CCT-Flashcards

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Tmc9
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129381
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CCT-Flashcards
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2012-01-21 20:57:53
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  1. Kehr's sign
    • referred left shoulder pain
    • ?sleen or eptopic
  2. Kernig's sign
    • back, leg pain on knee extension
    • ?bacterial meningitis
  3. Brudzinki's sign
    • back, leg pain on neck flexion
    • ?bacterial meningitis or subarachnoid bleed
  4. Hamman's sign
    • crunching sound heard on auscultation over the anterior chest with heartbeat
    • ?tracheobracheal injury
  5. pco2 high
    • pH low
    • acidosis
  6. pco2 low
    • pH high
    • alkalosis
  7. pH low
    • HCO3 low
    • acidosis
  8. pH high
    • HCO3 high
    • alkalosis
  9. PCO2 lab values
    • 35-45
    • respiratory
  10. pH lab values
    • 7.35-7.45
    • metabolic
  11. HCO3 lab values
    • 22-26
    • metabolic
  12. drugs for AAA
    Nipride and beta-blockers
  13. first adjustment on ventilator
    TV first, not rate
  14. most common dislocation
    hip
  15. most common sponateous recurrence of dislocation
    anterior shoulder
  16. brain natriuretic peptid BNP (3)
    • heart failure markers due to overdistension
    • below 100 is normal
    • 500-700+ is heart failure
  17. rotor wing pilot required hours
    • 2000 hours
    • 1000 PIC
    • 100 hours at night
  18. CVP (measures, norm, port)
    • right side preload
    • 2-6
    • proximal port
  19. catheter markers (3)
    • RA/CVP=25-30
    • RV = 35-45
    • PA = 50-55
  20. anterior spinal cord injury
    complete motor, pain and temperature loss below level of lesion
  21. Brown spinal cord injury
    ipsilateral loss of motor, position and vibration
  22. Central cord injury
    greater motor weakness to UE than LE
  23. Autonomic Dysreflexia
    • urinary retention
    • massive increase in sympathetic tone
    • causes increase in HTN
    • tx-foley catheter
  24. adult blood volume
    70 ml/kg
  25. peds blood volume
    80 ml/kg
  26. mild hypothermia
    • 32-36
    • decreased heart rate
  27. moderate hypothermia
    • 29-32
    • loss of shivering
    • ALOC
  28. severe hypothermia
    • 20-28
    • coma
    • VF
  29. two major causes of heat loss
    • radiation
    • evaporation
  30. thermoregualtion ceases
    28 degrees
  31. rules of flight following
    • 15 minutes max between comm center during flight
    • 45 minutes max on ground
  32. rotor wing shutoff
    • throttle
    • fuel
    • battery
  33. survival sequence
    • shelter
    • fire
    • water
    • food
  34. order of assessment for abdomen
    • inspect
    • auscultation
    • palpation
    • percussion
  35. contraindications for thrombolytics
    • hx of hemmorhagic stroke
    • CVA last 12 months
    • SBP over 180
    • pregnancy or 1 month post partum
  36. PaO2
    Plasma measured as pressure
  37. SaO2
    hemoglobin measured as percentage
  38. bariobariatrauma
    • nitrogen release in obese pts
    • tx w high flow o2 15min prior to takeoff
  39. peds SBP
    90+2xage
  40. peds DBP
    2/3xSBP
  41. three killers of ventilator patients during flight
    • pericardial tamponade
    • tension pneumothorax
    • hypovolemia
  42. crush injury killer
    renal failure
  43. complications of crush injury
    • DIC
    • compartment syndrome
    • renal failure
    • hyperkalemia
  44. Charles' law
    • temperature and volume proportional
    • temp up=volume up
    • up 100meters=down one degree centegrade
  45. Henry's law
    • gas in liquid proportional to gas above liquid
    • the bends, decompression, soda can, co2 in blood
  46. Dalton's law
    • tissue swelling
    • hypoxic hhypoxia, o2 available at altitue
  47. Graham's law
    • gas moves from high to low concentration
    • cellular gas exchange, diffusion
  48. boyle's law affects which area?
    what law affects the GI the most?
