Critical Care 4

12. A 20 year-old man presents to the emergency center via ambulance with multiple stab wounds to the chest. He is tachycardic and diaphoretic. As you are performing your initial trauma assessment, he becomes unresponsive and you can no longer palpate a carotid pulse. The most appropriate next step is:

2. All of the following are useful modalities in the assessment of penetrating cardiac injury EXCEPT:

11. A 34-year-old male presents to the ER after sustaining a stab wound to the chest just medial to the left midclavicular line at the level of the fourth intercostal space. He is diaphoretic and tachycardic. He has muffled heart sounds. The patient from the previous question is taken to the operating room for definitive repair of her right ventricle laceration. Which of the following is NOT an appropriate method of cardiorrhaphy?

10. A 34-year-old male presents to the ER after sustaining a stab wound to the chest just medial to the left midclavicular line at the level of the fourth intercostal space. He is diaphoretic and tachycardic. He has muffled heart sounds. The injury can be reasonably approached via all of the following incisions EXCEPT:

Which of the following is NOT an indication for foreign body extraction in a patient who has retained intracardiac fragments following a gunshot injury?

2. Which of these vasopressors has predominantly alpha activity?

3. Which of these conditions would cause pulmonary capillary wedge pressure (PCWP) to underestimate the left ventricular end diastolic pressure (LVEDP)?

4. Which organism is most commonly isolated in patients with DSWI?

5. What hemodynamic changes are seen in a patient with cardiac tamponade?

6. Which of these does NOT result in low SvO2?

7. In what percent of cardiac surgery patients does HIT occur?

8. A patient is placed on venovenous ECMO but is unable to receive anticoagulation. Which of the following the patient most at risk for?

9. Which of the following represents a proper indication for venovenous (VV) ECMO for a patient with acute respiratory distress syndrome (ARDS)?

10. In ARDS the following findings are present EXCEPT:

11. The most appropriate statement regarding the benefit of “Lung rest” as a ventilation strategy in ECMO:

12. Which of the following is not a consideration in ECMO cannulation strategy?

13. Which of the following is NOT a physiologic benefit of prone positioning:

14. The principle of lung protective ventilation is:

15. Which of the following represents a likely contraindication to ECMO?

16. Blood flow in pumpless extracorporeal lung assist (PECLA) is driven by: