Safety and Transport
8%of exam
Flight Physiology
6%of exam
Airway, Anesthesia & Analgesics
15%of exam
Medical Emergencies
13%of exam
Neurological
11%of exam
Cardiac
14%of exam
Trauma & Burn
12%of exam
Maternal-Fetal & Neonatal
7%of exam
Pediatric
8%of exam
Professional Considerations
6%of exam
Quick Facts
- Exam
- FP-C
- Credential
- Flight Paramedic
- Items
- 135 (110 scored)
- Time
- 2.5 hours
- Pass
- 73/110 raw
- Format
- Prometric, paper, or LRP
- Level
- Advanced specialty
- Blueprint
- 2020 outline (current)
Aircraft & Mission Safety
- CAMTS
- Accreditation body standard
- LZ ops
- Landing zone safety
- IIMC
- Inadvertent instrument conditions
- NVGO
- Night vision goggle ops
- Sterile cockpit
- No distractions, critical phases
- CRM
- Crew resource management
- Risk assessment
- Go/no-go decision
- Hazard reporting
- Report near-misses
Boyle's Law vs Dalton's Law
Boyle's Law
- Pressure times volume constant
- Explains gas expansion
Dalton's Law
- Sum of partial pressures
- Explains altitude hypoxia
Expansion vs hypoxia mechanism
Gas Laws & Altitude
- Boyle's Law
- Pressure inverse volume
- Dalton's Law
- Sum of partial pressures
- Henry's Law
- Gas dissolves per pressure
- Graham's Law
- Diffusion inverse sqrt density
- TUC
- Time of useful consciousness
- Hypoxic hypoxia
- Low inspired O2
- Trapped gas
- Expands per Boyle's Law
- Cabin altitude limit
- 8,000 ft max, pressurized
DOPE Airway Deterioration Mnemonic
Displacement, Obstruction, Pneumothorax, Equipment failure
D: tube displacedO: airway obstructedP: pneumothorax developedE: equipment failure
Cric vs Needle Decompression
Cricothyrotomy
- Failed airway rescue
- Surgical airway access
Needle decompression
- Tension pneumothorax rescue
- Chest, not airway
Airway vs chest emergency
Airway Rescue Algorithm
- RSI fails first attempt→Optimize position, reattempt
- Can't intubate, can ventilate→Bag-mask or SGA
- Can't intubate, can't oxygenate→Surgical cricothyrotomy
- Tube placement uncertain→Waveform capnography confirms
- Post-intubation hypotension→Fluid bolus, pressor
RSI & Difficult Airway
- RSI
- Rapid sequence intubation
- Failed airway
- Can't intubate, can't oxygenate
- Cric
- Surgical airway rescue
- DOPE
- Displacement Obstruction Pneumothorax Equipment
- Waveform capnography
- Confirms tube placement
- NIPPV
- Noninvasive positive pressure vent
Sedation & Analgesia Agents
- Etomidate
- Induction, hemodynamic neutral
- Ketamine
- Induction, preserves airway drive
- Fentanyl
- Analgesia, fast onset
- Rocuronium
- Non-depolarizing paralytic
- Succinylcholine
- Depolarizing paralytic, fast onset
- Propofol
- Sedation, causes hypotension
DKA vs HHS
DKA
- Ketones present, acidotic
- Type 1 more common
HHS
- Extreme hyperglycemia, no ketones
- Type 2, older adults
Ketotic vs non-ketotic
Endocrine & Metabolic
- DKA
- Diabetic ketoacidosis, high glucose
- HHS
- Hyperosmolar hyperglycemic state
- Adrenal crisis
- Needs steroid replacement
- Anion gap
- Na minus Cl plus HCO3
- Sepsis
- Infection plus organ dysfunction
Toxicology & Critical Labs
- Naloxone
- Opioid reversal agent
- Activated charcoal
- GI decontamination, select overdoses
- ABG
- pH, CO2, O2, HCO3
- Lactate
- Marker of hypoperfusion
- Coag panel
- PT/INR and PTT values
Cushing's Triad Order
HTN, then bradycardia, then irregular breathing
Rising ICP causeLate, ominous signHerniation warning sign
Neuro Deterioration Response
- GCS drops 2+ points→Reassess airway, ICP
- Signs of herniation→Hyperosmolar therapy now
- Cushing's triad present→Treat as high ICP
- Suspected LVO stroke→Rapid transport, stroke center
Neuro Assessment & TBI
- GCS
- Eye plus verbal plus motor
- ICP goal
- Treat above 22 mmHg
- CPP
- MAP minus ICP
- Cushing's triad
- HTN, bradycardia, irregular respirations
- LVO
- Large vessel occlusion stroke
- Hyperosmolar therapy
