IBSC FP-C Certified Flight Paramedic

According to Boyle's Law, what happens to a gas pocket in the pleural space during ascent to 8,000 feet?

• AThe gas pocket will decrease in volume by 25%
• BThe gas pocket will remain unchanged regardless of altitude
• CThe gas pocket will expand due to decreased atmospheric pressure
• DThe gas will be absorbed by surrounding tissues at altitude

A patient with a traumatic brain injury has a small pneumocephalus identified on CT scan. What is the primary concern regarding air transport?

• AThe patient will experience increased oxygen toxicity at altitude
• BIntracranial air will expand, potentially causing increased ICP
• CLower oxygen levels will worsen the brain injury
• DVibration from the aircraft will worsen the injury

In the standard atmosphere at 10,000 feet, total dry ambient pressure is about 523 mmHg. Which law gives oxygen partial pressure as 0.21 × 523 mmHg?

• ABoyle's Law
• BCharles's Law
• CDalton's Law
• DHenry's Law

Under the CAMTS 12th-edition fixed-wing standard, how should the team determine a safe cabin altitude for a patient with a pressure-sensitive condition?

• AApply a single 5,000-foot limit to all patients
• BUse physician guidance or disease-specific altitude policy
• CUse the aircraft’s cruising altitude as the patient’s altitude limit
• DApply the flight crew’s oxygen threshold to the patient

During a weather-related divert, the pilot and medical crew disagree on whether to continue to the destination or land at the alternate. Which Crew Resource Management (CRM) principle should be applied?

• ALet the pilot decide without hearing the medical assessment
• BShare both assessments and respect the pilot’s flight authority
• CLet the most senior clinician decide where the aircraft lands
• DAsk the sending physician to decide if the aircraft can continue

A 45-year-old patient requires rapid sequence intubation in flight. There is no known contraindication to succinylcholine. Which regimen pairs a usual adult induction dose with a rapid-onset neuromuscular blocker?

• AMidazolam 10 mg IV after succinylcholine 1.5 mg/kg IV
• BEtomidate 0.3 mg/kg IV followed by succinylcholine 1.5 mg/kg IV
• CPropofol 2.5 mg/kg IV without a neuromuscular blocker
• DKetamine 2 mg/kg IV without a neuromuscular blocker

A transport ventilator has automatic altitude compensation and remains within its specified operating range. What is the best approach during ascent?

• AIncrease the respiratory rate in proportion to altitude
• BReduce FiO2 to maintain the original delivered tidal volume
• CIncrease inspiratory time in proportion to altitude
• DKeep the ordered tidal volume and verify delivery on the monitor

A patient with a difficult airway requires a surgical cricothyrotomy during flight. What is the correct anatomical location for the incision?

• AThrough the thyroid cartilage
• BThrough the cricothyroid membrane
• CThrough the cricoid cartilage
• DBelow the cricoid at the first tracheal ring

An intubated adult has a reliable SpO2 of 82% on FiO2 0.40. The airway and circuit are patent, and the team is checking for the cause of worsening oxygenation. Which setting can raise inspired oxygen immediately without first increasing airway pressure?

• AIncrease the respiratory rate to 18
• BIncrease PEEP to 8-10 cm H2O
• CIncrease FiO2 and reassess the oxygen response
• DDecrease tidal volume to 400mL

During RSI, an adult develops a heart rate of 42 bpm and hypotension after succinylcholine. Oxygenation and ventilation are being supported and a pulse is present. What is the initial atropine dose for persistent symptomatic bradycardia?

• AAtropine 1 mg IV
• BAtropine 0.5 mg IV
• CAtropine 0.02 mg/kg IV
• DAtropine 3 mg IV

Which listed device is expected to deliver the highest inspired oxygen concentration to a spontaneously breathing adult?

• ANasal cannula at 6 L/min
• BSimple face mask at 10 L/min
• CNon-rebreather mask at 15 L/min with reservoir
• DVenturi mask at 40% FiO2

An adult with ARDS is transported on tidal volume 6 mL/kg predicted body weight, PEEP 10 cm H2O and FiO2 0.80. A valid inspiratory hold measures plateau pressure at 35 cm H2O. Which adjustment directly reduces the excessive plateau pressure?

• AIncrease PEEP to improve oxygenation
• BDecrease tidal volume to reduce plateau pressure
• CIncrease respiratory rate to improve minute ventilation
• DThe current settings are appropriate

A patient with an inferior wall STEMI develops profound bradycardia with hypotension. The heart rate is 38 bpm and BP is 72/48. What is the most appropriate initial treatment?

• AAtropine 1mg IV and prepare for transcutaneous pacing
• BDopamine infusion at 10 mcg/kg/min
• CImmediate synchronized cardioversion
• DAdenosine 6mg rapid IV push

A patient with new severe left ventricular systolic dysfunction after an MI has PAOP 24 mmHg, CVP 18 mmHg, cardiac index 1.8 L/min/m², and high systemic vascular resistance. Which type of shock best fits the combined findings?

• AHypovolemic shock
• BDistributive shock
• CCardiogenic shock
• DObstructive shock

An adult with left ventricular pump failure remains hypotensive despite an initial vasoactive infusion. The team wants an agent with a strong alpha-adrenergic pressor effect and less arrhythmia risk than dopamine. Which agent fits?

• AContinue to escalate dopamine
• BNorepinephrine
• CDobutamine alone
• DNitroglycerin

A 12-lead ECG confirms sustained monomorphic ventricular tachycardia at 220 bpm in an adult with a pulse and no hemodynamic compromise. Which listed IV regimen is an appropriate initial antiarrhythmic?

• AImmediate synchronized cardioversion at 200 J before a drug trial
• BAdenosine 6 mg rapid IV push
• CAmiodarone 150 mg IV over 10 minutes
• DAmiodarone 300 mg rapid IV push

A patient with an intra-aortic balloon pump (IABP) is being transported. The balloon inflates during which phase of the cardiac cycle?

• ADuring systole to increase afterload
• BDuring diastole to increase coronary perfusion
• CDuring the entire cardiac cycle
• DOnly during arrhythmias