Critical Care Paramedic Review Flashcards

Preparing for your Critical Care Paramedic certification exam? MedicNerd.com now offers you the time-tested technique of flashcards. Despite their name, flashcards are not flashy, but they accomplish two vital things:

  1. Flashcards weed out the fluff & help you focus strictly on essential information
  2. Flashcards repetitively force your brain to recall that information when questioned

These are the very cards that MedicNerd.com’s Founder used to prepare and pass his Critical Care Paramedic certification exam.

You now have 24/7 access to our constantly updated CCP Review Flashcards…currently over 230 cards!

Now get to work below & invest the time in your education to pass your Critical Care Paramedic exam!

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Describe stagnent hypoxia

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reduction in cardiac output or circulatory system malfunction

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CAMTS: EVOC should be repeated how often?

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every 4 years

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List two medications frequently used in pre-term labor

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magnesium sulfate and terbutaline

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how do you calculate MAP?

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[(diastolic x 2)+systolic]/3

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Seizure: What is the pediatric dosage for Versed?

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0.15 mg/kg

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What is the normal expected urinary output for an adult patient with electrical burns?

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50 – 100 ml/hour

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What is an appropriate treatment for brain herniation?

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hyperventilation

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Where are Bark Scorpions primarily found?

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Arizona and Mexico

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Wolf-Parkinson-White (WPW) Syndrome is indicated on an ECG by what?

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delta wave (produced by early depolarization)

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What is the sedative of choice for children?

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Ketamine

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Describe hypemic hypoxia

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reduction of oxygen carrying capacity (ie, blood loss)

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OB: treatment of variable decelerations

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reposition the mother

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Outside pediatrics, Ketamine is considered the drug of choice for patients presenting with which medical condition?

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asthma

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List 3 relative contraindications to fibrinolytic therapy

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HTN, pregnancy, recent trauma

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What do we call the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream?

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rhabdomyolysis

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What is the core body temperature range for moderate hypothermia?

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30 – 34 C

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List 3 signs of brain herniation

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unequal or pinpoint pupils, coma, decorticate/decerebrate posturing

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When are escorts by law enforcement a good idea?

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never

escorts = bad

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List 4 contraindications to IABP therapy

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aortic aneurysm, aortic valve insufficiency, severe aortic disease, severe peripheral vascular disease

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Neonatal conditions: what is Tetrology of Fallot?

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a cyanotic heart defect that results in poor oxygenation of the blood; requires surgery to correct

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Lab Values: What is the normal range for Sodium (Na+)?

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136 – 142 mEq/L

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list three treatments for SIADH

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fluid restriction, 3% sodium chloride (hypertonic solutions), no hypotonic solutions

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Ventilators: What does PIP stand for?

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Peak inspiratory pressure

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The treatment goal for hyperglycemia is to reduce glucose levels by how much?

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no more than 100mg/dL per hour

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What does a dicrotic notch represent?

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in an artery wave form, the dicrotic notch (located on the descending side of the wave form) denotes closure of the valve immediately behind the catheter

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In patient’s with upper GI bleed, ______ and _______ can be given to help decrease bleeding by constricting blood flow through the liver.

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Octreotide (Sandostatin) and Vasopressin

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Capnography: square pattern is:

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normal breathing

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What lab test is used for monitoring Heparin therapy?

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PTT

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List 2 classic presentations of Digitalis toxicity

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flu-like signs/symptoms and visual disturbances (yellow/orange halos)…think of Van Gogh’s ‘Starry Night’

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What is the normal range for central venous pressure (CVP)?

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2 – 8 mm Hg

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FiO2 stands for?

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fraction of inspired oxygen

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Repeated doses of Etomidate can result in what condition?

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acute adrenal insufficiency

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What is the term used to describe typical DKA breathing?

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kussmaul

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OB: when testing variability, what is moderate variability?

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acceleration in fetal HR of 10-25 bpm

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What is the core body temperature range for severe hypothermia?

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less than 30 C

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Aspirin overdose results in respiratory _________.

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alkalosis

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What does CVP stand for?

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central venous pressure

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Seizure: What is the pediatric dosage for Cerebyx?

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10-20 mg/kg

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What are the signs and symptoms of pit viper bite?

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local pain, edema, tachycardia, numbness, parasthesias, bleeding disorder, vomiting, confusion

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OB: early decelerations are associated with what and seen when?

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associated with head compression and seen in active labor and mirrors contractions

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What two electrolyte abnormalities should you expect to find in a treated burn patient (especially when normal saline is used)?

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hyperkalemia (elevated potassium) and hypernatremia (elevated sodium)

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Seizure: What is the pediatric dosage for valium?

