AHA BLS training

A heart attack is a "_________" problem

"Clot"

Sudden cardiac arrest is often a "________________" problem.

"rhythm"

Rescue Breathing rates for adults and children/infants when pulse is strong but victim is unresponsive, gasping, or not breathing.

1 breath every 5-6 seconds or 10-12 breaths per minute for adults for children and infants 1 breath every 3-5 seconds or 12-20 breaths per minute

Acronyms: 1. CPR 2. BLS 3. AED 4. C-A-B

1. Cardiopulmonary resuscitation 2. Basic life support 3. Automated external defibrillator 4. Compression-airway-breathing

Team dynamic: roles

1. Clear roles and responsibilities 2. Knowing your limitations 3. Constructive intervention

Team dynamic: how to communicate

1. Closed-loop communication 2. Clear message 3. Mutual respect

How to perform back slaps & chest thrusts on a RESPONSIVE infant who is choking.

1. Hold the infant facedown and resting on your forearm, with the head slightly lower than the chest. 2. Support the head and jaw with your hand 3. Deliver up to 5 back slaps forcefully between the infant's shoulder blades, using the heel of your hand. Deliver each slap with sufficient force to attempt to remove the foreign body. 4. Place your free hand on the infant's back, supporting the head with the palm of your hand, turn the infant over while carefully supporting the head and neck. 5. Keep the infant's head lower than the chest, and deliver up to 5 quick downward chest thrusts in the same location that you perform compressions at a rate of 1 per second 6. Repeat the sequence of 5 back slaps and 5 chest thrusts until the object is removed or until the infant becomes unresponsive.

Team dynamic: what to communicate

1. Knowledge sharing 2. Summarizing and reevaluating

How to use pocket mask

1. Place the mask on the victim's face, using the bridge of the nose as a guide for correct position. 2. Seal the mask against face placing the index finger & thumb of your hand closest to the top of the victim's head along edge of the mask. Now place thumb of your other hand along lower edge of the mask. 3. place the fingers of that hand under the bony part of the victim's lower jaw, near the chin, avoid the soft tissue under the chin. Open the airway by using the head tilt-chin lift. 4. press the mask down while lifting the jaw to hold the mask tightly against the face. 5. Give 2 breaths while watching for chest rise.

The 4 universal steps for operating AED device

1. Power on the AED if needed. Follow the AED prompts as a guide to next steps. 2. Attach AED pads to the victim's bare chest. 3. "Clear" the victim and analyze the rhythm. 4. If the AED advises a shock, it will charge and then tell you again to clear the victim. Clear the victim before delivering the shock. Press the shock button. The shock will produce a sudden contraction of the victim's muscles. If no shock is needed, and after any shock delivery, immediately resume CPR, starting with chest compressions.

Pediatric Chain of Survival Links

1. Prevention of cardiac arrest 2. early high quality CPR 3. activation of the emergency response system 4. effective advanced life support 5. integrated post cardiac arrest care

The 3 groupings of the elements of team dynamics

1. Roles 2. What to communicate 3. How to communicate

What are the BLS steps for adults?

1. Scene safety 2. Check for responsiveness and verify they are unresponsive 3. Shout for nearby help and activate emergency response system , then get AED equipment or send someone to do so 4. Breathing and pulse check, look for no breathing or only gasping, and check for pulse.

If infant becomes unresponsive while choking.

1. Shout for help 2. lay infant on hard flat surface 3. Begin CPR 4. When time to give breaths look for object first and remove if you can see it and reach it. NO BLIND FINGER SWEEPS 5. continue cycles of CPR If alone after 2 mins activate emergency response system

How to perform Heimlich maneuver/ abdominal thrusts.

1. Stand/kneel behind the victim, place your arms around their waist; with one hand, locate the navel. 2. Make a fist with the other hand and place the thumb side of your fist against the victim's abdomen, just above the navel and below the breastbone 3. Grasp your fist with the other hand and press your fist into the victim's abdomen with a quick, forceful upward thrust. 4. Repeat thrusts until the object is expelled from the airway or the victim becomes unresponsive.

Differences of adult and pediatric

1. age 1 to puberty is considered a child (chest/underarm hair for boys, breasts for girls) 2. you can use 1 or 2 hand compressions @1/3 depth of childs chest 3. In 1 rescuer scenario stay with 30:2 compression/ breath In 2 rescuer team change to 15:2 compression/breath 4. In 1 rescuer if you did not witness the arrest do 5 cycles of CPR before leaving to activate the emergency response system to ensure victims brain is oxygenated

Adult Chain of Survival Links (out of hospital)

1. immediate recognition of cardiace arrest & activation of emergency response system 2. early CPR w/ emphasis on chest compressions 3. rapid defibrillation 4. effective advanced life support 5. integrated post-cardiac arrest care

Adult Chain of Survival Links (in-hospital)

1. surveillance, prevention, and treatment of prearrest conditions 2. immediate recognition of cardiac arrest and activation of the emergency response team/code team 3. Early CPR with emphasis on chest compressions 4. Rapid defibrillation 5. Multidisciplinary post-cardiac arrest care

How do you perform a rescue breath without barrier breathing piece?

1. use head tilt-chin lift positioning 2. Pinch nose closed w thumb and index of hand on forehead 3. Take a regular breath and seal lips around victims mouth 4. give 1 breath for 1 second watching for chest rise (repeat head tilt if chest does not rise) 5. give second breath for 1 second and return to compressions even if unable to ventilate after the two breaths.

Correct sequence for 2-rescuer adult BLS:

1. verify scene safety 2. 2nd rescuer activates emergency response system and gets AED while 1st stays w/ victim 3. assess for breathing and pules 4. 1st rescuer begins CPR w/ chest compressions 5. AED arrives and powers on 6. 2nd rescuer attaches AED pads to bare chest 7. 2nd rescuer "clears" the victim for AED alalyze and shock 8. Resume CPR

Once CPR begins what should you minimize interruptions in chest compressions to?

10 seconds

how many compressions followed by how many breaths for CPR?

30 compressions followed by two breaths and repeat cycle until signs of rhythm return

About how often does a person die from cardiac arrest?

About every 90 seconds

When using a bag mask where should you be located?

Above/at the head of the victim

T/F Adult AED pads should never be used on an infant.

Adult AED pads may be used on an infant if pediatric pads with a dose attenuator or manual defibrillator is not available.

What condition may cause a patient to stop breathing but still have a pulse?

Opioid-Associated Life-Threatening Emergency

When should the rescuer operating the AED clear the victim?

BEFORE analysis and BEFORE delivery of the schock

If there is no breathing or only gasping, and no pulse what should you do?

Begin CPR cycles of 30 compressions and 2 breaths. Use AED as soon as is available

What is anterolateral placement?

Both pads will be placed on the victim's bare chest. Place one AED pad directly below the right collarbone. Place the other pad to the side of the left nipple, with the top edge of the pad a few inches below the armpit.

Where do you do a pulse check on an infant?

Brachial pulse check

Cardiac Arrest

Cardiac arrest occurs when the heart malfunctions and stops beating unexpectedly.

Where should you perform a pulse check on an unresponsive adult?

Carotid Pulse Check

When food or other objects block an persons airway ___________ occurs.

Choking

Which signs indicate that a person has a severe airway obstruction?

Clutching at the throat with the thumb and fingers Being unable to speak Skin turning blue No coughing

How fast can death occur if a victim of cardiac arrest does not receive immediate lifesaving treatment?

Death can occur within minutes

If victim is too large to wrap arms around and choking what should you do?

Do chest thrusts instead of abdominal thrusts, wrapping arms around chest instead.

T/F If a victim has a hairy chest, the rescuer should not spend time shaving the chest before applying the AED pads.

False

T/F When a victim has a pacemaker, the rescuer should attach the AED pad directly over the pacemaker.

False

When performing CPR for a child, the rescuer should compress the chest by using 2 fingers.

False

T/F For an unresponsive child who has a pulse but is not breathing, deliver 1 breath every 6 seconds.

False For rescue breathing given to infants and children, give 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute.

T/F When an advanced airway is in place, the rescuer should compress at a rate of 90 to 100/min.

False The compression rate when an advanced airway is in place should remain at 100 to 120/min, with no pause to deliver breaths.

Regarding infant BLS : During 1-rescuer infant CPR, the rescuer uses the heel of 1 hand to provide chest compressions.

False single rescuer should use 2 fingers in the center of the infant's chest, just below the nipple line, on the lower half of the breastbone.

T/F In an infant who is choking, chest thrusts are delivered in the middle of the chest, over the upper half of the breastbone.

False While keeping the infant's head lower than the chest, the rescuer should deliver up to 5 quick, downward chest thrusts in the same location as for chest compressions, just below the nipple line, over the lower half of the breastbone. For choking relief in an infant, the sequence of up to 5 back slaps and up to 5 chest thrusts is repeated until the object is removed or the infant becomes unresponsive.

How do you check for brachial pulse on an infant?

For 5- 10 seconds use 2-3 fingers to lightly press on inner side of upper arm

Advanced Airways breaths rule for CPR

For all ages, perform continual compressions at a rate of 100 to 120/min without pauses for breaths, and give 1 breath every 6 seconds (10 breaths per minute).

