from a high concentration to a low concentration.
Term
What is Henry's Law?
Definition
A gas dissolved in a liquid is directly proportional to the pressure of the gas above the liquid. C=k+Pgas
Term
At what altitude does the volume of gas in the GI tract triple?
Definition
25k feet
Term
What gas law affects the GI track the most?
Definition
Boyle's Law
Term
What are the hemodynamic signs of cardiogenic shock?
Definition
CVP: High CO: Low CI: Low PAS/PAD: High PCWP: High SVR: High HR: Intially fast, the slows down
Term
What is Boyle's Law?
Definition
Boyle's Balloon. As volume increases, pressure decreases. P1V1=P2V2.
Term
What is Charles' Law?
Definition
Temperature and volume are proportional. Increase temperature equals increased pressure. V1/T1=V2/T2
Up 100m=decrease of 1C
Term
When do we use passive rewarming?
Definition
Mild hypothermia only. Up 1C/hr with blankets and heater
Term
When is active rewarming?
Definition
Apply heat to body.
Term
What temp is warm and dead?
Definition
32C
Term
At what temp does heat stroke occur?
Definition
Over 42C
Term
What is Grey Turner's sign?
Definition
Flank bruising (retroperitoneal bleeding)
Term
What is Coopernail's sign?
Definition
Scrotum/labia bruising (abdominal/pelvic bleeding)
Term
What is Halstead's sign?
Definition
Marbled abdomen (bleeding)
Term
What is Cullen's sign?
Definition
Umbilical discoloration (pancreatitis)
Term
What is Murphy's sign?
Definition
RUQ pain with inspiration (gallbladder)
Term
What is Levine's sign?
Definition
Fist to chest "clutching" (cardiac)
Term
What are some causes of hypoxic hypoxia?
Definition
Altitude, decreased alveolar oxygen, tension pneumo (altitude)
Term
What is hypemic hypoxia?
Definition
Decreased O2 carrying capacity of the blood.
Term
What is histotoxic hypoxia?
Definition
Poisoning
Term
What is stagnant hypoxia?
Definition
Decreased cardiac output, poor circulation (G forces, CHF)
Term
What is the normal FHR?
Definition
120-160
Term
What factors indicate fetal well being?
Definition
FHR, fetal movement, variability
Term
What is the most important indicator of fetal well being?
Definition
Variability
Term
What is the treatment for fetal distress?
Definition
LOCK: left lateral recumbent, O2, correct contributing factors, keep reassessing
Term
How does preload relate to CHF patients?
Definition
Many CHF patients are relatively hypovolemic. Caution with diurectics and medications that can decrease preload.
Term
What lab test indicates CHF?
Definition
BNP=lab test non specific >500
Term
What medications should not be given for CHF?
Definition
Beta blockers, except Coreg.
Term
What is the primary cause of death with vent dependent patients?
Definition
Ventilator acquired pneumonia.
Term
What is digoxin and what does it do?
Definition
It is a cardiac glycoside, it can cause hypokalemia, and can cause EKG changes (DIG dip) ST depression
Term
What is the treatment for ARDS?
Definition
PEEP
Term
What is the CXR findings for ARDS?
Definition
Ground glass appearance, wide spread pulmonary infiltrates.
Term
What are the effects of PEEP?
Definition
Increased pulmonary vascular resistance and can cause hypotension over 15cm H2O
Term
What is normal (physiologic) PEEP?
Definition
3-5cm H2O
Term
How high a BP do you treat?
Definition
Over 220 systolic or MAP over 130
Term
What increased serum lab value indicates dehydration?
Definition
Sodium, Normal 135-145
Term
What are the objective pieces of data to assessment?
Definition
ABCs, neurological assessment. Differential assessment for altered LOC: AEIOUTIPS (alcohol, endocrine, electrolytes, encephalopathy, insulin, O2, uremia, toxidromes, trauma, temperature, infection, psych, porphyria, pharmacy, space occupying lesion, subarachnoid hemorrhage, stroke, sepsis.
