Chapter 34: Transport of Infants and Children Test Bank

Multiple Choice

1. Which of the following types of health care providers generally compose the crew for infant transport?

a. Discharge planner and nurse b. Respiratory therapist and nurse c. Physician and nurse d. Discharge planner and physician

ANS: B

Data show that most pediatric transport teams in the United States are led by a nurse and accompanied by a respiratory therapist.

REF: p. 648

2. Which of the following professional organizations have developed educational requirements or training programs for pediatric transport personnel?

I. National Board for Respiratory Care

II. American Association for Respiratory Care

III. American Academy of Pediatrics

IV. Air & Surface Transport Nurses Associationa. I and II only b. III and IV only c. I, II, and III only d. II, III, and IV only

ANS: D

Several different professional organizations have developed training/ educational requirements for pediatric transport teams. The Air & Surface Transport Nurses Association (ASTNA, Greenwood Village, CO), American Association for Respiratory Care (AARC, Irving, TX), Commission on Accreditation of Medical Transport Systems (CAMTS, Anderson, SC), and the American Academy of Pediatrics (AAP, Elk Grove Village, IL) National Certification Corporation (NCC, Chicago, IL) are commonly recognized.

REF: p. 649 a. Personnel salaries b. Cost associated with training personnel c. Transport vehicles d. Updating equipment

3. What is the most expensive component of a pediatric transport program?

ANS: C

The single largest expense of a transport program is the operation and maintenance of its transport vehicles.

REF: p. 650

4. What are some of the operational features that characterize a pediatric transport unit?

I. 110-V AC electrical power

II. Point-of-care radiographic equipment

III. Medical air and oxygen

IV. Suction capabilities and equipmenta. III and IV only b. I, II, and IV only c. I, III, and IV only d. II, III, and IV only

ANS: C

All vehicles used to transport patients must comply with local, state, and federal guidelines for both air and ground ambulances. The vehicles must have 110-V AC electrical power available for the medical equipment used during transport. There should be sufficient medical gas (medical air and oxygen) capacity for all transport operations plus reserve capacity for use in the event of mechanical breakdown. The vehicles must also have provisions for suction equipment. The medical equipment used in transport, as well as the stretcher/incubator, must be safely secured within the vehicle during transport. The vehicle must have interior room, which will allow the transport team to treat and assess the patient and on occasion perform procedures safely during transport. All transport vehicles must have two-way communication capability, using radios or cellular phone. Each mode of transport ground, rotor wing (helicopter), and fixed wing (airplane) has advantages and disadvantages. The vehicle chosen should be appropriate for the patient population and geographic area served.

REF: p. 650

5. Which of the following distances is generally considered the maximum mileage in one direction for ground transport of a critically ill child? a. 15 miles b. 30 miles c. 45 miles d. 60 miles

ANS: B

Ground transport should be considered when distances are 30 miles or less one way for critical patients and, for stable patients, less than 80 miles one way.

REF: p. 650 a. Large enough for two incubators and eight personnel b. Large enough for one large incubator and two team members c. Large enough to secure two transport incubators and room to seat enough team members to provide care d. Large enough to be versatile regardless of the equipment and personnel needs

6. How large should the interior of an ambulance be for accommodating equipment and personnel?

ANS: C

The ambulance interior should be large enough to secure two transport incubators for transport of twins and room to seat the transport team members required for the care of two patients.

REF: p. 650

7. Which of the following distances is considered the effective radius for rapid transport of critically ill patients via helicopter? a. Less than 30 miles b. Between 30 and 150 miles c. Between 150 and 250 miles d. Between 250 and 300 miles

ANS: B

Helicopters are effective for rapid transport of critical patients within a 30- to 150-mile radius.

REF: p. 650 a. To avoid the crew “blacking out” b. To provide the patient’s oxygenation needs c. To avoid the patient becoming hypercarbic d. To reduce the risk of fire

8. Why must fixed-wing aircraft have the ability to control cabin pressure during the transport of critically patients?

ANS: B

All airplanes used for critical patient transport should have the ability to control the cabin altitude (pressurization), which makes transporting critically ill patients with marginal arterial oxygenation possible.

REF: p. 651

9. Which of the following communication systems is the most advantageous for fixed-wing ambulances to have to accomplish air-to-hospital communications? a. UHF/AM transceiver b. Walkie-talkie type phone c. VHF radios d. Satellite-type cell phone

ANS: D

Because of the short-range limitations of UHF radios, fixed-wing air ambulances should be equipped with a satellite-type cell phone for air-to-hospital communication. This will allow communication from just about any location around the world.

REF: p. 651 a. The patient always receives volume-controlled ventilation. b. The patient always receives pressure-controlled ventilation. c. The type of ventilation used is determined by the physician’s order. d. The type of ventilation used depends on the patient’s needs.

10. During transport, how is the decision made to provide volume- or pressure-controlled ventilation?

ANS: D

The decision to use a volume-limited or a pressure-limited ventilator should be based on the patient's size and ventilatory requirements.

REF: p. 652

11. What has proved to be the benefit of point-of-care blood analysis during transport? a. Cost-effectiveness b. Durability of the equipment c. Reduced patient stabilization time d. The need for fewer blood samples

ANS: C

Studies have shown that point-of-care testing reduces stabilization times and has the potential to improve the quality of care during transport.

REF: p. 653 a. Enough to last 30 minutes beyond the calculated duration b. Twice the calculated amount c. Three times the calculated amount d. Enough gas is always on board

12. How much medical gas needs to be taken on a transport?

ANS: B

The amount of gas taken should be approximately double that required. This allows for emergency usage in the event of mechanical breakdown of a vehicle.

REF: p. 653 a. Decreased urine output b. Respiratory rate decreases c. Endotracheal tube cuff pressure decreases d. Depth of breathing increases

13. Which of the following effects are expected during ascent in air transport?

ANS: D

As the aircraft and patient rise in altitude, the volume of contained gases will expand. This expansion has the following clinical implications for patient care: increased respiratory rate and depth, changes in intravenous flow rates, nausea and vomiting, increased need to urinate, increased pain, endotracheal tube cuff expansion (prevented by filling the cuff with normal saline), and increased sinus pressure in the case of head colds or blocked sinuses.

REF: p. 654 a. A higher flight altitude is necessary. b. Air-to-ground communications become difficult. c. Fuel consumption often increases. d. The aircraft may encounter more altitude-related concerns.

14. What are the negative effects of an aircraft flown with a sea-level cabin altitude?

ANS: C

Cabin pressurization creates an artificial atmospheric pressure inside the aircraft, known as cabin altitude. The cabin altitude can be adjusted from sea level to a maximal differential (usually 5000 to 6000 ft) depending on patient requirements and aircraft operations. An aircraft flown with a sea-level cabin altitude will not experience any of the effects of high altitude, but this could have a negative effect on the operation of the aircraft. Because of the pressure differential, the aircraft might need to be flown at a lower flight altitude to allow for the sea-level cabin pressurization. This lower flight altitude might increase the fuel burn (possibly requiring a fuel stop), slow the aircraft and thus increase transport time, and expose the aircraft to more severe weather concerns. Documentation of the cabin altitude during the patient transport should be included in the patient transport record. If for any reason flight cabin altitude may compromise the patient’s condition, medical control should be contacted.

REF: p. 654