Term
|
Definition
| Back, leg pain on knee extension. Possible bacterial meningitis. |
|
|
Term
|
Definition
| Referred left shoulder pain. Possible splenic injury. |
|
|
Term
|
Definition
| Back, leg pain on neck flexion. Possible bacterial meningitis or subarachnoid bleed. |
|
|
Term
|
Definition
| Crunching sound heard over anterior chest synced with heartbeat- tracheobronchial injury. |
|
|
Term
|
Definition
Possible croup
A/P neck view |
|
|
Term
|
Definition
Possible epiglottitis.
Lateral neck view. |
|
|
Term
|
Definition
0.1 mmol/L +- 0.5
>2.0 in critically ill indicates significant lactic acidosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Fraction of inspired oxygen |
|
|
Term
|
Definition
| Partial pressure of arterial oxygen |
|
|
Term
|
Definition
| Partial pressure of alveolar oxygen |
|
|
Term
|
Definition
| Partial pressure of venous oxygen |
|
|
Term
|
Definition
| Arterial saturation of oxygen |
|
|
Term
|
Definition
|
|
Term
| Partial pressure of oxygen at sea level |
|
Definition
|
|
Term
| What is the fastest way to increase the partial pressure of oxygen in the blood stream (PaO2)? |
|
Definition
|
|
Term
| What is the percentage of O2 that is attached to HgB? |
|
Definition
|
|
Term
| What is the percentage of O2 that is attached to plasma? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Nipride and beta blockers |
|
|
Term
| First adjustment on ventilator |
|
Definition
| Tidal volume first, not rate |
|
|
Term
|
Definition
|
|
Term
| Most common spontaneous dislocation recurrence |
|
Definition
|
|
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
|
Definition
|
|
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
|
|
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
|
|
Term
| What are the two major types of heat loss? |
|
Definition
| Radiation and evaporation |
|
|
Term
| When does thermoregulation cease? |
|
Definition
|
|
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
|
|
Term
| What is the time that a crew must report while on the ground? |
|
Definition
|
|
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
|
|
Term
| Who and when are cell phones prohibited? |
|
Definition
| The FCC prohibits cell phone use while air borne. |
|
|
Term
|
Definition
| Plasma-measured as pressure |
|
|
Term
|
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
|
Definition
|
|
Term
| When does SBP drop in peds? |
|
Definition
| After loss of 25% blood volume. |
|
|
Term
|
Definition
|
|
Term
| What are three killers of vented patients during flight? |
|
Definition
| Pericardial tamponade, tension pneumo, hypovolemia. |
|
|
Term
| What causes death in crush injuries? |
|
Definition
|
|
Term
| What are complications of crush injuries? |
|
Definition
| DIC, compartment syndrome, renal failure, hyperkalemia. |
|
|
Term
| What is the CAMTS requirement for intubations? |
|
Definition
|
|
Term
| What is the CAMTS requirement for live intubations during training? |
|
Definition
|
|
Term
| What is the CAMTS requirement for specialty team response? |
|
Definition
|
|
Term
| Under CAMTS is the medical director required to live in the same state? |
|
Definition
|
|
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
|
|
Term
| Under CAMTS what is the minimum fuel capacity for an ambulance? |
|
Definition
|
|
Term
| What level of Gs has to set of an ELT? |
|
Definition
|
|
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
|
|
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
|
|
Term
| What is considered a medium velocity weapon? |
|
Definition
|
|
Term
| What is considered a low velocity weapon? |
|
Definition
|
|
Term
|
Definition
| Rotation on a 360 degree axis. |
|
|
Term
|
Definition
| Deviation up to 90 degrees from a straight path |
|
|
Term
| What is the normal value for CVP/RAP? |
|
Definition
|
|
Term
|
Definition
| CO=HR X SV Normal is 4-8 L/min |
|
|
Term
| What is normal Cardiac Index (CI)? |
|
Definition
|
|
Term
| What are normal Pulmonary artery systolic/diastolic pressures? |
|
Definition
|
|
Term
| What are normal wedge pressures (PAWP/PCWP)? |
|
Definition
|
|
Term
| What is normal Systemic Vascular Resistance (SVR)? |
|
Definition
|
|
Term
| When should CVP or PA be assessed on mechanically ventilated patients? |
|
Definition
|
|
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
|
|
Term
| In a trauma patient what does a scaphoid abdomen indicate? |
|
Definition
|
|
Term
| What are the signs of an Abruptio placenta? |
|
Definition
|
|
Term
| What are the signs of a Placenta previa? |
|
Definition
|
|
Term
| What is the correct Terbutaline dose? |
|
Definition
|
|
Term
| Define postpartum hemorrhage |
|
Definition
|
|
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
|
|
Term
|
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
|
Definition
| Gas moves from a high concentration to a low concentration. |
|
|
Term
|
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
|
|
Term
| What gas law affects the GI track the most? |
|
Definition
|
|
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
|
Definition
| Boyle's Balloon. As volume increases, pressure decreases. P1V1=P2V2. |
|
|
Term
|
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
|
|
Term
| What temp is warm and dead? |
|
Definition
|
|
Term
| At what temp does heat stroke occur? |
|
Definition
|
|
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
|
Definition
| Marbled abdomen (bleeding) |
|
|
Term
|
Definition
| Umbilical discoloration (pancreatitis) |
|
|
Term
|
Definition
| RUQ pain with inspiration (gallbladder) |
|
|
Term
|
Definition
| Fist to chest "clutching" (cardiac) |
|
|
Term
| What are some causes of hypoxic hypoxia? |
|
Definition
| Altitude, decreased alveolar oxygen, tension pneumo (altitude) |
|
|
Term
|
Definition
| Decreased O2 carrying capacity of the blood. |
|
|
Term
| What is histotoxic hypoxia? |
|
Definition
|
|
Term
| What is stagnant hypoxia? |
|
Definition
| Decreased cardiac output, poor circulation (G forces, CHF) |
|
|
Term
|
Definition
|
|
Term
| What factors indicate fetal well being? |
|
Definition
| FHR, fetal movement, variability |
|
|
Term
