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Critical Care Transport/Flight Paramedic Exam/297 Questions with Answers
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Critical Care Transport/Flight ParamedicExam/297 Questions with Answers
Sickled cells - -Red blood cells that are less deformable and do not pass
through microcirculation as easily, cause an increase in blood viscosity, and
are sequestered and destroyed by the liver and spleen
-Acute chest syndrome - -Condition that accounts for 25% of premature
deaths in patients with sickle cell disease; the leading cause of
hospitalization and death of sickle cell patients; symptoms include fever,
cough, chest pain, dyspnea, new infiltrates on chest x-ray; no definitive
therapy, only supportive care
-Integrilin, ReoPro, and Aggrastat - -The three glycoprotein IIb/IIa inhibitors
that bind to a platelet receptor glycoprotein and inhibit platelet aggregation
-760 mmHg/1 atm - -Barometric pressure at sea level
-Physiologic zone - -Atmospheric zone; sea level-10,000 ft; human body is
well adapted; adequate pressure to allow for oxygen exchange, impairments
are frequently due to changes in pressure (ascent or descent)
-Physiologically deficient zone - -Atmospheric zone; 10,000-50,000 ft;
noticeable deficits to humans; reduced barometric pressure results in poor
oxygen exchange; most noticeable impairment is hypoxia (trapped gases
can also cause hypoxia)
-Space equivalent zone - -Atmospheric zone; 50,000-250,000 ft;
environment incompatible with human life; pressurized suits and sealed
cabins required; impairments include hypoxia, trapped gas, and emboli
-Boyle's Law - -Gas law; When temperature remains constant, the volume of
a gas is inversely proportional to its pressure; As a gas bubble ascends, it
expands. As it descends, it gets smaller; P1(V1) = P2(V2)
-Charles' Law - -Gas law; At a constant pressure, the volume of gas is
directly proportional to its temperature; For every 1,000 ft (333 meters) of
altitude increase, temperature decreases 2 degrees Celsius; V1/T1 = V2/T2
-Ideal Gas Law - -Gas law; created to explain Boyle's Law vs. Charles Law; It
takes a large amount of temperature change to affect a small amount of
volume; pV = nRT (absolute pressure of gas x volume = amount of
substance x gas constant x absolute temperature)
, -Dalton's Law - -Gas law; The total pressure of a gas mixture is the sum of
the individual partial pressure of all the gas in the mixture; As altitude
increases, the amount of oxygen molecules decreases, but the percentage of
molecules remains the same; Pt = P1 + P2 + P3... (Pt = total pressure of a
gas)
-Henry's Law - -Gas law; The amount of gas in a solution is proportional to
the partial pressure of gas in contact with the liquid; decompression
sickness: increased nitrogen absorbed into the blood at depth, nitrogen
"bubbles" exit the blood with rapid change in air pressure; soda bottle: CO2
held in suspension by pressure, lid is removed and CO2 exits to equalize with
atmospheric pressure; P = KHC
-Graham's Law - -Gas law; With temperature and pressure held constant,
the relative rate of diffusion of a gas is inversely proportional to the square
roots of the density of those gases; The less dense the gas, the more rapidly
the gas will diffuse through the air; Lighter gases diffuse more rapidly in
narrowed peripheral airways (heliox); CO2 has a solubility factor 19 times
greater than O2 and will more rapidly diffuse across a membrane
-15 PSI/1 atm - -Amount of pressure at 33 ft of ocean depth
-indifferent stage - -first of the four stages of hypoxia; sea level to 10,000 ft
in altitude; 33,000-39,000 ft if breathing 100% oxygen; SpO2 of 90-95%;
night vision lost 5,000 ft; slight increase in heart rate and respiratory rate
-compensatory stage - -second of the four stages of hypoxia; 10,000-15,000
ft in altitude; 39,000-42,000 ft if breathing 100% oxygen; SpO2 80-90%;
signs and symptoms include deceased alertness, subtle errors in judgement,
fatigue, irritability, headache, tachycardia, tachypnea, increased blood
pressure, increased tidal volume, altered mental status
-disturbance stage - -third of the four stages of hypoxia, 15,000-20,000 ft in
altitude; 42,000-45,200 ft if breathing 100% oxygen; SpO2 70-80%; signs
and symptoms include fatigue, dizziness, cyanosis, impairment, tachypnea,
altered mental status, impaired central and peripheral vision, and personality
changes; period of useful consciousness is 15-20 minutes
-critical stage - -last of the four stages of hypoxia; 20,000-23,000 ft in
altitude, 45,200-46,800 ft if breathing 100% oxygen; SpO2 60-70%; signs
and symptoms include severe altered mental status, seizures, impairment,
unconsciousness, severe mental and physical capacitation, and death
-hypoxic hypoxia - -one of the four types of hypoxia; inadequate
oxygenation secondary to reduced partial pressures of oxygen in inspired air;
, caused by reduced PaO2, impaired gas exchange across the alveolar-
capillary membrane, or impaired ventilation
-anemic (hypemic) hypoxia - -one of the four types of hypoxia; inadequate
tissue oxygenation secondary to reduced to reduced oxygen-carrying
capacity (from either inadequate availability of oxygen molecules or
obstructive pathology that prevents oxygen from diffusing across alveolar
membranes); caused by CO poisoning, anemia, blood loss, drugs causing
methemoglobinemia, alcohol use or abuse, COPD, pneumonia, pulmonary
edema, or pulmonary embolism
-stagnant hypoxia - -one of the four types of hypoxia; inadequate tissue
oxygenation secondary to reduced cardiac output, pooling of blood, reduced
blood flow to tissues, or restriction of blood flow; cause by heart failure,
shock, gravitational forces, positive pressure ventilation, or pulmonary
embolism
-histotoxic hypoxia - -one of the four types of hypoxia; inadequate tissue
oxygenation secondary to metabolic disorder or poisoning of the cytochrome
oxidase enzyme system resulting in cellular inability to utilize oxygen;
caused by toxic gas poisoning, alcohol or narcotic abuse, or cyanide
poisoning
-temperature - -the "vital sign" should be monitored on ALL patients during
flight, especially pediatric patients
-30 degrees - -angle at which the patient's head should be raised on the
stretcher in most cases, especially intubated patients and patients with head
injuries
-rotor-wing aircraft - -type of aircraft typically used for transports less than
150 nautical miles; operates at sustained speeds of 100-200 mph and at
altitudes less than 10,000 ft
-fixed-wing aircraft - -type of aircraft typically used for transports over 150
nautical miles; operates at speed ranges from 300-600 mph and at altitudes
up to 38,000 ft
-Part 91 - -the section of Title 14 of the Code of Federal Regulations that
governs the operation of all aircraft within the U.S., including the waters
within 12 nautical miles of the U.S. coast; can only be used when NO medical
crew is on board
-Part 135 - -the section of Title 14 of the Code of Federal Regulations that
governs all commuter or on-demand commercial flight operations; contains
strict weather minimums and duty times; requires that pilots have no more
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