ADM

Question 1

Normal Human Temp.

Answer 1

98.6

Question 2

Hypothermia

Answer 2

Severe: 81F
Ventricular fibrillation: 77F

Question 3

Pulse

Answer 3

Normal: 60-80 at rest
Tachycardia: >120bpm
Bradycardia: <60bpm

Question 4

Respiration

Answer 4

Normal: 12-16 breaths per minute

Question 5

Blood Pressure

Answer 5

120/80

Question 6

When should a complete Neuro exam NOT be completed prior to recompression?

Answer 6

Acute or recent onset of gross neurological deficit.
Diver surfaces unconscious.
Symptomatic omitted decompression.
Severe symptoms preventing patient from completing neuro.

Question 7

OPQRST

Answer 7

Onset, Provocation, Quality (sharp, dull ache), Radiation, Severity (0-10), Timing (Onset, better, worse.)

Question 8

Six parts of the Neurological Exam?

Answer 8

Mental status, coordination, cranial nerves, sensory, strength, and DTR.

Question 9

12 Cranial Nerves

Answer 9

Olfactory-Smell
Optical-Reading/Peripherals
Occulomotor- Pupil Dilation/Eye Movement
Trochlear- Look down your nose
Abducen-Lateral eye movement
Trigeminal- Face Sensation/Chewing
Facial- Movement of face
Acoustic- Hearing/Balance
Spinal Accessory- Neck movement Glossopharyngeal- Gag
Vagus- Roof of mouth/Vocal Coord (say Ahh)
Hypoglossal- Tongue movement

Question 10

Henry’s Law

Answer 10

The amount of gas that will dissolve in a liquid is proportional to the partial pressure of gas above the liquid.

Question 11

What year did Sir Robert Boyle observe bubbles in the eye of a snake in a vacuum?

Answer 11

1670

Question 12

Define Tissue Perfusion?

Answer 12

The act of getting oxygen via blood from the lungs to the tissues.

Question 13

Define Tribonucleation?

Answer 13

Bubbles created when two surfaces in a viscous liquid are rapidly separated or moved.

Question 14

Aviation Decompression Sickness
Altitudes less than ____: Low Risk
Altitudes between ______ and _____: Moderate Risk.
Altitudes Greater than _____: High Risk

Answer 14

<20000
20000-30000
>30000

Question 15

Altitude Decompression Sickness manifests in what two ways?

Answer 15

Joint pain
Cerebral DCS Type II symptoms

Question 16

What is the treatment for Aviation Decompression Sickness?

Answer 16

100% Surface O2 with aviators mask or hood for 2 hours. Joint pain only and symptoms present no later than 2 hours after flight.)
If pain resolves before return to 1ata, treat with 2 hours of O2.
If pain present at 1ata, must have some resolution after 30min O2.
Max 3 hours 100% O2.
If criteria not met or symptoms recur or worsen: TT6.

Question 17

Type 1 DCS

Answer 17

Joint Pain (musculoskeletal)
Skin (cutaneous)
Lymphatic swelling.

Question 18

Type II DCS Symptoms

Answer 18

Neurological
Inner Ear (staggers)
Cardiopulmonary (chokes)

Question 19

Symptoms for Cardiopulmonary DCS?

Answer 19

Burning pain
Distress
Cough
Dyspnea

Question 20

Symptoms of Spinal Cord DCS?

Answer 20

Pain will radiate causing girdle-like presentation.
May be dull or lancing.
Heralds onset of other symptoms.

Question 21

What can cause Pulmonary O2 Toxicity?

Answer 21

History of long exposure of O2 concentration greater than .5 ata.

Question 22

Symptoms of Pulmonary O2 Toxicity?

Answer 22

Coughing
Burning
Dyspnea

Question 23

CNS O2 Toxicity
_________ is perhaps the clearest warning, but it may occur late if at all.

Answer 23

Muscle twitching

Question 24

CNS O2 Toxicity
Convulsions may still occur after ____ to ____ minutes off O2.

Answer 24

1-2

Question 25

CNS O2 Toxicity occurs most frequently when ppO2 exceeds _____ wet or _____ dry.

Answer 25

1.3 ata wet 2.4 ata dry

Question 26

What is the grading scale for strength test on a Neuro?

Answer 26

5- Normal: Equal strength bilaterally 4-Mild: able to resist slight force of examiner 3-Moderate: Overcome gravity but not examiner 2-Severe- Muscle contraction but not resist gravity 1-Profound: Flicker or Trace 0- Paralysis

Question 27

Define Shock.

Answer 27

The inadequate perfusion of the cells and tissues of the body caused by insufficient blood flow through the capillaries.

Question 28

5 types of shock?

Answer 28

Anaphylactic- Allergic reaction Cardiogenic- Heart attack Hypovolemic/Hemmorrhagic- blood loss Neurogenic- Dilation of blood vessels due to nerve paralysis resulting from spinal cord injury. Psychogenic- fright or fear.

Question 29

What are the three stages of shock?

Answer 29

Compensated: Body correcting for loss Decompensated: body is no longer compensating. Irreversible: Body can no longer maintain tissue perfusion.

Question 30

Signs and symptoms of Shock?

Answer 30

Increased heart rate. Increased respirations. Cool pale skin. BP drops. Dilated pupils Cyanosis Nausea/Vomiting

Question 31

Surface O2 Administration Rate?

Answer 31

12-15 lpm for non rebreather 4-6 for nasal cannula

Question 32

What drugs are considered absolutely safe for diving?

Answer 32

None.

Question 33

What is the proper pee-pee rate for a diver suffering from DCS?

Answer 33

.5cc/kg/hr or more.

Question 34

Which part of the neuro exam do you ask the patient about their dive profile?

Answer 34

History

Question 35

What are 6 things that might produce unconsciousness?

Answer 35

Hypoxia, CNS O2 Tox, Hypercapnia, AGE, DCS, CO Poisoning

Question 36

When can Pulmonary O2 Tox occur?

Answer 36

Long exposure of O2 concentrations greater than .5 ata.

Question 37

What method of fluid replacement should be used for a person suffering from “chokes”?

Answer 37

None, consult a UMO

Question 38

What is a direct vs indirect bubble effect?

Answer 38

Effect of the bubble at the site and effect elsewhere as a result of the bubble blocking the flow.

Question 39

What cranial nerve governs face sensation?

Answer 39

Trigeminal.

Question 40

True/False Rolling a diver inflicted with Pneumothorax on the affected side can assist the body in sealing the hole.

Answer 40

True

Question 41

What cranial nerve governs blurriness of vision?

Answer 41

Optical nerve

Question 42

What is the proper rate of urinary output?

Answer 42

.5/cc/kg/hr

Question 43

What is the effect of the drip rate on an IV as the chamber ascends and descends during a treatment,

Answer 43

Rate increases on descent and decreases on ascent.

Question 44

How far should a catheter be inserted on a male and female?

Answer 44

Male: 4 inches Female: 2 inches

Question 45

True/False Mental status change is common in dive related casualties?

Answer 45

FALSE

Question 46

Do we administer anticoagulants and lidocaine for all DCS patients?

Answer 46

No.

Question 47

Treatment for shock.

Answer 47

Keep warm. Monitor vitals. 100% O2. ELEVATE THE FEET. NOT THE HEAD.