CFRN Flight and Transport 5 â Questions and Answers
Question 1: When calculating oxygen supply for a ventilated patient being transported on a fixed-wing aircraft, the formula for E-cylinder duration is:
- (Gauge PSI Ã 0.3) / flow rate = minutes
- (Gauge PSI Ã 0.28) / flow rate = minutes (Correct answer)
- (Gauge PSI Ã 0.3) / tidal volume = minutes
- (Gauge PSI â 200) Ã 0.28 / flow rate = minutes
Correct answer: (Gauge PSI Ã 0.28) / flow rate = minutes
For an E-cylinder, the constant is 0.28; multiply gauge PSI by 0.28 and divide by flow rate in L/min to get minutes of supply remaining.
Question 2: A patient is being transported via helicopter following a diving accident with suspected decompression sickness. The flight nurse should request the pilot fly at:
- The maximum service ceiling to speed transport
- The lowest safe altitude, ideally below 1,000 feet AGL (Correct answer)
- Exactly 8,000 feet cabin altitude as per standard protocol
- Altitude does not affect decompression sickness management
Correct answer: The lowest safe altitude, ideally below 1,000 feet AGL
Flying at the lowest safe altitude minimizes further nitrogen bubble expansion per Boyle's Law, reducing the risk of worsening decompression sickness.
Question 3: During air medical transport, the primary cause of spatial disorientation in flight crew is:
- Hypoxia causing visual blurring
- Conflicting signals between the vestibular system and visual system (Correct answer)
- CO2 retention from mask-based oxygen delivery
- Auditory overload from engine noise exceeding 90 dB
Correct answer: Conflicting signals between the vestibular system and visual system
Spatial disorientation results from the vestibular system's misleading proprioceptive signals conflicting with visual references, particularly in IMC conditions.
Question 4: A patient receiving a heparin infusion during air transport develops signs of heparin-induced thrombocytopenia (HIT). The flight nurse's priority action is:
- Slow the infusion rate by 50% and reassess in 20 minutes
- Discontinue the heparin infusion and notify receiving facility (Correct answer)
- Switch to a low-molecular-weight heparin as an alternative
- Administer protamine sulfate immediately
Correct answer: Discontinue the heparin infusion and notify receiving facility
Heparin must be immediately discontinued if HIT is suspected; continuing it risks life-threatening thrombosis, and protamine is not indicated for HIT.
Question 5: Night vision goggles (NVGs) used in air medical operations amplify which part of the electromagnetic spectrum?
- Ultraviolet light (200â400 nm)
- Near-infrared light (700â900 nm) (Correct answer)
- Mid-wave infrared thermal emissions (3â5 Ξm)
- Visible blue-green spectrum (400â550 nm)
Correct answer: Near-infrared light (700â900 nm)
NVGs amplify near-infrared light (700â900 nm) that is invisible to the naked eye, enabling low-light navigation without overt white light sources.
Question 6: The CAMTS (Commission on Accreditation of Medical Transport Systems) standard most directly governs which aspect of air medical operations?
- FAA pilot certification requirements for air ambulance operations
- Quality and safety standards for medical transport programs (Correct answer)
- Billing and reimbursement rules for CMS transport codes
- Scope of practice for flight nurses at the state level
Correct answer: Quality and safety standards for medical transport programs
CAMTS is an accreditation body that establishes quality, safety, and operational standards for medical transport programs, not regulatory bodies for pilots or billing.
Question 7: A patient in traumatic cardiac arrest is being transported by helicopter 8 minutes from a trauma center. The flight nurse should:
- Initiate CPR and ACLS per protocol and continue transport to definitive surgical care (Correct answer)
- Terminate resuscitation efforts on scene per ATLS guidelines
- Request diversion to the nearest ED regardless of trauma capability
- Delay departure until ROSC is achieved on scene
Correct answer: Initiate CPR and ACLS per protocol and continue transport to definitive surgical care
Traumatic cardiac arrest may be reversible with rapid surgical hemorrhage control, so CPR during expedited transport to a trauma center is appropriate.
CFRN Flight and Transport 5
When calculating oxygen supply for a ventilated patient being transported on a fixed-wing aircraft, the formula for E-cylinder duration is: