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A series of critical care transport nursing scenarios, covering a wide range of medical emergencies and patient conditions that transport nurses may encounter during patient transfers. The scenarios cover topics such as cardiac pacing, intraosseous access, spinal motion restrictions, oxygen therapy, neuromuscular blockade, intraocular pressure management, biological agent exposure, chest tube management, ventilator management, hemorrhagic shock, stroke care, and more. Detailed information on the appropriate nursing interventions and clinical decision-making required to effectively manage these complex patient situations during transport. The scenarios are designed to test the transport nurse's knowledge, critical thinking skills, and ability to prioritize care in dynamic and challenging pre-hospital environments.
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The flight team is requested to transport a 43-year-old patient to a referral center 60 minutes away. Upon arrival bedside, the RN reports no urine output for four hours. Creatinine has increased from 1.3mg/dL to 2.3 mg/dL. Ventilator FiO2 is being increased to 100%; Positive end-expiratory pressure (PEEP) is 10 cm H2O. BP 85/70 mmHg Intra-aortic balloon pump (IABP) 1:1 ratio Augmented IABP pressure 100 mmHg Mean arterial pressure 82 mmHg ABG pH 7.15 PaCO2 54 mmHg PaO2 58 mmHg HCO3 16 mmol/L Base excess -12 O Saturation 88% What should the flight nurse do PRIOR to transporting this patient? - \Contact the sending physician The nurse is preparing to transport a young child from an outlying hospital to a pediatric trauma center. The child was involved in an unrestrained motor vehicle accident and has numbness in bilateral feet. The sending nurse asks if they should remove spinal immobilization because the CT scan of the spine revealed no abnormalities. The flight nurse should: - \maintain immobilization Which of the following assessment findings would be consistent with postpartum hemorrhage? - \a boggy and enlarged soft uterus The flight team arrives to transport a patient who has been "coding" on/off for 15 minutes. The patient continues to experience ventricular fibrillation and has been defibrillated seven times. The patient has a temporary pacemaker in place. Settings are: Mode: VOO Rate: 70 beats/min Output: 10 mA Sensitivity: asynchronous The flight nurse begins to assist and recommends changing the mode to VVI and the sensitivity to "full demand" based on of the fact that: - \Asynchronous pacing may cause R-on-T phenomenon A transport nurse is caring for a trauma patient who develops pulseless electrical activity during transport. After administration of epinephrine 1 mg IV and an IV fluid
bolus of 2 L, the patient's pulse is restored. The cardiac arrest was MOST likely caused by - \hypovolemia. The flight team is transporting a patient with severe asthma that is receiving high flow oxygen. The patient is noted to be markedly more dyspneic and speaking in one word sentences. The nurse obtains an arterial blood gas which reveals: pH 7.2 PaO2 55 mmHg PaCO2 60 mmHg HCO3- 29 mEq/L What is the nurse's next PRIORITY intervention? - \Perform drug-assisted intubation The flight team is called for a previously healthy 53-year-old who had stents placed today. Ejection fraction is 10%. Upon arrival, the patient is alert and oriented x4; skin is pink, cool & clammy. Respirations are labored and crackles are auscultated throughout all lung fields. Vital signs: BP 95/75 mmHg HR 120 beats/min (sinus tachycardia) RR 32 breaths/min SpO2 92% on NRB ABG results 1 hour ago: pH 7. PaCO2 48 mmHg PaO2 60 mmHg HCO3 20 mEq/L Base excess - What is the PRIORITY for this patient? - \Apply non-invasive positive pressure ventilation The flight nurse is called to an ICU to transport a ventilated patient 24 hours after a major chest trauma. The patient has high pressure alarms with worsening oxygenation and increased peak inspiratory pressures. Pink, frothy sputum sputum is noted. The nurse suspects the primary cause to be: - \Pulmonary contusion Which of the following is the MOST appropriate intervention to prevent and protect the patient from and to reduce the risk for pulmonary barotrauma from mechanical ventilation? - \Attempt to lower the plateau pressure.