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0.1-0.3 mg/kg

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OB: when testing variability, what is average variability?

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acceleration in fetal HR of 6-10 bpm

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Which of the following can result in high-pressure alarms? hypovolemia, connections, pneumothorax, obstructions

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connections, pneumothorax, obstructions

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What is the formula used to calculate Minute Volume (Ve)?

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Rate (f) x Tidal Volume (Vt)

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What is the normal ejection fraction for an adult?

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55 – 70%

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Spinal cord injuries: What causes Brown-Sequard Syndrome?

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caused by penetrating injury resulting in hemisection of the cord; only involves one side of the cord

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A BNP (B-type natriuretic peptide or brain natrirretic peptide) is a test used to evaluate what?

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heart failure

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What is fetal hydrops (hydrops fetalis)?

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a condition in which abnormal amounts of fluid build (edema) up in two or more body areas of a fetus or newborn

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What is normal inspiratory:expiratory (I:E) ratio?

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1:2

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Spinal cord injury: How would Brown-Sequard Syndrome present?

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weakness in arm and leg of the injured side; pain and temperature loss on the opposite side of the injury

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Vent settings: What is the goal plateau pressure setting?

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less than 30cm of water

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Define: respiratory alkalosis

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pCO2 below normal value

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describe compartment syndrome

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compression of nerves and blood vessels within the injured area

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What is the only depolarizing agent used in the United States?

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succinylcholine

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Increased AHD effects on sodium level, osmolality, and urinary output:

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decreased sodium levels, decreased osmolality, decreased urinary output

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Succinylcholine should be avoided in what patients because it causes prolonged paralysis?

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organophosphate poisonings

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OB: What is the treatment for amniotic embolism?

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oxygen, IV fluids, and rapid transport

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Lab Values: What is the normal range for Platelets (Plt)?

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150 – 350 × 10³/µL

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OB: patients, what is variability?

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fluctuation in response to stimulus (measured over 60 seconds) is a good indicator of fetal well being

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Arterial Blood Gases: What is the normal range for PCO2?

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35 – 45

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Arterial Blood Gases: What is the normal range for HCO¯3?

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21 – 28 mEq/L

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List two presentations of placenta previa

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bright red blood and painless

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List 4 absolute contraindications to fibrinolytic therapy

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active internal bleeding, suspected aortic dissection, hemorrhagic stroke, intracranial neoplasms (cancers)

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Rhabdomyolysis is most harmful to what organ?

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kidney

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Capnography: elevated baseline indicates:

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re-breathing of CO2

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Decreased ADH effects on sodium level, osmolality, and urinary output:

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increased sodium levels, increased serum osmolality, increased urine output

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What is the normal stroke index?

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25 – 45ml per meter squared

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Anticonvulsants: list the 4 anticonvulsants used for pediatrics

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valium, versed, ativan, cerebyx

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List four treatments for hypernatremia (high sodium)

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sodium bicarb, insulin, dextrose, kayexalate

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In treating hyperglycemia, administering insulin will result in a decrease of what (not BGL) and ought to be supplemented?

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potassium and no more than 10 mEq IV per hour

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List two treatments for DKA treatment

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insulin, fluids

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Arterial Blood Gases: What is the normal range for pH?

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7.35-7.45

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What are the basic vital sign goals when treating a patient with a thoracic or abdominal aortic aneurysm?

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HR of 60-80 bpm, SBP of 100-110 mm Hg, MAP of 70-75

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Why would a treated burn patient be hypernatremic?

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from the retention of salt contained in IV fluids used for fluid resuscitation

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For what degree burns do you use in the parkland formula?

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2nd and 3rd degree burns only

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When treating patients with thoracic or abdominal aortic aneurysm, what is the preferred drug of choice?

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beta-blockers (labetalol, esmolol)

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What does ICP stand for?

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intracranial pressure

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Lab Values: What is the normal range for osmolality?

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275 – 295 mOsm/kg

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What is the usual BGL for a patient experiencing DKA?

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400-900

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Post-partum complications: What is the most common cause of maternal death?

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pulmonary embolism

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What is the antidote for a Heparin overdose?

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protamine sulfate

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How do you calculate CPP?

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MAP – ICP

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Mixed Venous Blood Gases: What is the normal range for PCO2?

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40 – 50

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With Aspirin overdose, which ABG abnormality will be noted first?

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metabolic acidosis

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Which two lab values are used for monitoring kidney function?

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BUN & creatinine

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What does “SIADH” stand for?

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syndrome of inappropriate ADH (antidiuretic hormone)

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What is normal range for intracranial pressure (ICP)?

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0 – 15 mm Hg

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Is a patient in HHNK acidotic or not?

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not acidotic

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Use of magnesium sulfate is common in women who are in pre-term laobr. If _________ are absent due to magnesium toxicity, turn the infusion off.

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deep tendon reflexes (DTR’s)

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What affect does ADH have on the kidneys?

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causes increased water reabsorption into the blood; results in lower volume of higher concentrated urine

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OB: treatment of early decelerations

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monitor the patient

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Lab Values: What is the normal range for Potassium (K+)?

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3.5 – 5.0 mEq/L

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PIP stands for?

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peak inspiratory pressure

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Lab Values: What is the normal range for Magnesium (Mg)?

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1.3 – 2.1 mEq/L

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What is the normal range for MAP?

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80-100

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List two presentations of placental abruption (abruptio placentae)

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dark red blood and shearing pain

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Lab Values: What is the normal range for Calcium (Ca++)?

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8.2 – 10.2 mg/dL

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Mixed Venous Blood Gases: What is the normal range for HCO-3?

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22 – 26 mEq/L

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DOPE stands for?

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dislodgment, obstructions, pneumothorax, equipment

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Patient presents with unconsciousness, posturing, signs/symptoms of increased ICP, but has a normal CT scan…what do you suspect?

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DAI (diffuse axonal injury)

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When using the Parkland formula, how much and when is the fluid administered?

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1/2 of the volume given in the first 8 hours from time of burn; the remaining volume is given over the next 16 hours

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pH above normal value…is this acidic or alkaline?

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alkaline

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OB: describe variable decelerations and what it is associated with

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described as abrupt onset of variable fetal HR with quick recovery; associated with short cords, nuchal cords, and amniotic fluid deficiency

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Neonatal conditions: what are Tet Spells and how are they treated?

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periods of cyanosis after eating or crying; treated with oxygenation (ie, bagging the patient) until resolved

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This injury involves severe mechanical disruption of the axons in both cerebral hemispheres & often extends to the brainstem

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diffuse axonal injury (DAI)

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When administering meds, is delivery to circulation faster via the IV or IO route?

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neither, they are both effective means of vascular access

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What IV fluid is used in burn patients?

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LR

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Arterial Blood Gases: What is the normal range for PO2?

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80 – 100 mm Hg

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What is the treatment of a pit viper bite?

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ABC’s, keep the patient calm, administer CroFab anti-venom

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What is normal positive end-expiratory pressure (PEEP)?

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3 cm H2O

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Capnography: shark fin indicates:

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bronchospasm

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Describe Marfan’s Syndrome

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genetic disorder causing tall stature; long forearms, legs, and fingers; and a concave chest (pectus excavatum)

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What is the treatment of rhabdomyolysis?

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early and aggressive fluids (hydration)

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What is a common finding in hydrofluoric (HF) acid exposure and the treatment?

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hypocalcemia treated with calcium gluconate

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Describe HHNK breathing

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LTBB…lucky to be breathing!

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List three treatments for diabetes insipidus (DI)

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give ADH (pitressin), give fluids, monitor ECG for ischemia

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What is normal CVP?

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dehydration…(2 – 8)…fluid overload

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What can be administered to reverse the effects of magnesium toxicity?

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calcium gluconate

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What is the normal amount of cardiac output per minute for an adult?

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4 – 8 liters per minute

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What does hemotoxic venom do to the patient?

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disrupts the normal clotting cascade

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Spinal cord injuries: Describe how anterior cord syndrome occurs

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usually from hyperflexion

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When treating elevated ICP, maintain PCO2 in what range?

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25 – 35 mm Hg

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OB: This presents during or after delivery when amniotic fluid enters maternal circulation from a tear in the placenta, often from placenta previa or placenta abruption

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amniotic fluid embolism

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Why would a treated burn patient be hyperkalemic?

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caused by tissue and cell destruction

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The administration of succinycholine is contraindicated in which condition/state?

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hyperkalemia

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What is the usual level of dehydration during DKA?

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4-6 liters

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What is the treatment for Bark Scorpion sting?

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suction secretions and secure the airway

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Spinal cord injuries: How would anterior cord syndrome present?

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loss of motor function and sensation to pain, temperature, and light touch

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List two causes of diabetes insipidus (DI)

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head problem, dilantin (remember starts with “DI”)

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Aspirin over dose results in metabolic ________.

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acidosis

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A patient exposed to a burned carpet complains of SOB and coughing, what may be the cause?

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cyanide poisoning

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What is the treatment for mild hypothermia?

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passive re-warming, active external re-warming

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What is the minimum goal coronary perfusion pressure?

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50

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Rule to keep in mind in regards to administering potassium: never give more than ___ per hour IV

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10mEq

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Define: metabolic acidosis

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HCO3 below normal value

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What is the core body temperature range for mild hypothermia?

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34 – 36 C

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What kind of dressing do you place over a burn?

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sterile dry

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You are transporting a patient who was just recently paralyzed for intubation. He becomes tachycardic, presents with significant muscle rigidity, his ETCO2 is noted to climb despite proper ETT placement, and becomes hyperthermic. What emergent condition should you suspect and how to treat?

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malignant hyperthermia, treated with dantrolene

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What does CPP stand for?

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cerebral perfusion pressure

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What is the treatment for severe hypothermia?

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active re-warming, warm IV fluids, warm/humidified oxygen, handle gently

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Which of the following can result in low-pressure alarms? hypovolemia, connections, pneumothorax, obstructions

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hypovolemia and connections

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In new borns, what is patent ductus arteriosus (PDA)?

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when the ductus arteriosus does not close allowing some oxygenated blood to to move back into the heart rather than enter circulation

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List 3 causes of SIADH

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oat meal cell carcinoma, viral pneumonia, head problem

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What is the Parkland formula?

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4ml x kg x %burn

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Describe histotoxic hypoxia

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cells can’t use molecular oxygen (ie, cyanide, ETOH, or carbon monoxide)

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pH below normal value…is this acidic or alkaline?

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acidic

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Ventilators: What is the expected dead space?

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approximately 2mL/kg or weight in pounds

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What is your RSI induction medication of choice for a young pediatric patient with exacerbation of asthma?

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Ketamine

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Seizure: What is the pediatric dosage for Ativan?

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0.05-0.1 mg/kg

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What medication is used to close PDA’s in premature infants?

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indocin (indomethacin)

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Ketamine provides a reliable level of sedation and has ________ properties

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bronchodilator

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What is Wolf-Parkinson-White (WPW) Syndrome?

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the heart has an extra electrical pathway (circuit); can lead to episodes of rapid heart rate

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Lab Values: What is the normal range for Chloride (Cl-)?

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96 – 106 mEq/L

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With a patient in DKA, are excess ketones detected?

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yes

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Ventilators: To what is the Tidal Volume (Vt) usually set?

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7 – 10 mL/kg of ideal body weight

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OB: what is the preferred medication to treat pre-term labor for a patient with a cardiac history?

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terbutaline

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Spinal cord injuries: Describe how a central cord injury usually occurs

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usually occurs with hyperextension or flexion of the cervical region

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What is the treatment for moderate hypothermia?

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passive re-warming, active external re-warming, IV medications as needed

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List 3 classic signs of meningitis

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fever, nuchal rigidity (stiff neck), and Brudzinski’s sign

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Long term use of Nitroprusside can lead to what type of poisoning?

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cyanide

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A patient suffers a crush injury after a stack of wood fell onto his lower extremity. After the wood is removed, the patient’s extremity is ashen in color and pulseless. What do you suspect?

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compartment syndrome

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Pediatric Scenario: you have a 4kg female seizing, what is your Cerebyx dosage?

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80 mg

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What is the treatment for organophosphate poisoning?

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Atropine 2mg and Pralidoxime 1-2G

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Ventilator issues: What is the most common cause of high pressure alarms?

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asynchronous breathing (the patient breathing against or out of sync with the ventilator)

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What is the usual BGL for a patient experiencing HHNK?

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1000-2000

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Define: metabolic alkalosis

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pCO2 above normal value

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Spinal cord injuries: How would a central cord injury present?

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weakness or parasthesias in the upper extremities

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What are used to prevent closure of PDA’s in patient’s with other underlying issues (i.e., transposition of great vessels)?

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prostaglandins

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What is the normal cardiac index?

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2.5 – 4.2 liters per minute per meters squared

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Describe the injury caused by an alkali burn (pH greater than 7)

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leads to saponification (hydrolysis) of lipids (fats) and causes fatty tissue to lose its function

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Definition: this looks at factors related to personal attributes, vector or agent attributes, and environmental attributes before, during, and after an injury or death

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Haddon Matrix

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HHNC is caused by:

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increased glucose levels often secondary to stress; patient still makes insulin

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What is a normal wedge pressure (PCWP)?

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8 – 12 mmHg

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PEEP stands for?

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positive end expiratory pressure

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List two treatments for HHNK treatment

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fluids, little insulin

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Who are most at risk from Bark Scorpion stings?

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Crumb-Crunchers and Old Farts

(the very young and the elderly)

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What is a common cardiac characteristic found in patients with Marfan’s Syndrome?

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a dilated aorta, putting the patient at a higher risk for aortic aneurysm and rupture

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What is the only pit viper that injects neurotoxic venom?

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Mojave rattlesnake