| What is the most important indicator of fetal well being? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| What are signs of a fat embolus? |
|
Definition
| Fever, rash after fracture. |
|
|
Term
| What is the blood loss for a humerus? |
|
Definition
|
|
Term
| What is the blood loss for femur? |
|
Definition
|
|
Term
|
Definition
| Pulmonary artery wedge pressure/pulmonary capillary wedge pressure |
|
|
Term
|
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
|
|
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
|
|
Term
| On a ventilated patient how is oxygenation changed? |
|
Definition
|
|
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
|
Definition
|
|
Term
| How do you confirm the the ELT is working? |
|
Definition
|
|
Term
| What things are required for twin engine off shore operations? |
|
Definition
|
|
Term
| What is the induction agent of choice with bronchospastic patients? |
|
Definition
|
|
Term
| What are the indications for ativan and dosage? |
|
Definition
|
|
Term
| What is the Mannitol dose? |
|
Definition
|
|
Term
| What is the drug of choice for tricyclic antidrepressant OD? |
|
Definition
|
|
Term
| What is the drug of choice for beta blocker OD? |
|
Definition
|
|
Term
| What is the dose for Fentanyl? |
|
Definition
|
|
Term
| What drug is the treatment for malignant hyperthermia? |
|
Definition
|
|
Term
| What is the drug of choice for GI bleeds? |
|
Definition
|
|
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
|
|
Term
| What is the most common hypothermia dysrhythmia? |
|
Definition
|
|
Term
| What is the sign of hypokalemia on EKG? |
|
Definition
|
|
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
|
|
Term
| What is the CPP goal with increased ICP? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is normal CPP (head)? |
|
Definition
|
|
Term
|
Definition
|
|
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
|
|
Term
|
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
|
|
Term
| What is the normal lab value for Sodium? |
|
Definition
|
|
Term
| What is the normal lab value for chloride? |
|
Definition
|
|
Term
| What is the normal lab value for Calcium? |
|
Definition
|
|
Term
| What electrolyte does Metabolic acidosis elevate? |
|
Definition
|
|
Term
| What is the time of useful consciousness with SUDDEN decompression at 30k feet? |
|
Definition
|
|
Term
| What is the time of useful consciousness with SUDDEN decompression at 41k feet? |
|
Definition
|
|
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
|
|
Term
| What are the leads that show ST elevation for an anterior MI? |
|
Definition
|
|
Term
| What are the leads that show ST elevation for an lateral MI? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
|
Term
| What do you do monitor for IABP migration/dislogdement? |
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Definition
| Assess left radial and urine output |
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Term
| What is the lethal IABP timing cycle problem? |
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Definition
| Late deflation or early inflation |
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Term
| What is the oxyhemoglobin disassociation curve left shift? |
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Definition
| "L" stands for Alkalosis. Left shift = hemoglobin holding on to oxygen, Alkalosis, Low CO2, Low Temp, Low DPG, Mxydema coma |
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Term
| What is the oxyhemoglobin disassociation curve right shift? |
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Definition
"R" stands for raised
Right = raise/releases oxygen, acidosis, raised CO2, Raised temp, Raised DPG, Thyroid storm |
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Term
| Where is the Phlebostatic axis? |
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Definition
| Fourth intercostal space, level of atria |
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Term
| Why is the Phlebostatic axis important? |
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Definition
| It is where pressure measurements are made with invasive lines |
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Term
| What does Boyle's law affect on ascent? |
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Definition
| Barodontalgia, barosinusitis, bariobariatrauma |
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Term
| What does Boyle's law affect on descent? |
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Definition
|
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Term
| Define the levels of HTN? |
|
Definition
Mild: 140-150/90-99
Moderate: 160-179/100-109
Severe: Over 180/110 |
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Term
| What is the dose for administration of RBC? |
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Definition
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Term
|
Definition
|
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Term
| What is the rule for ABG CO2 and pH? |
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Definition
|
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Term
| What is the rule for ABG Bicarb and pH? |
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Definition
|
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Term
| What is the rule for Bicard replacement? |
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Definition
| kg/4 X base deficit= meq of bicarb needed |
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Term
| What is the rule for PaO2 at altitude? |
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Definition
| PaO2 drops 5 for every 1000' of elevation |
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Term
| What are the stages of hypoxia for different altitudes? |
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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 |
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Term
| When is night vision lost? |
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Definition
|
|
Term
| What is a PA catheter called? |
|
Definition
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Term