The flight nurse is assessing fetal heart tones during transport. The heart rate is noted to be 170 beats/min. Fifteen minutes later, the heart rate is noted to be 175 beats/min. The flight nurse's NEXT action should be to: - \Administer an IV fluid bolus What term describes stress that is considered normal, encountered in daily living, and may enhance function, heighten awareness, or provide new perspectives? - \eustress The flight nurse arrives at the bedside of an intubated, 80kg adult patient with asthma exacerbation. Vent settings are: Vt 800ml Assist Control rate of 28 FiO2 100% PEEP of 5cm The patient continues to have inspiratory and expiratory wheezes despite nebulizers. ABGs are: pH 7. PaO2 98 PaCO2 66 SaO2 90% What vent changes should the flight nurse make to improve the patient's ventilation? - \Decrease tidal volume and decrease respiratory rate The MOST accurate way to ensure endotracheal tube placement in the field is - \ETCO2 monitoring. A patient that presented to a rural facility suffered a stab wound to the neck at the level of C4. The airway is patent and the knife has been left in place. The priority intervention for the transport of this patient is: - \Leave the knife securely in place and stabilize it The flight team is called to transport a patient to interventional radiology who was involved in a motor vehicle collision and sustained rib fractures to the entire right side. A right chest tube was placed and is draining approximately 200ml/hr. Upon the flight team's initial assessment, the patient's right side was ecchymotic from the axilla to the iliac crest, which is a new finding. BP 80/60 mmHg HR 125 beats/min (sinus tachycardia)
The nurse anticipates the etiology of the new ecchymosis is MOST likely due to: - \Intercostal artery rupture The nurse is caring for a patient who was assaulted with a baseball bat. The patient was struck multiple times in the right flank and back and ecchymosis is noted on bilateral flanks. Vital signs are: BP: 78/45 mmHg (56 MAP) HR: 140 beats/min RR: 38 breaths/min SpO2: 92% (4L nasal canula) The nurse would question the use of which diagnostic/assessment tool? - \CT abdomen and pelvis A rotor-wing transport team experiences an engine failure and has a forced landing in water. Which of the following is the correct sequence for successful egress from the helicopter? - \unplug, unstrap, exit, inflate While preparing to intubate a two-year-old child, the flight nurse should: - \utilize a Miller blade. Which medication would work MOST effectively to increase peripheral vascular tone? - \norepinephrine (Levophed) The flight nurse arrives at the scene of a motor vehicle accident. The patient that should be treated FIRST is a - \21-year-old with a chest wound who is breathing at 5 breaths/min. On scene, a 2 year old is reported to be unconscious secondary to foreign body aspiration. Using a laryngoscope, the transport nurse notes a coin just below the glottis. The nurse should - \use Magill forceps to remove the coin. The flight nurse is preparing to transport a patient with a suspected arterial gas embolism. The nurse should arrange to transport the patient - \in a manner that requires under 1,000 feet of altitude change. A 330-lb (150-kg) patient is being transported. Upon initiation of mechanical ventilation, the high-pressure alarm sounds. Peak inspiratory pressure is 45 cm H2O, plateau pressure is 36 mm Hg, I:E ratio is 1:2.3 and oxygen saturation is 92%. The ventilator is on the following settings: Mode Assist controlRate 16 breaths/minTidal volume 900 mLFiO2 60%PEEP 5 cm H2O Which of the following ventilator settings should be decreased? -
sending nurse reports 950ml of bloody chest tube drainage over the last 4 hours. The vitals are: HR: 115 beats/min BP: 100/70 mmHg RR: 26 breaths/min SPO2: 96% on 15 LPM via NRB The nurse's PRIORITY action should be to administer: - \balanced transfusion The flight crew arrives at the referring facility to transport a marathon runner who collapsed at the finish line. The patient is agitated, hot to touch, dry, and is breathing rapidly. The priority interventions for this patient are: - \Rapid cooling and ECG monitoring The flight crew is preparing to transfer a patient with morbid obesity. The flight nurse knows that transporting the patient in a semi-Fowler's position is advantageous because it: - \decreases the work of breathing. The transport team responds to the scene of a patient with suspected stroke. On arrival, the patient reports a sudden onset of severe headache, photophobia, and neck stiffness. Although imaging is required for a definitive diagnosis, the flight crew recognizes the signs and symptoms are consistent with which of the following neurological emergencies? - \Subarachnoid hemorrhage The flight crew responds to an interfacility transfer of a patient struck in the face with a high-speed baseball. The patient was diagnosed with a small subdural hematoma and a zygomatic fracture. On assessment, the patient is neurologically intact with normal vital signs but complains of severe pain, loss of vision, and reduced eye movement on the affected side. Intraocular pressure is documented at 46 mmHg; the flight crew knows the MOST appropriate intervention prior to transport is: - \Facilitate an emergent decompression The flight team responds to a facility for the transport of 30 week gestation preterm infant. The neonate weighs 1200 grams. The nurse knows that this infant would be classified as: - \Very low birth weight A patient with a saddle pulmonary embolism has become more lethargic. The patient's vital signs are: BP 72/47 mm Hg HR 120 beats/min RR 20 breaths/min O2 Sat 80% (room air) The NEXT appropriate intervention should be to administer which of the following? -
\alteplase (Activase) Relaying patient information to a base hospital over the radio is protected by what section of the Health Insurance Portability and Accountability Act (HIPAA)? - \Privacy Rule What information would lead the transport team to suspect a biological agent exposure?
