BCEN CFRN Practice Test

The first priority in a post-crash scenario is to secure the scene and ensure all crew and patients are accounted for and safe. Securing the scene mitigates any potential hazards and gathers all individuals in a safe and manageable area. This is essential before administering any medical care or setting up communication equipment.

The SBAR (Situation, Background, Assessment, Recommendation) technique is used to provide a clear and concise patient handoff. 'Situation' involves briefly explaining the current situation and reason for transport. 'Background' provides relevant patient history. 'Assessment' includes the nurse's evaluation of the patient's condition. 'Recommendation' suggests the next steps. Using all four elements ensures comprehensive communication. Focusing solely on flight time or the patient's condition without using the full SBAR structure can lead to incomplete information transfer.

The primary concern when preparing a landing zone is ensuring it is clear of any obstructions. This includes removing debris, securing any loose objects, and determining a flat area that is free from power lines, trees, and other obstacles that may pose danger to the helicopter while landing. Ensuring a clear and large enough area minimizes the risk of accidents during the helicopter's approach and landing. While safety markings and communication are important, they do not directly impact the physical safety as obstructions do.

At higher altitudes, the partial pressure of oxygen decreases, leading to hypoxia. This can significantly impact patients with respiratory conditions like COPD, as their reduced capacity to exchange gases becomes more pronounced. Monitoring and managing oxygen levels are critical to prevent complications. Pulmonary edema and barotrauma are also concerns in flight transport, but hypoxia is a primary challenge due to reduced oxygen availability at altitude.

Manually activating the beacon will ensure it starts transmitting distress signals, which can be critical for rescue operations. The switch should be moved to the 'On' position to send out the emergency signal. This knowledge is essential for all crew members to expedite rescue efforts. Other actions, such as attempting to reboot or switch device batteries, may not be feasible or effective in triggering the beacon's transmission.

Ensuring scene safety by establishing a safe perimeter and identifying safe entry points is crucial to prevent additional exposure to hazardous substances. Direct patient care cannot be safely performed until the nurse verifies the area is secure and appropriate PPE is available. Initiating decontamination procedures or administering life-saving interventions within the hot zone before ensuring it's safe poses risks to both the nurse and the patients. Waiting for a hazmat team without taking any preparatory actions might delay critical safety measures.

Hypoxia is a major concern at high altitudes and can lead to symptoms such as fatigue, decreased cognitive function, and impaired judgment. This makes it especially critical for air medical crew to monitor their own physiological status as well as that of their patients. Dehydration and vibration are also possible stressors but are less directly linked to the described symptoms. Temperature fluctuations can cause discomfort and thermal regulation issues, but the primary cause of fatigue and decreased cognitive function is hypoxia.

In a handoff report, using the SBAR (Situation, Background, Assessment, Recommendation) method ensures that critical information about the patient's condition, recent treatments, and ongoing care needs are communicated clearly. The patient's current medical status update informs the receiving provider of any recent changes in condition or treatments, which is crucial for planning continued care. Pre-existing medical conditions are also important but are part of the 'Background' and not as critical in immediate handoff. Contact information for the referring provider is useful but less crucial in the direct care handoff.

Night-vision goggles (NVGs) are specifically designed to help users see in low-light conditions, making them an essential tool for nighttime navigation in unfamiliar terrain. While GPS and maps are also important, NVGs provide real-time visual enhancement, which is critical when visibility is poor.

The first priority after an emergency landing is to ensure the immediate safety and health of the crew and patient by checking for injuries and providing necessary medical care. While contacting emergency services, using location devices, and assessing supplies are essential, they come after securing the immediate safety of everyone on board. Checking for injuries allows the nurse to determine if anyone needs immediate medical intervention, which is critical in the first moments post-crash.

The correct answer is to try switching to a secondary frequency or backup radio system. This is because there may be interference or an issue with the primary channel, and using an alternative frequency or system can quickly restore communication. Checking if the radio is properly connected and functional is also essential, but if the original loss was sudden and unexpected, trying different frequencies first is more efficient. Returning to the last known area of coverage may take too much time and may not be feasible during critical transport operations.

At higher altitudes, the partial pressure of oxygen decreases, leading to lower oxygen saturation in the patient's blood. This can significantly affect patients with pre-existing respiratory conditions, causing increased respiratory distress. While vibration and noise are stressors, they do not directly impact oxygen saturation levels.

Ensuring the landing zone (LZ) is clear of obstacles like trees, wires, and poles is crucial for pilot visibility and helicopter safety. Obstacles can cause collisions, especially at night when visibility is reduced. While the LZ should also be well-lit and easily accessible, the presence of obstacles poses the most immediate danger to safe landing and takeoff operations.

During air transport, the decrease in atmospheric pressure at higher altitudes leads to a reduction in the partial pressure of oxygen. This can cause hypoxemia, particularly in patients with underlying respiratory or cardiac conditions like CHF. The body’s ability to uptake oxygen diminishes, exacerbating dyspnea and reducing oxygen saturation.

Effectively stepping into a leadership role and assigning specific duties ensures that the team stays organized and focused. It is important to immediately communicate the change in roles to avoid confusion and ensure all team members are aware of their responsibilities. Simply taking over tasks without communicating with the crew can lead to disorganization and missed steps.