Paramedic CCT Critical Care Transport Exam 2026/2027 | Critical Care Paramedic Transport, Exams of Nursing

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Paramedic CCT Critical Care Transport Exam 2026/

| Critical Care Paramedic Transport

Fresh frozen plasma (FFP) requires ABO compatibility, no Rh citric acid may bind with calcium, causing hypertension hemolytic reaction palpitations, abdominal/back pain rapid onset caused by ABO incompatibility stop the infusion, keep urine output high at 100 ml/hr febrile reaction fever, flushing Caused by bacterial lipopolysaccharides and anti-leukocyte antibodies administer Tylenol IV continue infusion anaphylactic reaction rapid stop infusion, IV Benadryl Transfusion Associated Circulatory Overload (TACO)

occurs whenever presents with HTN, JVD stop infusion, lasix Transfusion Related Acute Lung Injury (TRALI) dyspnea, tachycardia, fever, cyanosis, acute pulmonary edema symptoms begin 1-6 hours leading cause of death, stop transfusion Brooke formula 2 ml x kg x BSA universal/consenus formula 4 electrical burns 3 pedi thermal burns 2 adult thermal burns parkland 4 ml x kg x BSA adynamic ileus decrease or loss of bowel motility, seen in patients with burns >20% Boyle's law low voltage <1000 volts high voltage

1000 volts alternating current (AC) tetanic contraction that "freezes" victim to source high potential for vfib explosive exit wound

hypothermia temps mild: 90-95 F (32.2-35 C) severe: below 90 F (32.2 C) shivering stops at 32 C hypothermia treatment warmed IV fluids at 39 C (102.2 F) severe hypothermia findings cardiac instability starts at 33 C (91.4 F) Osborn wave, J wave drowning considerations increased PEEP (pedi 30) divers should avoid flying for ___ hours after dive completion 12 greatest pressure changes occur at 4 feet below the surface arterial gas embolism transport pressurized aircraft (fixed) rotary wing <1000 ft MSL decompress sickness treatment high flow O avoid CPAP Nifedipine promotes pulmonary vasculature dilation HAPE/HACE treatment descend

Tylenol poisoning stage 1 flu symptoms Tylenol poisoning stage 2 liver injury Tylenol poisoning stage 3 peak liver enzymes Tylenol poisoning stage 4 recovery Acetylsalicylic Acid (Aspirin) overdose tinnitus, N/V respiratory alkalosis --> metabolic acidosis liver failure --> elevated ammonia ^ ICP beta blocker OD glucagon 5-10 mg followed by infusion 1-5 mg/hr calcium channel blocker OD (amlodipine, verapamil, cardigan, nifedipine) calcium chloride/gluconate cardiac dysrhythmia cardiac glycosides (digoxin) OD flu like symptoms, visual disturbances yellow/green halos EKG- slurred upslope on QRS cardiac glycosides (digoxin) OD treatment Digibind (Digoxin Immune Fab) Dilantin (Phenytoin) OD

Anticholinergic poisoning atropine, dramamine, diphenhydramine, Jimson weed Treat with physostigmine (0.5-2 mg slow IVP) Anticholinergic toxidrome mad as a hatter (ams) blind as a bat (dilated pupils) red as a beet hot as a hare (dry skin) dry as a bone (dry mucus membranes) SLUDGE Salivation Lacrimation Urinary incontinence Diarrhea GI Emesis hypoxic low oxygen stagnent hypoxia blood isn't moving high G forces, cariogenic shock hypemic hypoxia reduced O2 carrying capability of blood anemia, hemorrhage, carbon monoxide histotoxic hypoxia poisoning cyanide, alcohol, nitro, sodium nitroprusside, sildenafil stages of hypoxia

I ndifferent C ompensatory D isturbance C ritical causes of anion gap acidosis MUDPILES: Methanol, Uremia, DKA, Propylene, Iron, Lactate, Ethylene glycol, Salicylates changes during pregnancy cardiac output increased 20-40% hematocrit decreased preterm baby <37 weeks surfactant posters baby