| What is the proximal port for on a PA catheter for? |
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Definition
| Measuring CVP, giving medications |
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Term
| What are the S/S of bad placement of a PA catheter? |
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Definition
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Term
| What is the procedure for bad placement of a PA catheter? |
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Definition
| Float forward to PA or pull back to RA |
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Term
| What does a PA catheter measure? |
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Definition
| Right heart directly, left heart indirectly |
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|
Term
| Which PA catheter port is used to measure? |
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Definition
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|
Term
| What should the pressure back be set to for a PA catheter? |
|
Definition
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|
Term
| What is normal Cardiac index (CI)? |
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Definition
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|
Term
| What are the nine stressors of flight? |
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Definition
| Third spacing, fatigue, g forces, noise, vibration, hypoxia, dehydration, temp changes, pressure changes |
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Term
| What are personal factors affecting stressors of flight? |
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Definition
| DEATH, drugs, exhaustion, alcohol, tobacco, hypoglycemia |
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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 |
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Term
| In what time frame do thrombolytics have to administered? |
|
Definition
| Within three hours of onset of pain |
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Term
| When diving how many feet equals one ATM? |
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Definition
| 33 feet (don't forget the one atm that is above the water) |
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Term
| What are the hemodynamic signs of hypovolemic shock? |
|
Definition
| CVP: Down CO: Down CI: Down PAWP: Down SVR: Up HR: Fast |
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Term
| What are the lab values for acute respiratory failure? |
|
Definition
pO2 below 60
pCO2 above 50 |
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|
Term
| What is Newton's first law? |
|
Definition
| An object in motion tends to stay in motion |
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|
Term
| What is Newton's second law? |
|
Definition
|
|
Term
| What is Newton's third law? |
|
Definition
| For every action there is an equal and opposite reaction |
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|
Term
| What is the Tetralogy of Fallot (TOF)? |
|
Definition
| PROV: Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, Ventricular septal defect |
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|
Term
|
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 |
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Term
| What do atrial waveforms show? |
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Definition
| Filling pressures, right atrial pressure (CVP), left atrial pressure (PAWP/PCWP) |
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Term
| What do ventricular waveforms show? |
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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 |
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Term
| What do arterial waveforms show? |
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Definition
| Pulmonary artery pressure (PAP). It has dicrotic notch on the down slope of the right side of the waveform |
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Term
|
Definition
| A wave= rise in atrial pressure as a result of atrial contraction |
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|
Term
|
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 |
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Term
|
Definition
| Rise in atrial pressure as it refills during ventricular contraction |
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Term
| What is the A wave coorelation to EKG? |
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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 |
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Term
| What is the C wave correlation to EKG? |
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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 |
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|
Term
| What does the V wave coorelate to in the EKG? |
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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 |
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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) |
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|
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. |
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Term
| How do you measure waveforms? |
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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 |
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Term
| What is the formula for Cardiac Output? |
|
Definition
|
|
Term
| What is the dicrotic notch? |
|
Definition
| Closure of the aortic valve |
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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 |
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Term
| What does CPK >20 indicate? |
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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 |
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|
Term
|
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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