Term
What is bowel sounds in the chest a sign of?
Definition
Diaphragmatic rupture, most common on left side
Term
What is crunching sound over the chest synchronized with HR?
Definition
Tracheobronchial injury. Hamman's Sign.
Term
What is the preferred method of moving spinal injured patients?
Definition
Scoop stretcher
Term
What is a sign of pulmonary contusion?
Definition
Low sats despite O2, rales
Term
What are signs of a ruptured diaphragm?
Definition
Chest/abdomen pain radiated to left shoulder
Term
What are signs of a tracheobronchial injury?
Definition
Hemoptysis, sub q air, air leak with chest tube, TX advance ETT below level of injury into right mainstem
Term
What are signs of an esophageal perforation?
Definition
Fever, hematemisis
Term
What are signs of a fat embolus?
Definition
Fever, rash after fracture.
Term
What is the blood loss for a humerus?
Definition
750ml
Term
What is the blood loss for femur?
Definition
1500ml
Term
What is PAWP/PCWP
Definition
Pulmonary artery wedge pressure/pulmonary capillary wedge pressure
Term
What do PAWP/PCWP show?
Definition
Looks at the left side of the heart, if high can indicate pulmonary congestion, CHF, and cardiogenic shock
Term
What is normal PAWP/PCWP?
Definition
8-12mmHg
Term
What are the correct ETT depths?
Definition
Adult: 3 X ETT size, average 19-23
Peds: 10 + age in years
Neo: 6 + weight in kg
Term
On a ventilated patient how is the CO2 changed?
Definition
Adjust rate, TV
Term
On a ventilated patient how is oxygenation changed?
Definition
Adjust PEEP, PAP
Term
What is the Parkland Formula?
Definition
4ml X kg X TBSA. 1/2 over 1st 8 hours, rest over next 16 hours.
Term
What is the Consensus formula?
Definition
2-4ml X kg X TBSA. 1/2 over first 8 hours, rest over next 16 hours.
Term
What is the rule of nines for adults?
Definition
Head 9%, anterior torso 18%, back 18%, each arm 9%, each leg 18%, neck or genitals 1%
Term
What is the rule of nines for peds?
Definition
Head 18%, Anterior torso 18%, back 18%, each arm 9%, each leg 14%, neck or genitals 0%.
Term
What is the ELT fq?
Definition
121.5
Term
How do you confirm the the ELT is working?
Definition
Tune it in and listen
Term
What things are required for twin engine off shore operations?
Definition
Raft, PFD
Term
What is the induction agent of choice with bronchospastic patients?
Definition
Ketamine
Term
What are the indications for ativan and dosage?
Definition
Seizures, 1-2mg, max 4mg
Term
What is the Mannitol dose?
Definition
1-2g/kg
Term
What is the drug of choice for tricyclic antidrepressant OD?
Definition
Sodium Bicarbonate
Term
What is the drug of choice for beta blocker OD?
Definition
Glucagon
Term
What is the dose for Fentanyl?
Definition
3mcg/kg
Term
What drug is the treatment for malignant hyperthermia?
Definition
Dantrium (dantrolene)
Term
What is the drug of choice for GI bleeds?
Definition
Sandostatin (octreotide)
Term
What are the signs of Neurogenic shock?
Definition
CVP: Down CO: Down CI: Down PCWP: Down SVR: Down(distributive shock) HR: Normal to slow
Term
What are the arterial lines sites?
Definition
Radial, femoral. Pressure bag at 300mmHg
Term
What is the purpose of an arterial line?
Definition
Monitor pressure, blood draw, ABG
Term
What signs are there in an arterial line as far as dampening is concerned?
Definition
Underdampening: caused by air in system, loose connection, low pressure bag, altitude changes
Overdampening: Kinking, increased bag pressure, tip against artery wall
Term
What is the most common reperfusion dysrhythmia?
Definition
AIVR
Term
What is the most common hypothermia dysrhythmia?
Definition
VF with Osborn Wave
Term
What is the sign of hypokalemia on EKG?
