Certification Review

Abstract

1.Which of the following is a “total artificial heart” device? A.JarvikB.HeartWareC.DeBakeyD.AbioCorAnswer: D. The AbioCor is a total artificial heart device. The other options are all left ventricular assist devices.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 467.2.Pump failure occurs during transport of a 56-year-old man with an intra-aortic balloon pump (IABP) in place. Which of the following interventions is appropriate? A.Stop the pump, clamp the catheter, and place the patient in the left lateral position.B.Stop the pump and inflate the IABP catheter once every 3–5 minutes manually with a 60-mL syringe.C.Begin cardiopulmonary resuscitation and place the IABP in the internal 80 default setting.D.Decrease the inflation volume in the catheter and place the pump on a 1:3 timing mode.Answer: B. If pump failure occurs during transport, stop the pump and inflate the IAB catheter every 3–5 minutes manually with a 60-mL syringe. For an IAB rupture, the team should stop the pump, clamp the catheter, and place the patient in the left lateral position. Begin CPR and place the IABP in the internal 80 default setting if the patient arrests.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 444.3.Which of the following IABP timing errors will result in retrograde coronary blood flow? A.Early inflationB.Late inflationC.Early deflationD.Late deflationAnswer: C. Early deflation will cause retrograde coronary blood flow. Early inflation results in premature closing of the aortic valve, causing aortic regurgitation. Late inflation results in suboptimal coronary perfusion. Late deflation increases resistance or afterload.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 442.4.How often during air medical transport should the flight crew manually autofill the IABP catheter? A.Every 2,000 ft of ascent and 1,000 ft of descentB.Every 1,000 ft of ascent and 2,000 ft of descentC.Every 1,000 ft of ascent and descentD.Every 2,000 ft of ascent and descentAnswer: A. When a manual autofill is required, the transport crew should perform it with every 2,000 feet of ascent and every 1,000 feet of descent. New generations of IABPs have sensors that detect altitude changes, and they will perform the autofill automatically.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 442.5.The goal of inflation during IABP catheterization is to produce a ____________, which optimizes diastolic augmentation. A.Rapid rise in systolic pressureB.Rapid rise in aortic pressureC.Rapid decrease in systolic pressureD.Rapid decrease in aortic pressureAnswer: B. The goal of inflation is to produce a rapid rise in aortic pressure to optimize diastolic pressure, thereby increasing oxygen supply to the coronaries.Holleran R, editor. Air and surface patient transport: Principles and practice. 4th ed. St. Louis: Mosby; 2010: 441.