\clusters of patients in the same location with the same symptoms The flight crew is called to transport a child who was involved in a motor vehicle collision and the child is diagnosed with massive hemothorax and a chest tube was placed. Upon reassessment the patient has flat neck veins, hypotension, tachypnea, and cyanosis. The flight nurse anticipates which PRIORITY intervention prior to departure? - \Pericardiocentesis The flight crew is called to transport a patient diagnosed with a non-ST elevation myocardial infarction (NSTEMI). The patient has a history of hypertension and obesity and their body mass index is 37. On initial assessment, the patient is supine in bed, confused and restless. The PRIORITY intervention for the flight crew is: - \Place the patient in an upright position The nurse is transporting a patient with severe angioedema. An initial attempt at rapid sequence intubation was unsuccessful and the patient's oxygen saturation is now 60%. The next BEST course of action for the nurse to take is to perform - \an immediate surgical cricothyrotomy. The flight crew responds to a scene call of a mother in a remote location who has given birth to a full-term infant. The delivery was uncomplicated and facilitated by local EMS. The neonate is demonstrating rapidly increasing work of breathing and increased oxygen requirements. The flight nurse suspects neonatal respiratory distress syndrome. The initial treatment should be: - \Continuous positive airway pressure The flight team has been called to bedside to perform a rapid sequence intubation. The patient is post motor vehicle collision with head trauma and in spinal immobilization. Vital signs are: BP 110/60 mmHg HR 118 beats/min RR 12 breaths/min O2 saturation 87% (non rebreather mask at 15L/min) Glasgow Coma Scale: 7 (e2, v2, m3) What is a PRIORITY intervention in performing this procedure? - \Pre-oxygenation The flight nurse arrives on scene of an interfacility transfer for altered mental status of a 70 year-old. The hospital reports the following lab work:
lower extremities are also noting a similar assessment. The flight nurse documents the patient's Glasgow Coma Score as: - \E1, V3, M3 = 7 The flight team is called to the scene of a patient who was involved in a motor vehicle collision. The patient is 30 weeks pregnant and presents with abdominal cramping, bruising to the abdomen, and an open wrist fracture. Initial vital signs: HR 125 beats/min BP 85/50 mmHg RR 25 breaths/min SPO2 100% (4L nasal canula) Fetal HR 115 beats/min The PRIORITY intervention is: - \Aggressive intravenous resuscitation The flight team is called to transport a patient with a gunshot wound to their left chest. The patient has crepitus around the left neck, upper abdominal pain, and is spitting up blood. The flight team has inserted a chest tube and notes particulate matter in the drainage. The flight nurse knows the definitive intervention is: - \Esophageal repair The flight nurse is called to transport a patient who has received activase (Alteplase) for an occlusion of the right middle cerebral artery. Upon making contact with the patient, the flight nurse recognizes the patient is unresponsive with unequal pupils, which is a change from their baseline stroke assessment. After the airway is managed, the NEXT priority intervention is: - \Repeat head CT The nurse is asked to transport a patient from a rural hospital to a stroke receiving center. The patient has an initial National Institute of Health (NIH) score of 8 and stroke- like symptoms originated two hours ago. Thrombolytic therapy has not been administered. The patient's vital signs are: HR: 105 beats/min BP: 190/95 mmHg RR: 18 breaths/min SPO2: 96% (room air) The nurse's NEXT action should be: - \Administer labetalol (Trandate) IV push Multiple flight crew members have expressed concerns over the care abilities of a specific flight nurse and have requested removal from clinical duties. Due to staffing issues, the medical director and leadership elect to allow the flight nurse to continue to staff the clinical crew. If a patient were to receive an injury while under the care of the flight nurse, the air medical provider could be in breach of which of the following professional issues? - \Vicarious Liability