Definition
Peaked Ps, flat Ts
Term
What is the sign of hyperkalemia on EKG?
Definition
Flat Ps, peaked Ts (treat with calcium)
Term
What is the MAP goal with a CHI?
Definition
MAP: 80-100mmHg
Term
What is the CPP goal with increased ICP?
Definition
CPP: 70-90
Term
What is normal ICP?
Definition
ICP: 0-10
Term
What is normal CPP (head)?
Definition
CPP: 70-90
Term
What is normal MAP?
Definition
MAP: 80-100
Term
What is normal CPP (heart)?
Definition
Heart CPP: 50-60 (head is higher than heart, same as coronary perfusion pressure)
Term
What are the values for altered level of consciousness?
Definition
GCS Mild: 14-15
GCS Moderate: 9-13
GCS Severe: 3-8
Term
What is the CPP Head formula?
Definition
CPP Head=MAP-ICP
Term
What is the MAP formula?
Definition
MAP=(2 X Diastolic) + Systolic/3
Term
What is the CPP Heart formula?
Definition
CPP Heart=DBP-Wedge pressure
Term
What are the rotor wing minimums?
Definition
Day/local: 500'ceiling, 1 mile visibility
Day/x country: 1000'ceiling, 1 mile vis
Night/local: 500'ceiling, 2 mile vis
Night/x country: 1000'ceiling, 3 mile vis
Term
What is the number one cause of air medical crashes?
Definition
Controlled flight into terrain, pushing the weather
Term
What is the normal lab value for Potassium?
Definition
3.5-4.5
Term
What is the normal lab value for Sodium?
Definition
135-145
Term
What is the normal lab value for chloride?
Definition
95-105
Term
What is the normal lab value for Calcium?
Definition
8.5-10.5
Term
What electrolyte does Metabolic acidosis elevate?
Definition
Potassium
Term
What is the time of useful consciousness with SUDDEN decompression at 30k feet?
Definition
90 seconds
Term
What is the time of useful consciousness with SUDDEN decompression at 41k feet?
Definition
Under 15 seconds
Term
What are the leads that show ST elevation for an inferior MI?
Definition
I SEE ALL LEADS
Inferior: II, III, aVf
Term
What are the leads that show ST elevation for an septal MI?
Definition
V1, V2
Term
What are the leads that show ST elevation for an anterior MI?
Definition
V3, V4
Term
What are the leads that show ST elevation for an lateral MI?
Definition
I, aVl, V5,
Term
What are the leads that show ST elevation for an posterior MI?
Definition
ST depression or reciprocal changes in V1-V4, ST elevation in V6
Term
What is the EKG sign for ischemia?
Definition
ST depression (1mm in 2 leads)
Term
What is the EKG sign for injury?
Definition
ST elevation (1mm in 2 leads)
Term
What is the EKG sign for infarct?
Definition
Q wave > 25% the height of the R wave
Term
What is the ETT cuffed vs. uncuffed rule for peds?
Definition
Uncuffed under 10 years
Term
What is the needle cricothyrotomy rule for peds?
Definition
Needle cricothyrotomy only under 11 years
Term
What is the nasal intubation rule for peds?
Definition
No nasal intubation under 12 years
Term
What is the primary cause of pre term labor?
Definition
Infection
Term
What are the CONTRAINDICATIONS for Terbutaline?
Definition
Insulin Dependent Diabetes Melitis, maternal HR over 120, vaginal bleeding
Term
What is the pregnancy induced hypertension (PIH) triad?
Definition
HTN, edema, proteinuria
Term
What is the O2 adjustment calculation to maintain saturation at altitude?
Definition
% O2 patient is on times pressure at departure altitude (mmHg) divided by pressure at altitude; FiO21 X P1/P2=FiO22
Term
What is ventilator mode CMV?
Definition
CMV: preset volume or PIP at set rate. Patient cannot iniate breath.
Term
What is ventilator mode AC?