- Mannitol or hypertonic saline
RUSH Exam Shock Categories
Pump, Tank, Pipes guide shock exam
Pump: cardiac contractility, tamponadeTank: volume status, IVCPipes: aorta, DVT source
IABP vs Impella
IABP
- Augments diastolic pressure
- Counterpulsation via balloon
- Needs stable rhythm
Impella
- Actively pumps blood
- Continuous flow device
- Rhythm independent
Assist vs active pump
Shock Type Recognition
- Cold, clammy, low output→Cardiogenic shock(Consider mechanical support)
- Warm, vasodilated, infection→Septic shock(Fluids plus norepinephrine)
- JVD, muffled heart tones→Obstructive shock(Tamponade or tension PTX)
- Trauma, low volume→Hemorrhagic shock(Blood products, control source)
ACS & Arrhythmia Recognition
- STEMI
- ST elevation, coronary occlusion
- Wellens syndrome
- Critical LAD lesion pattern
- VT
- Wide complex tachycardia
- Torsades
- Long QT VT variant
- Cardiogenic shock
- Pump failure, low output
STEMI vs Wellens Syndrome
STEMI
- ST elevation present
- Active occlusion now
Wellens syndrome
- T-wave inversion pattern
- Critical LAD, pain-free
Active vs impending occlusion
Hemodynamics & Mechanical Support
- IABP
- Intra-aortic balloon pump
- Impella
- Percutaneous LV assist device
- ECMO
- Extracorporeal life support
- MAP goal
- >65 mmHg typical target
- Vasopressors
- Norepinephrine first-line agent
Trauma Priority Sequence
- Massive hemorrhage visible→Direct pressure, tourniquet
- Airway compromise→Secure airway first
- Suspected tension pneumothorax→Needle or finger thoracostomy
- Burn >20% TBSA→Start Parkland fluid calc
Trauma & Burn Calculations
- Lethal triad
- Coagulopathy, acidosis, hypothermia
- Permissive hypotension
- SBP ~80-90 pre-control
- Parkland formula
- 4mL x kg x %TBSA
- Rule of nines
- Estimates burn surface area
- MTP
- 1:1:1 PRBC:FFP:plt
- Compartment syndrome
- Pain out of proportion
HELLP Syndrome Components
Hemolysis, Elevated Liver enzymes, Low Platelets
H: hemolysisEL: elevated liver enzymesLP: low platelet count
Preeclampsia vs Eclampsia
Preeclampsia
- HTN plus proteinuria
- No seizure activity
Eclampsia
- Preeclampsia plus seizures
- Obstetric emergency
No seizure vs seizure
OB & Neonatal Emergencies
- Preeclampsia
- HTN plus proteinuria after 20wk
- Magnesium sulfate
- Seizure prophylaxis in eclampsia
- Cord prolapse
- Knee-chest, elevate presenting part
- APGAR
- Newborn score at 1/5 min
- NRP
- Neonatal resuscitation algorithm steps
Pediatric Transport Pearls
- Broselow tape
- Length-based weight estimate
- Croup
- Stridor with barky cough
- RSV
- Bronchiolitis in infants
- NAT
- Suspect nonaccidental trauma pattern
- Pediatric DKA
- Cautious fluids, cerebral edema risk
Professional & Ethics
- JUST culture
- System error vs reckless
- GAMUT
- Transport quality metrics database
- EBM
- Evidence-based medicine practice
- DNR
- Honor advance directive wishes
- CISM
- Peer support after incidents
Common Traps
Preeclampsia vs eclampsia
No seizures yet ≠ Seizures already present
STEMI vs Wellens pattern
Active ST elevation ≠ T-wave warning sign
IABP vs Impella support
Augments native output ≠ Actively generates flow
DKA vs HHS
Ketotic, acidotic picture ≠ Non-ketotic, extreme glucose
Cric vs needle decompression
Airway rescue procedure ≠ Chest rescue procedure
Permissive vs aggressive resuscitation
Target lower pressure ≠ Until hemorrhage controlled
Boyle's vs Dalton's law
Gas volume expansion ≠ Partial pressure hypoxia
Last Minute
- 1.135 items: 110 scored, 25 unscored
- 2.2.5 hours, computer-based testing
- 3.Passing score: 73 of 110
- 4.Cardiac, Airway biggest weighted domains
- 5.Retest allowed after 30 days
- 6.Max three attempts per exam
- 7.Recertify every 4 years
- 8.Recert via 100 CE credits
- 9.Delivered via Prometric, paper, or LRP
- 10.Paramedic license plus experience recommended
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