  49. Gay-Lussac's law
    • temp up=pressure up
    • o2 tank pressure in heat and cold
  50. Boyles law
    • increased volume=decresased pressure
    • IABP purges with ascent or descent
    • BP cuff
    • ETT cuff
    • MAST
  51. High velocity
    +2000 FPS
  52. Medium velocity
    1000-2000 FPS
  53. Low velocity
    under 1000 FPS
  54. CVP value
    2-6
  55. Cardiac output value and formula
    • SV x HR
    • 4-8 lpm
  56. CI value
    2.5-4.2
  57. PAS/PAD value
    15-25/8-15
  58. PAWP value
    8-12
  59. SVR value
    800-1200
  60. chest tube location
    4th ICS, anterior auxillary
  61. needle thorocostomy site
    2nd ICS midclavicular or the 5th ICS anterior mid-auxillary line
  62. scaphoid abdomen indicates
    diaphragmatic rupture
  63. suspect with the fx of first 3 ribs
    aortic disruption
  64. abruptio placenta
    dark red, painful
  65. placenta previa
    red, painless
  66. terbutaline dose
    .25 SQ
  67. post partum hemorrhage
    over 500ml EBL
  68. uterine rupture
    fetal parts can be palpated over abdomen
  69. effects of altitude worsen with
    cold upper latitudes
  70. Universal law
    combines boyles and charles lawas
  71. passive rewarming
    • mild hypothermia only
    • blankets
    • ambient temperature
  72. active rewarming
    apply heat to body
  73. warm and dead
    32 degrees
  74. heat stroke
    over 42 degrees
  75. cullen's sign
    • umbilical discoloration
    • ?pancreatitis
  76. levine's sign
    • fist to chest clutching
    • ?cardiac
  77. grey turners sign
    • flank bruising
    • ?retroperitoneal bleeding
  78. coopernail's sign
    • scrotum/labia
    • ?abdominal/pelvic bleeding
  79. Halstead's sign
    • marbled abdomen
    • ?bleeding
  80. Cullen's sign
    • umbilical discoloration
    • ?pancreatitis
  81. Murphy's sign
    • RUQ pain with inspiration
    • ?gallbladder
  82. hypoxic hypoxia
    • altitude hypoxia
    • decreased alveolar o2
    • tension pneumo (eg altitude)
  83. hypemic hypoxic
    decreased o2 carrying capacity in blood
  84. histoxic hypoxia
    poisoning (nitrates)
  85. stagnant hypoxia
    • decreased cardiac output
    • poor circulation (eg g-forces, chf)
  86. normal FHR
    120-160
  87. factors fetal well bein
    • FHR
    • fetal movement
    • variability (most important)
  88. tx for fetal distress
    • LOCK:
    • left lateral recumbent
    • o2
    • correct contributing factors
    • reassurence
  89. CHF Preload
    • most pts are hypovolemic
    • careful with diuretics and other meds
  90. CHF labs
    BNP >500
  91. CHF medication
    • no beta blockers except for carvidolol (coreg)
    • natracor (nesteride) a synthetic version of BNP
  92. primary cause of death with vent dependent pts
    ventilator acquired pneumonia
  93. Digoxin class
    cardiac glycoside
  94. Digoxin causes what electrolyte imbalance
    hypokalemia
  95. digoxin ECG changes
    dig dip
  96. ARDS tx
    PEEP
  97. ARDS xray
    • widespread infiltrates
    • broken glass appearance
  98. effects of PEEP
    • increased pulmonary vascular resistance
    • can sause hypotension over 15cm h2o
  99. Normal physiologic PEEP
    3-5
  100. dehydration raises which serum
    sodium
  101. normal sodium level
    135-145
  102. bowel sounds heard in chest cavity
    • diaphragmatic rupture
    • usually left side
  103. preferred method for moving spinal pt
    scoop stretcher rather than logroll
  104. pulmonary contusion
    • low sats despite o2