Definition
AC: preset volume or PIP with every breath. Patient can trigger a breath, cannot control TV
Term
What is ventilator mode IMV/SIMV?
Definition
Intermittent Mechanical Ventilation: preset breaths, TV, PIP. Patient breaths allowed.
Simulated Intermittent Mechanical Ventilation: Allows variation of support
Term
What does IABP cause?
Definition
Increased cardiac output, better coronary perfusion
Term
When does a IABP deflate?
Definition
During ventricular systole
Term
What is the Dicrotic notch?
Definition
The aortic valve closing, synchronized with A line or EKG (most common trigger)
Term
What are the signs and symptoms of a IABP balloon leak?
Definition
Blood specs in tubing, alarm
Term
How do you prevent clots if the IABP fails?
Definition
Cycle manually every 30 minutes
Term
How much does IABP increase cardiac output?
Definition
10-20%
Term
What do you do monitor for IABP migration/dislogdement?
Definition
Assess left radial and urine output
Term
What is the lethal IABP timing cycle problem?
Definition
Late deflation or early inflation
Term
What is the oxyhemoglobin disassociation curve left shift?
Definition
"L" stands for Alkalosis. Left shift = hemoglobin holding on to oxygen, Alkalosis, Low CO2, Low Temp, Low DPG, Mxydema coma
Term
What is the oxyhemoglobin disassociation curve right shift?
Definition
"R" stands for raised
Right = raise/releases oxygen, acidosis, raised CO2, Raised temp, Raised DPG, Thyroid storm
Term
Where is the Phlebostatic axis?
Definition
Fourth intercostal space, level of atria
Term
Why is the Phlebostatic axis important?
Definition
It is where pressure measurements are made with invasive lines
Term
What does Boyle's law affect on ascent?
Definition
Barodontalgia, barosinusitis, bariobariatrauma
Term
What does Boyle's law affect on descent?
Definition
Barotitis media
Term
Define the levels of HTN?
Definition
Mild: 140-150/90-99
Moderate: 160-179/100-109
Severe: Over 180/110
Term
What is the dose for administration of RBC?
Definition
10ml/kg
Term
What is the dose of WBC?
Definition
20ml/kg
Term
What is the rule for ABG CO2 and pH?
Definition
CO2 up 10=pH down 0.08
Term
What is the rule for ABG Bicarb and pH?
Definition
HCO3 up 10=pH up 0.15
Term
What is the rule for Bicard replacement?
Definition
kg/4 X base deficit= meq of bicarb needed
Term
What is the rule for PaO2 at altitude?
Definition
PaO2 drops 5 for every 1000' of elevation
Term
What are the stages of hypoxia for different altitudes?
Definition
Indifferent: 10k MSL, increased HR and RR decreased night vision Compensatory: 10k to 15k MSL, HTN, task impairment Disturbance: 15k to 20k MSL, dizzy, sleepy, cyanosis Critical: 20k to 30k MSL, ALOC, incapacitated
Term
When is night vision lost?
Definition
5k MSL
Term
What is a PA catheter called?
Definition
Swan Ganz
Term
What is the proximal port for on a PA catheter for?
Definition
Measuring CVP, giving medications
Term
What are the S/S of bad placement of a PA catheter?
Definition
VT, ventricular ectopy
Term
What is the procedure for bad placement of a PA catheter?
Definition
Float forward to PA or pull back to RA
Term
What does a PA catheter measure?
Definition
Right heart directly, left heart indirectly
Term
Which PA catheter port is used to measure?
Definition
Distal port
Term
What should the pressure back be set to for a PA catheter?
Definition
300mmHg
Term
What is normal Cardiac index (CI)?
Definition
CI: 2.5-4.2
Term
What are the nine stressors of flight?
Definition
Third spacing, fatigue, g forces, noise, vibration, hypoxia, dehydration, temp changes, pressure changes
Term
What are personal factors affecting stressors of flight?
Definition
DEATH, drugs, exhaustion, alcohol, tobacco, hypoglycemia
Term
What is Dalton's law and what are examples of it's affects?
