FP-C common mistakes
FP-C · Understand the traps and how to avoid them.
Sets initial ventilator settings and never reassesses them after a cabin altitude change, patient repositioning, or change in compliance, ignoring capnography and peak pressures.
Candidates fixate on the initial airway setup and treat ventilator settings as static, even though altitude and clinical changes alter gas volume and ventilation.
What to do instead
Recheck EtCO2, SpO2, peak inspiratory pressure, and chest rise after every altitude change and after any change in patient condition; titrate settings and document the reassessment.
Anchors on the first likely diagnosis and stops a structured secondary assessment once initial vital signs and chief complaint fit a familiar pattern.
Time pressure and confirmation bias make the first impression feel sufficient, so subtle findings such as unilateral weakness, rash, or focal pain are missed.
What to do instead
Perform and document a deliberate secondary survey, repeat vital signs, and ask explicit red-flag questions before committing to a working diagnosis.
Does not preflight gas-filled devices for altitude expansion, such as pneumatic splints, chest tubes, ET tube cuffs, or IV bags, and discovers overinflation or malfunction in flight.
Candidates focus on clinical care and forget the physics of gas expansion at altitude.
What to do instead
Use an altitude checklist before takeoff: vent or check gas-filled devices, adjust ET cuff pressure, and confirm chest tube drainage systems are functioning.
Delays needle decompression for suspected tension pneumothorax because breath sounds are not classic or because the patient is not yet profoundly hypotensive.
Atypical presentations and fear of the procedure cause hesitation, even though obstructive shock can progress rapidly in transport.
What to do instead
Treat suspected tension pneumothorax immediately on clinical signs such as severe respiratory distress, unilateral absent breath sounds, hypotension, and tracheal deviation; do not wait for imaging.
Relies on a normal blood pressure to rule out significant hemorrhage and misses compensated shock signs such as tachycardia, narrowed pulse pressure, delayed capillary refill, and altered mentation.
Normal blood pressure is falsely reassuring, especially in young trauma patients who maintain pressure until late decompensation.
What to do instead
Trend shock index, mental status, skin signs, and pulse pressure; initiate hemorrhage control and blood product planning before frank hypotension develops.
Estimates a pediatric weight or uses adult dosing defaults instead of a length-based tape or measured weight for medications and equipment.
Pediatric transports are infrequent and time pressure encourages quick estimation.
What to do instead
Use a length-based tape or measured weight for every pediatric drug dose and device size, and independently double-check all calculations.
Does not obtain or act on a point-of-care glucose in a patient with altered mental status, seizure, or focal neurologic deficit.
The presentation is assumed to be traumatic, psychiatric, or primary neurologic, so hypoglycemia is not considered.
What to do instead
Check glucose in every altered mental status or seizure patient, treat hypoglycemia immediately, and recheck after treatment.
Accepts a transport assignment without a structured preflight risk assessment or crew resource management brief, then discovers equipment, communication, or role gaps in flight.
Urgency and routine familiarity cause crews to skip briefings and assume everyone shares the same plan.
What to do instead
Complete a preflight checklist and brief threats, roles, communication plan, and sterile-cockpit expectations before departure.
Calculates an infusion or push-dose medication once and administers it without an independent verification of concentration, rate, route, or pump programming.
Familiarity with common drugs and time pressure lead to skipped double-checks.
What to do instead
Use standard concentrations, label all syringes, verbalize the dose and route, and require an independent double-check before administration.
Gives repeated crystalloid boluses for hemorrhagic shock without early blood products, hemorrhage control, or damage-control resuscitation principles.
Candidates default to medical-shock fluid resuscitation and undervalue early hemorrhage control.
What to do instead
Prioritize tourniquet or pelvic binder placement, early blood products when available, permissive hypotension as appropriate, and rapid transport to definitive hemorrhage control.