CTRN flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Glasgow Coma Scale range

The Glasgow Coma Scale sums eye (1–4), verbal (1–5), and motor (1–6) responses for a total of 3 to 15; a score of 8 or less indicates airway compromise.

Shock index

Shock index is heart rate divided by systolic blood pressure. Normal is 0.5 to 0.7, and values above 0.9 suggest occult hypoperfusion in trauma and medical patients.

Mean arterial pressure formula

MAP equals systolic pressure plus twice the diastolic pressure, divided by three. A MAP of at least 65 mmHg is the standard adult perfusion target in transport.

Cushing triad

Cushing triad is hypertension with widened pulse pressure, bradycardia, and irregular respirations. It indicates rising intracranial pressure and impending herniation.

Capillary refill threshold

Capillary refill normally returns in under 2 seconds when a fingertip or the sternum is pressed. Longer refill, mottling, and cool skin indicate poor peripheral perfusion.

PaO2/FiO2 ratio

The PaO2/FiO2 ratio compares arterial oxygen partial pressure to inspired oxygen fraction. Normal is roughly 400–500; below 300 indicates mild ARDS, below 200 moderate, below 100 severe.

Endotracheal tube cuff pressure

Cuff pressure should be kept between 20 and 30 cmH2O. Higher pressures risk tracheal mucosal ischemia; lower pressures allow air leak and increase aspiration risk.

Pediatric uncuffed tube size

For children, uncuffed endotracheal tube internal diameter in millimeters equals age in years divided by 4, plus 4. Cuffed tubes use age divided by 4, plus 3.5.

Lung-protective tidal volume

Lung-protective ventilation uses 6 mL per kilogram of predicted body weight, keeping plateau pressure under 30 cmH2O to reduce ventilator-induced lung injury.

Minute ventilation

Minute ventilation is respiratory rate multiplied by tidal volume, normally about 5 to 8 liters per minute in adults, and it determines carbon dioxide elimination.

Classes of hemorrhagic shock

Class I is under 15% blood loss, class II 15–30%, class III 30–40% with tachycardia and hypotension, and class IV over 40% with profound instability.

Septic shock first-line vasopressor

Norepinephrine is the first-line vasopressor in septic shock, titrated to a mean arterial pressure of at least 65 mmHg after adequate fluid resuscitation.

Lactate as perfusion marker

Serum lactate above 2 mmol/L suggests tissue hypoperfusion, and values above 4 mmol/L are associated with higher mortality and trigger sepsis bundle protocols.

Pediatric fluid bolus

The standard pediatric crystalloid bolus is 20 mL/kg of isotonic fluid, reassessing after each bolus for signs of overload or improvement in perfusion.

Permissive hypotension in trauma

Permissive hypotension targets a systolic pressure of 80–90 mmHg in bleeding trauma patients without brain injury until hemorrhage control, avoiding crystalloid-driven clot disruption.

Parkland burn formula

Parkland formula estimates 24-hour resuscitation as 4 mL of lactated Ringer's per kilogram per percent total body surface area burned, with half given in the first 8 hours after injury.

Rule of Nines adult

Adult body surface is divided as head 9%, each arm 9%, anterior trunk 18%, posterior trunk 18%, each leg 18%, and perineum 1% for burn size estimation.

Tension pneumothorax decompression sites

Needle decompression is performed at the second intercostal space in the midclavicular line or the fifth intercostal space in the anterior axillary line, followed by tube thoracostomy.

Exertional heat stroke criteria

Heat stroke is defined by core temperature above 40°C with central nervous system dysfunction, such as confusion or coma, and is treated with immediate cold-water immersion.

Ischemic stroke thrombolysis window

Intravenous thrombolysis is generally given within 4.5 hours of symptom onset, while mechanical thrombectomy may be offered up to 24 hours in carefully selected patients.

Status epilepticus first-line drug

A benzodiazepine is first-line for status epilepticus. If seizures persist, a second-line agent such as levetiracetam, fosphenytoin, or valproate is given.

DKA insulin and potassium

In diabetic ketoacidosis, insulin infusion is withheld when serum potassium is below 3.3 mEq/L until potassium is repleted, because insulin drives potassium intracellularly.

Naloxone titration goal

Naloxone reverses opioid-induced respiratory depression and should be titrated to restore adequate spontaneous ventilation, not to produce full arousal, which can precipitate withdrawal and agitation.

Sepsis one-hour bundle

The sepsis bundle includes measuring lactate, obtaining cultures, giving broad-spectrum antibiotics, and administering 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or more, all within one hour.

Oxygen cylinder duration formula

Cylinder duration in minutes equals gauge pressure in psi multiplied by the cylinder factor, divided by flow in liters per minute; the E-cylinder factor is 0.28.

Boyle's law in transport

As altitude increases and barometric pressure falls, trapped gas expands. Pneumothoraces, endotracheal cuffs, and air splints must be monitored during air transport.

Helicopter approach safety

Approach a helicopter only after eye contact and a signal from the pilot or crew, stay clear of the tail rotor, and keep your head low on sloping terrain.

I-PASS handoff

I-PASS stands for Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver, a structured handoff framework used in transport.

SBAR communication

SBAR is a structured report format: Situation, Background, Assessment, and Recommendation. It standardizes handoffs between transport crews and receiving teams.

EMTALA transfer requirement

EMTALA requires a medical screening examination and stabilization before transfer, and the transferring hospital remains responsible until the receiving facility formally accepts the patient.

Against medical advice refusal

A valid refusal requires documented decision-making capacity, an explanation of risks and alternatives, the patient's signature, and notification of a physician or supervisor per protocol.

Closed-loop communication

Closed-loop communication requires the receiver to repeat back the order and the sender to confirm it, reducing errors during high-stress transport care.