42 weeks normal fetal heart rate (FHR) 120 - 160 BPM fetal heart rate monitoring internal: scalp monitor external: doppler number one cause of poor variability fetal hypoxia the single most important predictor of fetal wellbeing variability (V)EALS-(C)HOPE variable decelerations - cord compression

stage 1 of labor cervix relaxes stage 2 of labor uterine contractions increase in strength and the infant is delivered stage 3 of labor placenta is expelled emergency c-section indications sustained bradycardia (<120 BPM for >10 minutes) sinusoidal waveform Premature Rupture of Membranes (PROM) rupture of membranes before the onset of labor administer steroids to stimulate fetal lung maturity most common cause of preterm labor infection preterm labor treatment administer Tocolytics Terbutaline (Brethine) stops uterine contractions subcutaneous 0.25 mg q 15 mins Magnesium Sulfate loading dose 2-6 grams IV over 30 minutes continuous infusion 2-4 grams/hour Magnesium toxicity lack of deep tendon reflexes, pulmonary edema treat with calcium gluconate or chloride deep tendon reflexes

0: absent reflex 1+: reduced 2+: normal 3+: brisk 4+: clonus pregnancy-induced hypertension (PIH) treatment hydralazine HELLP hemolysis, elevated liver enzymes, low platelets treat with blood products, corticosteroids, antihypertensives, mag (seizure prophylaxis) Anaphylactoid syndrome of pregnancy (amniotic fluid PE) DIC and anaphylaxis together treat with fluids, increased PEEP, FFP gestastional diabetes uteroplacental insufficiency, hypoglycemia in newborn shoulder dystocia turtle sign, use McRoberts maneuver McRoberts maneuver sharp flexion of the maternal hips that decreases the inclination of the pelvis increasing the AP diameter of the free anterior shoulder Mauriceau's maneuver use with breech delivery fingers into birth canal to free babies nose for breathing abruptio placentae emergency painful, bleeding (or no external bleeding) blunt force trauma

right to left shunt PVR > SVR, likey to have a patent foramen ovale and patent ductus arteriosus neonatal sepsis most commonly caused by PROM neonatal fluid resuscitation 10 cc/kg neonatal respiratory distress can be caused by meconium treat with PPV, high PEEP, or surfactant respiratory distress syndrome (RDS) surfactant deficiency Gastroschisis abdominal contents are coming out of the body on one side of the umbilical cord omphalocele "o" abdominal ring, protrusion of viscera associated with congenital defects like diaphragmatic hernia febrile seizures each one degree change >37 C, HR increases to 10 BPM VP shunt considerations raise head of bed 30 degrees, semi fowlers Shaken Baby Syndrome (SBS) findings bulging fontanelles, increased ICP, retinal hemorrhages child with CHF cardiomegaly + hepatomegaly stop IV fluids, digitalis digitalis dose

15 - 40 mcg/kg over 24 hours most common congenital cardiac defect ventricular septal defect (VSD) patent ductus arteriosus administer PGE1, keeps it open administer Indocin, closes it coarctation of the aorta (CoA) narrowing (coarctation) of the aorta presents with pale skin, irritability, heavy sweating, dib, difficulty feeding Tetralogy of Fallot (TOF) right to left shunt, four defects together tet spells: sudden cyanosis and syncope treat with knees to chest, morphine, fentanyl, 100% O Transposition of the great arteries aorta and pulmonary artery are reversed (deoxygenated blood circulates) anterior fontanel closes 16 - 18 months posterior fontanel closes 2 months Pediatric fluid replacement increased renal function infant 2 ml/kg/hr pediatric 1 ml/kg/hr pediatric normotensive systolic BP 90 + 2(age) pediatric hypotensive systolic BP

Epiglottitis thumb sign xray lateral antibiotics, humidified O bronchiolitis

905 viral- RSV (respiratory syncytial virus) Waddell's triad

1. Femur Fracture
2. Intra-abdominal or intra-thoracic injury
3. Head injury unknown cause of ingestion in peds give flumazenil and narcan, per exam Normal pH 7.35-7. Normal CO 35 - 45 Normal HCO 22 - 26 (good dating age) Normal PaO 80 - 100 Normal SaO

95% Base (deficit/excess) (-2) - (+2) Buffer systems: Bicarb reaction time seconds

Buffer systems: Lungs reaction time minutes Buffer systems: Kidneys reaction time hours to days Minute volume calculation Tidal volume x respiratory rate pCO2 > acidotic pCO2 < alkalotic HCO3 < acidotic HCO3 > alkalotic base deficit of < - 4 indicator for the potential need for blood transfusion base deficit of < - 19 indicates poor outcome (death likely) base deficit replacement formula 0.1 x (-BE) x patient weight in kg = bicarb needed PO2 of 60 is roughly equivalent to a SaO2 of 90% critical pH for intubation < 7.