The flight team has been called to the scene of a single vehicle rollover. The patient has a palpable skull deformity. The patient also has extensive soft tissue injury and open fracture to the left forearm, which is wrapped in blood-soaked dressings. Current vital signs are: HR 136 beats/min BP 72/50 mmHg RR 34 breaths/min SpO2 88% (15L nonrebreathing mask) Glasgow Coma Scale 7 (E2, V2, M3) The flight nurse's FIRST priority intervention is: - \Apply a tourniquet The flight nurse responds to a high speed motor vehicle collision on the highway. The patient is an 80-year-old male presenting with bruising on the abdomen and upper chest consistent with a seat belt outline. The patient's vital signs are: BP: 100/50 mmHg HR: 63 beats/min RR: 14 breaths/min SPO2: 95% (room air) The PRIORITY historical question is: - \Do you take any medications? The flight team has been called to a critical access hospital to transport a 7-week-old patient to a tertiary facility. The patient was brought to the ED after three days of malaise and poor feeding and cardiac monitoring reveals the following: The patient is lethargic and has prolonged capillary refill time. ED staff attempted vagal maneuvers unsuccessfully. The appropriate NEXT intervention is: - \Adenosine 0.1mg/kg rapid push During transport of a pregnant patient, the nurse notes the following vital signs: BP 172/112 mm Hg HR 98 beats/min RR 8 breaths/min The patient also has a urine output of less than 30 mL/hour for the last 3 hours, absent deep tendon reflexes, a magnesium sulfate maintenance infusion of 3 g/hr and oxygen at 15 L/min via a nonrebreathing mask. Based on this assessment, which of the following is the MOST appropriate initial intervention? - \Discontinue magnesium sulfate infusion, administer 1 g of 10% calcium gluconate, and assist with ventilation. Oxygen saturation is 86% with high flow oxygen via nonrebreathing mask on a patient with pulmonary contusions from blunt chest trauma. The next intervention should be - \positive pressure ventilation. The flight crew is called to transport a child from a motor vehicle collision. The child was restrained with a lap belt in a booster seat. The child is irritable, and has positioned themselves in the fetal position. The nurse knows this is MOST likely indicative of injury to the: - \Abdomen
preparing for advanced airway management in the patient with intracranial hemorrhage? - \Oral airway adjuncts are contraindicated. The flight team is transporting a 70kg patient in cardiogenic shock who is mechanically ventilated on multiple high-dose vasopressors and inotropes. Mean arterial pressure is 57 mmHg. Oxygen saturations are consistently 100%. Arterial blood gas results are: pH 7. pCO2 40 mmHg pO2 238 mmHg HCO3 24 mmol/L Base excess +2 mmol/L Ventilator settings are: Assist Control Mode Respiratory Rate 20 FiO2 50% Tidal Volume 450ml PEEP 18 cm H2O What adjustment should the transport team consider? - \Decrease PEEP The flight nurse is called to transport a patient diagnosed with an open book pelvic fracture. The patient has received multiple blood products and vital signs are stable upon arrival. Upon loading the patient into the helicopter, the nurse notes a significant decrease in blood pressure. The MOST likely cause is: - \Dislodging of tamponade in the retroperitoneal space The flight crew is transporting a patient receiving blood products via a mass transfusion protocol. The patient begins to exhibit carpopedal spasms while collecting a noninvasive blood pressure measurement. The MOST appropriate action for the flight crew is to administer: - \calcium chloride The flight crew is on scene for a 911 EMS request. The basic life support unit on scene leads the nurse to a tall, 19-year-old male who has sudden shortness of breath and decreased breath sounds on the left side. Vital signs are as follows: BP 134/70 mmHgHR 134 beats/minRR 30 breaths/minT (oral) 94.4°F (36.9°C)O2 Sat 80% on room air. The NEXT procedure the nurse should prepare for is: - \needle decompression.
