Cardiovascular Emergencies Flashcards

A flight nurse is transporting a patient with suspected cardiac tamponade. Which hemodynamic triad (Beck's Triad) is classically associated with this condition?

Answer: Hypotension, muffled heart sounds, and jugular venous distension

Beck's Triad for cardiac tamponade consists of hypotension, muffled heart sounds, and jugular venous distension (JVD).

During air transport, a patient develops a wide-complex tachycardia at 180 bpm with a pulse. The patient is hemodynamically stable. What is the most appropriate initial intervention?

Answer: Amiodarone 150 mg IV over 10 minutes

For stable wide-complex tachycardia of unknown origin, amiodarone 150 mg IV over 10 minutes is the preferred pharmacologic treatment.

A patient in the flight environment has a systolic BP of 70 mmHg, HR 120 bpm, and shows signs of right heart failure. Which vasopressor is preferred to avoid increasing pulmonary vascular resistance?

Answer: Norepinephrine

Norepinephrine is preferred in right ventricular failure as it improves systemic vascular resistance while having less effect on pulmonary vascular resistance than vasopressin or high-dose dopamine.

A CFRN is caring for a patient with an IABP (intra-aortic balloon pump) during transport. The balloon should inflate and deflate in relation to the cardiac cycle in which way?

Answer: Inflate during diastole, deflate just before systole

The IABP inflates during diastole to augment coronary perfusion and deflates just before systole to reduce afterload.

Which ECG finding is most consistent with hyperkalemia in a patient being transported after a crushing injury?

Answer: Peaked T waves and widened QRS complex

Hyperkalemia classically causes peaked (tall, narrow) T waves and progressive QRS widening, which can degrade into a sine-wave pattern.

During a rotor transport at high altitude, a patient with STEMI receives fibrinolytic therapy. Which finding represents a sign of successful reperfusion?

Answer: Development of accelerated idioventricular rhythm (AIVR) and decreasing ST elevation

Reperfusion after fibrinolysis is suggested by accelerated idioventricular rhythm, resolution of ST elevation, and relief of chest pain.

A flight nurse is managing a patient with Type A aortic dissection during transport. Which medication class is the priority to initiate first for blood pressure and heart rate control?

Answer: Beta-blockers

Beta-blockers are initiated first in aortic dissection to reduce heart rate and dp/dt (rate of pressure rise) before adding vasodilators to avoid reflex tachycardia.