Flight Paramedic Study Guide: Questions & Answers for FP-C/CCP-C Certification (2024/2025), Exams of Nursing

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Flight Paramedic Study guide for FP-C/

CCP-C QUESTIONS AND ANSWERS

2024/

Treatment for Pregnancy Induced Hypertension

• Hydralazine (apresoline)
• Labetalol
• Mag Time of Useful Consciousness (TUC) @30,000ft @41,000ft
• 30k: 90s
• 41k: 14s coarctation of the aorta narrowing of the descending portion of the aorta, resulting in a limited flow of blood to the lower part of the body presents w/. Bounding pulses in UE and threads pulse in lower **Target PaO2 for

1. ICP
2. Herniation**
3. 35-40mmHg
4. 30-35mmHg Capacitance formula C=VF C = capacitance, or compliance (mL/mm Hg) V = voltage F = Farad Blind Emergency percutaneous Pericardiocentesis Needle below Xiphoid process and point towards the shoulder and aspirate. If blood clotts you were in heart chamber and need to pull back

blood doesn't clot in pericardial cavity due to lack of fibrinogen Ventilator settings for: Airway Protection Keep in normal physiology PEEP: 5cmH Resp: 14- 16 Vt: 6-8cc/kg (IBW) Mallampati concerns Mouth opening less than 4cm is not good M1: easy MIV: difficult What drug do you avoid with head trauma? Morphine morphine causes respiratory depression and CO2 retention as well as vasodilation of cerebral arteries which increase cerebrospinal fluid pressure Ideal Body Weight (IBW) formula Men: 50 + 2.3kg(height-60) Women: 45.5kg + 2.3kg(height-60) Narcan complication Pulmonary Edema pulmonary ultra sound will show B-lines and can show pleural effusion and lung hepatization in pneumonia. TX: PPV or ETT Tetralogy of Fallot congenital malformation involving four distinct heart defects P- pulmonary stenosis R- right ventricular Hypertrophy O- overriding the aorta V- ventricular septal defect (VSD) Murphy's Sign Presents with RUQ pain with inspiration (gallbladder) Gay-Lussac's Law

the pressure of a gas is directly proportional to the Kelvin temperature if the volume is constant

• Temp increase, Pressure increase and opposite ex: O2 tank has 2200psi in afternoo and 1800psi in evening Federal Aviation Regulation (FAR) FAA rules established for the airlines to guard against potential safety hazards Par 91: no passengers par 135: passengers (14hr max for pilots) Post survival sequence Shelter Fire water Food Normal Body Temp 98.6 F (37 C) Central Cord Syndrome loss of function in upper extremities more so than lower. caused by injury to the middle portion of the spinal cord Anterior cord syndrome
• caused by flexion injuries
• occurs when 2/3 of the anterior cord is lost
• motor function, pain, and temperature sensation lost bilaterally below the lesion ( flaccidity below the lesion) Brown-Sequard Syndrome Hemi-section of the cord
• ipsilateral (same side) spastic paralysis and loss of position sense
• contralateral (opposite side) loss of pain and thermal sense Autonomic Dysreflexia Urinary retention and HTN (potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure) TX: Foley Kerning's Test

instruct pt. to flex hip and knee to 90 deg (ok for Dr. to support leg) then instruct pt. to extend knee (bilat., unaffected side first) Dx: possible bacterial Meningitis pos: inability to straighten leg or pain while straightening Ind: meningeal irritation, meningitis, or nerve root involvement, disc, tumor, radicular pain in pt. with lumbar radiculopathy Tube depth for neonate Weight(kg) + 6 PEDS weight formula 2(Age) + 8 Most common side effect of prostaglandin Apnea and Hypotension HELLP syndrome Hemolysis: RBC fragmentation Elevated Liver enzymes: can be over 4, Low Platelets under 100K (form of severe preeclampsia) Manifested by: RUQ pain, N/V, malaise, headache, visual changes, proteinuria, HTN Causes of low CVP hypovolemia, vasodilation MAP formula SBP+2(DBP)/ What closes PDA? Keeps it open? Closes~Indomethacin or continual oxygen Open~PGE Max distance UHF can travel 30 - 40 miles peds fluid rescusitation =? 4 - 2 - 1 4ml/kg/hr ——1st 10 kilo 2ml/kg/hr——-2nd 10 kilo 1ml/kg/hr——-20kilo + How do you maintain PDA

Indomethacin 0.2mg/kg followed by 0.1mg/kg over 12 hrs indomethacin is prostaglandin Synthroid inhibitor What type of shock? SVR: 1500. BP: 80/ CI: 2.1. HR: 62 PAWP: 2 CVP: 400 Neurogenic shock Steroid given to mom to stimulate Lung development in premature infants. Bethamethasone Treat: Increased ICP, Acidosis, ASA overdose Bicarb Treat CHF Systolic failure: increase LV clearing decrease preload: NTG, morphine, lasix decrease after load: nitroprusside increase contractility: dopamine Treat: crush injuries as well as mag antidote Calcium gluconate Neostigmine (Prostigmin) Scorpion stings Drug used for Non-Active Seizure Dilantin (phenytoin) Cerebryx Antibiotic for open Fx Invanz Anticonvulsant for Status Epileptic's

Phenobarbital Treats liver failure Lactulose Tidal Volume (TV) 6 - 8cc/kg PVR (pulmonary vascular resistance) o Afterload/resistance in the RIGHT side of the heart pumping to the lungs o Normal PVR = <250 dynes/sec/cm(-5) o High PVR (>250 dynes/sec/cm-5) - pulmonary hypertension Anion gap equation Na - (Cl + HCO3) Immediate life threatening injury secondary to major thoracic injury Lethal 7 Hidden 6 Lethal 7 Airway obstruction Tension Pneumo cardiac Tamp Open pneumo Massive Hemo Flail Chest Commotio cordis Hidden 6 (chest injury)

• Aortic rupture
• tracheobronchial disruption
• blunt cardiac injury
• diaphragmatic laceration
• esophageal perforation
• pulmonary contusion Fatal 5 hemorrhage
• chest
• abdomen and pelvis
• retroperitoneum
• long bones
• field/ floor acute upper airway obstruction sign

• Choking, inspiratory strider, wheezing in presence of cyanosis
• need to intubate
• after intubation, treat aspiration pneumonia with X-ray, IV antibiotics, and steroids Tylenol stages I. Flu-like II. 24-48hr "ow my liver" III. 72-96hrs "gonna die" IV. 4days+ "not dead yet" Heparin antidote protamine sulfate liver function tests group of blood tests that evaluate liver injury, liver function, and conditions commonly associated with the biliary tract diabetes insipidus (DI) antidiuretic hormone (ADH) is not secreted, or there is a resistance of the kidney to ADH Do not lower glucose levels more than? 100mg/do/hr TCA Nortriptyline (pamelor) amitryptyline (elavil) imipramine (tofranil) desipramine (norpramin) Weather minimums Day: 800', 2 miles Night: 800', 3 miles Boyle's Law A principle that describes the relationship between the pressure and volume of a gas at constant temperature Barometric pressure at sea level Sea level = 720 = 1ATM 18k MSL= 380torr = 0.5ATM 63K MSL= 0torr= 0ATM **Hyponatremia level for:
• AMS/seizure?
• Coma?**
• ams: under 130
• coma: under 120

PaCO2 normal range 35 - 45 mm Hg Bicarb Replacement Formula 0.1x (-BE)x Kg L.E.M.O.N L- Look Externally E- evaluate (3- 3 - 2) M- mallampati