The nurse lands on scene of a farm accident. The patient has suffered an amputation of the left arm. The bleeding is controlled and the vitals are stable. When preparing the extremity for transport, it should be: - \Wrapped in saline-soaked gauze, in a plastic bag, on ice A patient presents to the emergency department complaining of increased pain, numbness and tingling following a tibial fracture one day prior. Physical exam reveals swelling, diminished pulses, decreased capillary refill and coolness to touch in the affected extremity. They are being transferred to a tertiary facility for definitive care. The flight nurse understands that the priority intervention is to: - \Place the extremity at the level of the heart Which of the following cranial nerves is responsible for pupillary response in a closed- head injury patient? - \oculomotor (CN III) The flight team is transporting a patient for cardiac surgery evaluation. The patient had episodes of symptomatic bradycardia and complete heart block, which was treated with a temporary transvenous pacemaker. The patient is currently asymptomatic and pacemaker settings are: Mode: VVI Rate: 75 beats/min Output: 2 mA Sensitivity: 0.8mV BP was 100/65 mmHg on arrival; it is currently 80/50 mmHg. What is the NEXT action the flight team should take? - \Increase the output to 10mA The nurse is transporting a patient who has an intra-aortic balloon pump (IABP). An extra helium tank should be packed due to - \barometric changes. Which of the following should be done during slow decompression? - \Use supplemental oxygen until descent. The flight nurse is transporting a patient who has sustained critical injuries, and vital signs are unstable. After packaging the patient for transport, the family requests to see the patient before you leave the hospital. The most appropriate action is: - \Stop to allow the family to see the patient before departing. The transport nurse is receiving report at a hospital on a patient who had a myocardial infarction a day earlier and has a pulmonary artery catheter. Vital signs and PA catheter monitoring is as follows: BP 82/40 mm Hg HR 110 beats/min RR 24 breaths/min CVP 18 mm Hg PAP(Systolic) 40 mm Hg PCWP 20 mm Hg Based on the clinical presentation, which additional value should the nurse expect to note? -
\Look for physical hazards to the crew. A patient has sustained a traumatic brain injury. After rapid sequence intubation, the patient's vital signs are as follows: BP 112/30 mm Hg HR 42 beats/min RR irregular depth and quality In addition, the patient has right pupillary dilation with sluggish response and extensor motor posturing. Which of the following is the next most important intervention? - \Target ETCO2 levels between 30 and 35 mm Hg. A flight crew member who recently had a dental filling placed suffers severe dental pain to the tooth during the ascent phase of flight. This condition is the result of which gas law? - \Boyle's The flight crew lands on a highway for an accident scene involving a patient who was an unrestrained driver of a vehicle that hit a divider head on. The patient is alert and complains of chest pain. The ECG shows no ST elevation with decreased voltage across all leads. Vital signs are as follows: BP 95/60 mmHgHR 130 beats/minRR 14 breaths/minO2 Sat 93% room air The flight nurse should suspect: - \cardiac tamponade. The two MOST important factors affecting survival and prognosis of heatstroke are: - \Duration of event and core temperature The flight crew responds to an interfacility transfer of a patient who suffered a reported gun shot wound to the right anterior chest at the 5th intercostal space, resulting in a massive hemothorax. The sending facility reports all uncrossed blood products have been exhausted, and the patient remains in hemorrhagic shock. The sending physician requests the flight crew to auto-transfuse blood collected from the chest drainage system. The nurse questions this order due to: - \Risk of gastric contents in the collected blood The nurse is called to transport a patient who was found running around a music festival after ingesting an unknown substance. The patient is restrained in 4 points and is thrashing on the bed. The immediate intervention is: - \Administer midazolam (Versed) The flight team arrives to transport an adult patient from a rural ED who was the unrestrained driver involved in a motor vehicle collision and suffered trauma to the head, neck, and chest. The patient was intubated on scene and received two liters of IV crystalloid en-route and an additional three liters in the ED. The patient's vital signs are: BP: 74/58 mmHg HR: 120 beats/min RR: 14 (mechanical ventilation) SpO2: 86% (100% FiO2) Hemoglobin: 11 g/dL Hematocrit: 33%
The team anticipates the likely cause of the patient's refractory hypotension is likely due to: - \Blunt cardiac injury Which of the following elements is NOT required to be proven for a malpractice suit? - \malfeasance The flight team is called for a scene request of a car versus pedestrian. The patient is complaining of abdominal pain with pain to palpation of their pelvis. Vital signs are: BP 82/59 mmHgHR 127 beats/min RR 24 breaths/min SpO2 94% (room air) What is the PRIORITY intervention? - \Placement of a pelvic binder A flight team has survived an emergency landing in a remote, snow-covered area during the day. After accounting for all aboard and arranging for shelter, the team begins gathering combustible materials to build a signal fire. Which of the following will create smoke that can be MOST easily seen by search and rescue personnel? - \rubber The flight crew is transporting a burn patient that is 7-hours post burn with a 65% TBSA. During transport the patient becomes progressively hypotensive and tachycardic. The nurse knows that the decompensating trend is likely due to: - \Decreased venous return Following a prolonged bag-mask ventilation, a pediatric patient is intubated and mechanically ventilated. The flight nurse inserts a nasogastric tube. Improvement of which of the following would BEST indicate that the procedure resulted in the desired effect? - \peak inspiratory pressure (PIP) The flight nurse arrives on scene of a patient with a left lower extremity partial amputation. The injury occurred one hour prior to transport and bystanders placed a tourniquet, which has been effective. Transfusion of one unit of packed red blood cells (PRBCs) has been initiated. Current vital signs are heart rate 145 beats/min and blood pressure 84/62 mmHg. The NEXT priority action should be administration of: - \Tranexamic Acid (TXA) For informed consent, in addition to explaining the risks and benefits to the patient, the transport nurse should also include - \other possible alternative treatments available.