    • rales
  105. ruptured diaphragm
    chest/abd pain radiating to left shoulder
  106. tracheobronchial injury
    • hemotypsis
    • subq air
    • air leak with chest tube
    • advance ETT below injury
  107. esophageal perforation
    • fever
    • hematemesis
  108. fat embolus
    • fever
    • rash after fx
  109. humerus blood loss
    750 ml
  110. femur EBL
    1500ml
  111. high wedge pressures (3)
    • pulmonary congestion
    • CHF
    • cardiogenic shock
  112. normal wedge
    8012
  113. ett depth
    • adult 3xETT size
    • peds 10+years
    • neonate 6+kg
  114. on vent, to change co2
    • adjust rate
    • TV
  115. on vent, to change oxygenation
    adjust PEEP, PAP
  116. induction agent of choice for bronchospastic pt
    ketamine (ketalar)
  117. Ativan indication, dose, max
    • lorazepam
    • sz
    • 1-2mg
    • max 4mg
  118. mannitol dose
    1-2g/kg
  119. drug for cyclic depressant OD
    sodium bicarb
  120. drug choice for betablocker OD
    glucagon
  121. fentanyl dose
    sublimaze 3 mic/kig
  122. tx for malignant hyperthermia
    dantrium (dantrolene)
  123. drug for GI bleeds
    sandostatin (octreotide)
  124. maintain aterial line bag pressure at
    300mmhg
  125. most common reperfusion dysrhythmia
    AIVR
  126. most common hypothermia dysrythmia
    • VF
    • osbourne wave
  127. hypokalemia on ecg
    peaked p's, flat t's
  128. hyperkalemia on ecg
    • flat p's, peaked t's
    • tx with calcium
  129. MAP goal with CHI
    map 80-100
  130. CPP goal with increased ICP
    CPP 70-90
  131. normal ICP
    0-10
  132. normal CPP head
    70-90
  133. normal MAP
    80-100
  134. normal for CPP heart
    50-60
  135. CPP formula head
    MAP-ICP
  136. MAP
    (2xdiastolic+systolic)/3
  137. CPP formula heart
    DBP-wedge
  138. day rotor wing restrictions
    • 1 mile
    • 500 ft ceiling local
    • 1000 ft ceiling x-contry
  139. night rotor wing restrictions
    • local 500ft ceiling 2mile
    • x country 1000ft ceiling and 3 mile
  140. number one cause of medical crashes
    • controlled flight into terrain
    • pushing the weather
  141. normal potassium
    3.5-5.5
  142. normal sodium
    135-145
  143. normal chloride
    95-105
  144. normal calcium
    8.5-10.5
  145. metabolic acidosis elevates which electrolyte
    potassium
  146. ischemia
    st depression
  147. injury
    st elevation
  148. infarct
    q wave >25% the height of r wave
  149. peds guidlines
    • uncuffed tube under 10
    • needle cric only under 11
    • no nasal intubation under 12
  150. primary cause of PTL
    infection
  151. terbutaline contraindications
    • IDDM
    • maternal HR over 120
  152. PIH triad signs
    • HTN
    • edema
    • proteinuria
  153. CMV vent mode
    • preset volume or PIP at set rate
    • pt can't initiate breath
  154. AC vent mode
    • preset volume or PIP with every breath
    • can trigger breath
    • can't control TV
  155. IMV vent mode
    • preset breaths, TV, PIP
    • pt breaths allowed
  156. SIMV vent mode
    allows variation of support
  157. IABP action
    increase CO, coronary perfusion
  158. IABP deflates
    during ventricular systole
  159. IABP dicrotic notch
    • aortic valve closing
    • syncronized with a-line or ECG (most common)
  160. IABP s/s of balloon leak
    • blood specs in tubing
    • alarm
  161. IABP clot prevention
    cycle manually every 30 minutes
  162. IABP increases CO by
    10-20%
  163. IABP balloon rupture s/s
    rusty flakes in tubing
  164. IABP migration/dislodged
    • assess left radial
    • urine output
  165. lethal IABP timing cycles
    • late deflation
    • early inflation
  166. Oxyhemoglobin disassociation curve left shift (6)
    • l for low
    • hemoglobin holding o2
    • alkalosis
    • low co2
    • low temperature
    • low DPG
    • mxydema
  167. oxyhemoglobin disassociation curve right shift (5)
    • r for raise/releases oxygen
    • acidosis
    • raised co2
    • raised temp
    • raised DPG
    • thyroid storm
  168. mild HTN
    140-160/90-100
  169. moderate HTN
    160-180/100-110
  170. severe HTN
    over 180/110
  171. volume for RBC administration
    10 ml/kg
  172. volume for WBC
    20 ml/kg
  173. ABG co2 and pH
    co2 up 10 = pH down .08
  174. ABG bicarb and pH
    HCO3 up 10 = pH up 15
  175. ABG bicarb replacement
    kg/4 x base deficit
  176. ABG pao2 at altitude
    drops 5 for every 1000' elevation
  177. night vision lost
    5,000' MSL
  178. PAC pressure bag set to 7.3 mmHg
  179. normal CI
    2.5-4.3
  180. Stressors of flight (9)
    • third spacing
    • fatigue
    • g-forces
    • noise
    • vibration
    • hypoxia
    • dehydration
    • temp changes
    • barometric pressure changes
  181. Personal facters effecting stressors of flight
    • DEATH
    • drugs
    • exhaution
    • alcohol
    • tobacco
    • hypoglycemia
  182. Dalton's law
    • sum total of partial pressure equal to total atm
    • tissue swelling
    • altitude hypoxia
    • hypoxic
    • hypoxia
  183. thrombolitics must be administered within
    three hours of chest pain
  184. acute respiratory failure
    • po2 below 60
    • pco2 above 50
  185. newtons 1st law
    an object in motion tends to stay in motion
  186. newton's 2nd law
    force=massxacceleration
  187. newton's 3rd law
    every action has = and opposite reaction
  188. tetralogy of fallot (TOF)
    • PROV
    • p=pulmonary stenosis
    • r=right ventricular hypertrophy
    • o=overriding aorta
    • v=ventricular septal defect
  189. a wave
    • rise in atrial pressure as a result ot atrial concentration
    • correlates with PR interval
  190. c wave
    • not always visible on tracing
    • rise in atrial pressure which closure ot the AV valves bulge upward
    • mid to late QRS
  191. v wave
    • rise in atrial pressure as it refills during ventricular contraction
    • seen after peak of t wave
  192. x wave
    decline in righ atrial pressure during atrial relaXation
  193. y wave
    decline in right atrial pressure resulting from atrial emptYing
  194. record pressure measurement
    at the end of exhalation
  195. z point
    • a line drawn from end of QRS to hemodynamic tracing
    • delayed 0.08-0.12 on PAWP
  196. CO formula
    HR x stroke volume
  197. dicrotic notch
    closure of the aortic valve
  198. maintains the PDA open
    prostaglandin (PGE1)
  199. close the PDA
    • o2
    • indomethacin
  200. 32 weeks or less in gestation
    surfactant development
  201. common cause of sz in neonates
    • hypoglycemia less than 40 mg/dl
    • hypoxia
  202. neonate scaphoid abdomen
    diaphragmatic hernia managed with orogastric tube and PPV
  203. CPK greater than 20,000
    • indication of later DIC
    • acute renal failure
    • dangerous hyperkalemia in the heatstroke pt
  204. anion gap
    • normal 12+/- 4
    • more than 16 indicates underlying metabolic acidosis
    • MUDPILES

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