1. posterior pharynx exposed
2. partial post pharynx
3. only see base of uvula
4. No structure seen O- obstructions N- neck mobility ET tube Placement Distal tip 2-3cm or T2-T Induction and paralytic change for hemodynamically unstable PT Double paralytic half induction Where are chemoreceptors Medulla and pons Gold standard for monitoring ventilations Capnography Endocarditis #1 cause IV drug abuse Janeway lesions: red on palm Olsar Node: Painful red fingertips Treat: Seizure from unknown pills HR:108. BP: 96/ Temp, Hot dry skin, QT prolongation Benzo Sz caused by TCA tox

Treat: HTN caused by HYPOthermia Nitroprusside increases CO by reducing afterload and increasing SV pulse rate reduces CO Hypothermia ranges Mild: 33-35C Moderate: 29-32C severe: under 29 Herniating prevention

• Position eyes forward
• reverse trendelenburg
• maintain euvolemia
• sedate
• neuromuscular blocking agent S/S of Herniation Change in LOC Change in pupil size abnormal motor response cushings ICP monitor location Foremen of Monroe Coopernail Genital bruising/ perineum Sign of Pelvic Fx. Neonate A-cyanotic Left to right shunt
• causes fluid backup and CHF
• Pulmonary HTN and hypoxia TX: 02, Morphine, Lasix, Digoxin,dobutamine,Epi Neonate cyanotic Right to left shunt
• needs prostaglandin
• SpO2: 75- 80

Treat: Esophageal Varices Sandostatin Treat: Pediatric Hepatomegaly and cardiomegaly Fluid restrictions and give digitalis Intubated asthma Pt Lower Vt and FiO High PEEP Treat: Anterior MI tx after MONA Beta Blocker and fibrinolytic Omphalocele Abdominal ring protrusion of viscera and requires surgery Gastrochesis Defect w/ completed development of internal organs, abdominal contents coming out one side. Warm moist dressing Posterior MI Reciprocal changes in v1-v Breech Delivery procedure Mauriceaus's Dont touch until umbilicus delivered palpate cord for FHR give suprapubic pressure to deliver head. After shoulders delivered, rotate baby's trunk so that back is anterior and apply downward traction "FLOP" I:E ratio in asthma 1: Mac Blade Curved. Lifts vallecula Adult urine output 30 - 50cc/hr Rhabdo: 100cc/hr

Vessels used for CABG

**- bypass RCA

• bypass LAD** RCA: saphenous vein LAD: inferior mammary art Signs of Thyroid storm HR> 140 hyperthermia unexplained jaundice pulmonary edema Vent settings for ARDS Increase PEEP and Fio pH: 7. PaCo2: 25 PaO2: 56 HCO3: 24 Uncompensated Resp. Alkalosis Brain Natriuretic Peptide (BNP) Heart Failure marker from over distension of heart below 100= normal above 500-700= HF Treatment: Tachycardia, AAA, Stroke, Pre-Eclampsia Labetalol Treatment: Cyanide Toxicity, HTN, AAA, stroke Nitroprusside (nitride) decreases after load Starting to see Herniation changes, what do you do?
• Paralyze, intubate, slightly hyperventilate (30-32)
• assure adequate O2 and fluids
• mannitol or hypertonic solution
• Barbituate coma
• decompression craniotomy

pH change 0. K+ changes? 0.6 in opposite direction AAA treatment Nipride & Beta Blocker Early Inflation Occurs before aortic valve closure (No dicrotic notch) HTN crisis w/o tachycardia Hydralazine

• good for CVA and Pre Eclampsia Which drug class can be used to control ventricular rates in A-FLUTTER Ca Channel and beta blocker used for ventricular control. Most patients need to be on anti-coag at the same time. Treatment: Acute Mountain Sickness Acetazolamide Dorsalis Pedis Artery (PDA) Main artery of foot Continuation of anterior tibial artery as it crosses ankle joint. STEMI protocol
• ASA
• Once STEMI noticed, activate cath lab
• door to balloon <120 min
• if PCI not available, evaluate for thrombolitic therapy Signs of tracheobronchial injury Hemoptysis air leak with chest tube Tx: advance ETT below level of injury into R. Mainstem