to the anterior chest. The patient's chest x-ray is negative for any acute process. Which of the following interventions would be the most appropriate frontline therapy? - \Lidocaine The flight team is called to transport a patient who was found unresponsive in the basement of their home next to a furnace. The patient is drowsy, but awakens to verbal stimuli and states they are dizzy. Current vital signs: HR 110 beats/min BP 125/74 mmHg RR 26 breaths/min SPO2 100% on 4L nasal cannula Their skin is flushed, dry, and warm. The NEXT appropriate action would be: - \Initiate 15L oxygen via non-rebreather mask The flight team was dispatched for a patient who suffered a hard tackle while playing football. On assessment the nurse notes the patient is unable to move their arms or legs and their skin is flushed and warm. Vital signs are: Heart rate: 53 beats/minBlood pressure: 80/47 mmHgRespiratory rate: 18 breaths/minSpO2: 94% (room air) Which type of shock is the patient most likely experiencing? - \Distributive An intubated, morbidly obese patient with acute respiratory distress syndrome is being transported from a community hospital to a tertiary care facility. Ventilator settings are as follows: Mode Assist-control Rate 12 breaths/minTidal volume 800 mLFiO2 100%PEEP 5 cm H2O During transport, the patient's blood pressure steadily declines from 120/80 mm Hg to 96/45 mm Hg, and the patient appears restless. The patient has a respiratory rate of 26 breaths/min, plateau pressure of 39 mm Hg, and an auto-PEEP of 8 cm H2O. The nurse should FIRST: - \disconnect the ventilator tubing from the patient. A farmer was trapped beneath a wheel while performing maintenance on their tractor. They were extricated and found to have an open fracture of their left femur, pelvic instability, crepitus to the left lateral ribs, and bruising to the left flank. Two units of packed red blood cells have already been transfused. Vital signs are: BP 62/20 mmHg HR 140 beats/min RR 40 breaths/min SpO2 86% (15L nonrebreathing mask)
Glasgow Coma Scale 14 (E3, V5, M6) The flight team's NEXT intervention is to administer: - \Tranexamic acid (TXA) A formalized method used for communicating with other healthcare professionals at hand-off is known as - \SBAR (situation, background, assessment, recommendation). The flight crew is called to transport an adolescent who was clotheslined by a chain across their upper chest while riding a bicycle. The patient complains of dyspnea. They are anxious and subcutaneous emphysema is noted to their neck and upper thorax. The flight nurse suspects: - \Tracheobronchial disruption The flight crew is called to transport a patient at 28-weeks pregnant who presented to the referring facility with bright red vaginal bleeding and abdominal pain. The patient stated that earlier in the day, she was involved in a near miss motor vehicle accident where she needed to quickly brake her vehicle to prevent collision. Vital signs: HR 130 beats/min BP 90/40 mmHg RR 18 breaths/min SPO2 100% (2 liters nasal cannula) Fetal HR: 120 beats/min The flight nurse recognizes this is MOST likely due to: - \Placental abruption A nurse is transporting a patient with an intra-aortic balloon pump (IABP) catheter in the right femoral artery. The left arm becomes cool, mottled, and pulseless. The MOST likely cause for the clinical change is - \catheter migration. Which of the following is the MOST appropriate action during a helicopter water ditching? - \Allow water pressure to equalize before opening doors. The flight crew is continuing massive blood product transfusion from an outside hospital. The nurse knows the ratio of PRBC, Fresh Frozen Plasma, and platelets should be: - \1:1: An adult patient presented to the referring facility after suffering an electrical injury. Initial fluid resuscitation has started, and will be continued during transport. The goal for fluid resuscitation for this patient is: - \Urine output 100 ml/hr