CTRN key terms

A scoring tool that assigns points to routine vital signs and level of consciousness; rising totals flag clinical deterioration and prompt escalation of monitoring, treatment, or transfer to a higher level of care.

A 3-to-15 point score that sums eye opening, verbal response, and motor response to quantify consciousness; a falling score or a low motor score signals serious neurologic deterioration and need for urgent action.

Ongoing display and alarm review of the ECG rhythm during transport; it detects rate changes, dysrhythmias, and ST-segment shifts that occur with movement, vibration, hypoxia, or medication effects.

Recording twelve electrical views of the heart with correctly placed limb and precordial electrodes; prompt acquisition and transmission allow early identification of ischemia, injury, and conduction blocks while en route.

Checking pupil size, symmetry, and reaction to light; a newly fixed or dilated pupil, or an unequal pupil, suggests mass effect or herniation and requires immediate escalation of care.

Continuous display of exhaled carbon dioxide as a waveform plus a numeric end-tidal value; it confirms tracheal tube placement, estimates ventilation, and can indicate low pulmonary blood flow or airway obstruction.

Coordinated preoxygenation with near-simultaneous sedative and paralytic drugs to produce rapid unconsciousness and relaxation so a tracheal tube can be placed, reducing aspiration risk during transport.

A device such as a laryngeal mask seated above the vocal cords that channels gas into the trachea without entering it; it serves as a rescue or primary airway when intubation fails or is not feasible.

Manual positive-pressure breathing with a self-inflating bag and a tight-sealing mask; effective delivery needs an airway adjunct, a two-person technique when possible, and only enough volume to raise the chest.

A situation in which a trained provider cannot ventilate with a mask, place a supraglottic device, or intubate; it demands early recognition, a stated backup plan, and readiness for a surgical airway.

Positive pressure delivered through a tight-fitting mask, as CPAP or bilevel support, to improve oxygenation and reduce work of breathing in pulmonary edema or COPD without placing an endotracheal tube.

Pressure intentionally held in the airways at the end of exhalation that keeps alveoli open and improves oxygenation; high levels can reduce venous return and cause hypotension or barotrauma.

The average pressure driving blood into organs across the cardiac cycle, estimated as diastolic pressure plus one third of the pulse pressure; about 65 mm Hg is a common minimum target for perfusion.

The beat-to-beat pressure trace from an arterial catheter, showing upstroke, dicrotic notch, and runoff; contour changes and damping reveal catheter problems and provide data for vasopressor titration.

A blood marker of anaerobic metabolism; a high or rising level indicates inadequate tissue oxygen delivery and predicts worse outcomes in sepsis, hemorrhage, and other shock states.

Circulatory failure from blood loss that lowers preload and oxygen delivery; staged by heart rate, blood pressure, mentation, and urine output, and treated with prompt hemorrhage control plus blood product replacement.

Sepsis with hypotension that persists after fluids and requires vasopressors, usually with lactate above 2 mmol/L; management includes early antibiotics, source control, and careful fluid resuscitation.

A vasopressor that constricts vessels through alpha-adrenergic receptors to raise mean arterial pressure in shock unresponsive to fluids; it is infused continuously with frequent pressure checks and extravasation vigilance.

The late combination of rising blood pressure with a widened pulse pressure, slowing heart rate, and irregular respirations that indicates dangerously increased intracranial pressure and impending herniation.

Continuous seizure activity, or repeated seizures without regaining consciousness, lasting about five minutes or longer; it is an emergency requiring airway support, benzodiazepines, and a second-line anticonvulsant.

A hyperglycemic crisis with ketone production and metabolic acidosis causing dehydration, deep rapid breathing, and electrolyte losses; treatment is isotonic fluid, insulin infusion, and potassium replacement with frequent glucose checks.

Acute coronary occlusion producing ST-segment elevation on the ECG; care centers on rapid recognition, protocol-driven aspirin and anticoagulation, and transport to a facility capable of timely reperfusion.

Deliberate control of core temperature, commonly 32 to 36 degrees Celsius, in a comatose patient after return of spontaneous circulation to limit brain injury; transport requires sedation, shiver control, and continuous temperature monitoring.

A rapid, ordered assessment of airway, breathing, circulation, disability, and exposure in which life-threatening problems are treated as they are found, before any detailed history or examination.

A windlass device tightened proximal to a limb wound to compress the artery and stop life-threatening bleeding when direct pressure fails; record the application time and leave it in place.

Systemic illness after prolonged muscle compression, with muscle breakdown, high potassium, acidosis, and kidney injury; isotonic fluid given before release and cardiac monitoring reduce complications.

Techniques such as manual stabilization, a rigid collar, and a padded backboard or vacuum mattress that limit spinal movement when injury is suspected, preventing secondary neurologic damage during movement and transport.

A core temperature below 35 degrees Celsius that impairs clotting, slows drug metabolism, and provokes dysrhythmias; care includes removing wet clothing, insulating, active warming, and gentle handling.

Estimating fluid needs from burn size and body weight, for example with the Parkland formula, and titrating to urine output while watching for inhalation injury, airway swelling, and associated trauma.

Team behaviors such as briefing, role assignment, closed-loop communication, and assertively questioning unsafe actions that reduce human error during high-risk air and ground transport missions.

Preparing a helicopter landing site of adequate size and firmness, free of obstacles and loose debris, with wind direction known and all personnel clear of the tail rotor before the aircraft arrives.

Falling ambient pressure at altitude lets trapped gas expand; this affects endotracheal cuff pressure, air splints, pneumothorax, and bowel or eye gas, so adjustments and venting are needed before and during flight.

Estimated by multiplying cylinder pressure by the cylinder factor and dividing by flow in liters per minute; planning adds reserve for delays, weather, and the patient's increased oxygen demand.

A structured report giving situation, background, assessment, and recommendation; it standardizes transfer of care so critical information and pending actions are not lost between teams.

A federal law requiring hospitals that accept Medicare to provide a screening examination and stabilizing treatment for emergency conditions, and regulating transfers with documented risks and benefits.

Agreement to examination, treatment, or transport given after the provider explains the plan, alternatives, and material risks in understandable terms, and confirms the patient is able to decide.

A patient's refusal of recommended care or transport after being told the risks; document decision-making capacity, the discussion, and specific warnings, and notify medical direction per protocol.