MCQ Flashcards

During a rotor-wing transport at 8,000 feet MSL, a patient's endotracheal tube cuff was inflated with air at sea level. What is the most appropriate management?

Answer: Deflate and reinflate the cuff with saline or water to a pressure of 20–30 cmH2O

Air-filled cuffs expand at altitude due to Boyle's Law, risking tracheal injury; filling with liquid prevents volume changes.

A flight nurse is assessing a patient with a suspected tension pneumothorax. Which finding is MOST specific for this diagnosis in the flight environment?

Answer: Absent breath sounds on the affected side with hypotension and JVD

The triad of absent breath sounds, hypotension, and JVD strongly indicates tension pneumothorax requiring immediate needle decompression.

Which IV fluid is MOST appropriate for initial resuscitation of a burn patient during aeromedical transport?

Answer: Lactated Ringer's solution

Lactated Ringer's is the gold-standard resuscitation fluid for burns as recommended by the Parkland formula.

A pediatric patient (15 kg) requires succinylcholine for rapid sequence intubation. What is the correct dose?

Answer: 30 mg (2 mg/kg)

Pediatric RSI dosing for succinylcholine is 2 mg/kg IV due to children's larger volume of distribution.

During scene response to a motor vehicle crash, which mechanism most reliably predicts severe injury requiring trauma center transport?

Answer: Death of an occupant in the same vehicle

Death of another occupant in the same vehicle is a CDC field triage criterion indicating a high-energy mechanism linked to severe injury.

A patient in hemorrhagic shock has received 2 units of packed RBCs. The MOST appropriate next step following a balanced resuscitation strategy is to administer:

Answer: 1 unit of fresh frozen plasma and 1 unit of platelets

Balanced (1:1:1) resuscitation with pRBC:FFP:platelets reduces coagulopathy and improves survival in hemorrhagic shock.

Which altitude-related physiological change MOST significantly affects a patient with a closed pneumocephalus (air in the cranial vault)?

Answer: Expansion of intracranial air increasing ICP

Boyle's Law causes trapped gas to expand at altitude, increasing intracranial pressure and worsening neurological status.