Definition
Sum total of partial pressures equal to the total atmospheric pressure (Dalton's gang)
Tissue swelling, altitude hypoxia, hypoxic hypoxia
Term
In what time frame do thrombolytics have to administered?
Definition
Within three hours of onset of pain
Term
When diving how many feet equals one ATM?
Definition
33 feet (don't forget the one atm that is above the water)
Term
What are the hemodynamic signs of hypovolemic shock?
Definition
CVP: Down CO: Down CI: Down PAWP: Down SVR: Up HR: Fast
Term
What are the lab values for acute respiratory failure?
Definition
pO2 below 60
pCO2 above 50
Term
What is Newton's first law?
Definition
An object in motion tends to stay in motion
Term
What is Newton's second law?
Definition
F=MA
Term
What is Newton's third law?
Definition
For every action there is an equal and opposite reaction
Term
What is the Tetralogy of Fallot (TOF)?
Definition
PROV: Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, Ventricular septal defect
Term
What is a TET spell?
Definition
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 are spasms, sudden decrease in SVR secondary to hypovolemia, dehydration, hot weather or defecation. Usually seen between two weeks and four months of life
Term
What do atrial waveforms show?
Definition
Filling pressures, right atrial pressure (CVP), left atrial pressure (PAWP/PCWP)
Term
What do ventricular waveforms show?
Definition
Right 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 the right side of the waveform. Left ventricular pressure measured during cardiac cath
Term
What do arterial waveforms show?
Definition
Pulmonary artery pressure (PAP). It has dicrotic notch on the down slope of the right side of the waveform
Term
What is the A wave?
Definition
A wave= rise in atrial pressure as a result of atrial contraction
Term
What is the C wave?
Definition
Not always visible on tracing, rise in the atrial pressure which closure of the AV valves (Tricuspid and Mitral) bulge upward into the atrium following valve closure
Term
What is the V wave?
Definition
Rise in atrial pressure as it refills during ventricular contraction
Term
What is the A wave coorelation to EKG?
Definition
A wave generally coincides with the PR interval on the EKG in a right atrial pressure waveform. It will be slightly delayed in a left atrial pressure waveform
Term
What is the C wave correlation to EKG?
Definition
The C wave generally coincides with mid to late QRS on the EKG in a right atrial pressure waveform. It will be slightly delayed in a left atrial pressure waveform
Term
What does the V wave coorelate to in the EKG?
Definition
V wave is generally seen immediately after the peak of the T wave on the EKG in a right atrial pressure waveform. It will be slightly delayed in a left atrial pressure waveform
Term
What do wave descents indicate?
Definition
Decline in right atrial pressure during atrial relaxation (remember X in relaXation).
Deline in right atrial pressure resulting from atrial emptying (remember Y in emptYing)
Term
When are pressures recorded?
Definition
Record pressures 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 cardiac pressure to rise upon inspiration.
Term
How do you measure waveforms?
Definition
The end diastolic pressure can be estimated 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
What is the formula for Cardiac Output?
Definition
HR X Stoke volume=CO
Term
What is the dicrotic notch?
Definition
Closure of the aortic valve
Term
What things are particular to neonates?
Definition
Maintains the PDA open=prostaglandin
Closed the PDA= indomethacin and long term use of high flow O2
32 weeks or less= Use surfactant
Common cause of seizures=hypoglycemia <40 and hypoxia
Scaphoid abdomen=diaphragmatic hernia managed by orogastric tube or PPV
Term
What does CPK >20 indicate?
Definition
CPK levels greater than 20k is ominous and is an indication of later DIC, acute renal failure, and is potentially dangerous hyperkalemia in the heat stroke patient
Term
What is anion gap?
Definition
Na - (Cl + Bicarb/CO2)=AG
Normal 12 +-4
>16 indicates underlying metabolic acidosis
MUDPILES: methanol, Uremia, DKA, paraldehyde, isoniazide/iron, lactate, ethylene glycol, salicylate
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