What are the symptoms that women are more likely to experience during a heart attack?

Pain in jaw, arms, back, or neck light-headedness nausea/vomiting

A rescuer arrives at the side of an adult victim and suspects an opioid-associated life-threatening emergency. The victim is unresponsive and not breathing normally but has a pulse. Which action should the rescuer do next?

Give 1 breath every 5 to 6 seconds For a suspected opioid-associated life-threatening emergency in a victim who is unresponsive and not breathing normally but does have a pulse, the rescuer should give 1 breath every 5 to 6 seconds in an adult, and every 3 to 5 seconds in a child or infant. Then, if local protocol allows, the rescuer may give naloxone. But the rescuer should not delay breaths to give naloxone.

How do you need to push for compressions?

Hard, fast compressions allowing for the chest to fully recoil inbetween

What is the method to open airway for breaths?

Head tilt-chin lift 1. w/ hand on forehead push w palm to tilt head back 2. place fingers of other hand under bony part of jaw 3. lift jaw to bring chin forward (lifts the tongue away from back of throat)

What is a common CAUSE of cardiac arrest?

Heart attack

What term is often mistakenly used to describe cardiac arrest?

Heart attack

What is the abdominal thrust for airway obstructions on a standing or kneeling victim called?

Heimlich maneuver

When do you need to do CPR on an infant?

If there is no pulse or if pulse is less than 60 BPM with signs of poor perfusion despite adequate oxygenation begin CPR

What is the difference in infant mouth to mouth and adult mouth to mouth breathing?

In an infant we use the mouth-to-mouth-and-nose technique; if can't get mouth around both the use mouth-to-mouth and pinch nose

What positioning does your victim need to be in before starting chest compressions?

Laying on a firm, flat surface, face-up. If possible work with a bare chest to provide AED pad access later on.

Signs of a heart attack may appear or occur when?

May appear immediately or last weeks or longer

When to give Naloxone

Naloxone can reverse effects of opioids and may restore normal breathing When an opiod associated life threatening emergency is suspected and patient is unresponsive, not breathing normally, but does have a pulse begin giving rescue 1 breath every 5-6 sec. to an adult (1 breath every 3-5 sec for child/infant) and if protocol allows give naloxone Do not delay breaths to give naloxone and if patient has no pulse you can give naloxone after starting CPR

Do all heart attacks lead to sudden cardiac arrest?

No, Most heart attacks do not lead to sudden cardiac arrest, though a small percentage of people with a heart attack will develop sudden cardiac arrest

What is anteroposterior placement?

One pad will be placed on the victim's bare chest (anterior), and the other will be placed on the victim's back (posterior). Place one AED pad on the left side of the chest, halfway between the tip of the breastbone and left nipple, with the upper edge of the pad below the nipple line. Place the other pad on the left side of the victim's back, beneath the shoulder blade, next to the spine.

First rescuer role in a 2 person rescue?

Positioned at victims side begin CPR w/ chest compressions while counting out loud and delivering breaths.

A rescuer has determined that the victim suspected of having an opioid-associated life-threatening emergency is unresponsive, is not breathing normally, and has no pulse. Which action should the rescuer do next?

Provide high-quality CPR and use the AED as soon as it is available For a suspected opioid-associated life-threatening emergency in a victim who is unresponsive, is not breathing normally, and has no pulse, the rescuer should provide high-quality CPR and use the AED as soon as it is available. Then, if local protocol allows, the rescuer may give naloxone after starting CPR.

If there is no normal breathing but there is a pulse what should you do?

Provide rescue breathing by giving 1 breath every 5-6 sec. or about 10-12 breaths per min. Check pulse every 2 mins.

Rescuer 2 role in 2 person rescue?

Responsible for calling code, powering up AED device, and attaching pads. Also number 2 should be positioned at victims head and maintaining an open airway and giving breaths

After the AED delivers a shock, what should the rescuers do next?

Resume CPR immediately, beginning with chest compressions.

What should you do if choking victim becomes unresponsive?

Send someone to activate emergency response system Lower victim to the floor Begin CPR- however before breaths check to see if obstruction is visible in back of throat and remove if possible but DO NOT DO BLIND FINGER SWEEP

What are some of the signs of a heart attack that may appear commonly (men & women)

Severe discomfort in the chest or other parts of upper body Shortness of breath cold sweats nausea/vomiting

What happens during a heart attack

The heart continues to pump blood Possible heart damage occurs the longer a person goes without treatment

If a rescuer is alone and did not see the child collapse, the rescuer should perform 2 minutes of CPR before leaving the child to activate the emergency response system and get the AED.

True

Regarding infant BLS : During high-quality infant CPR, chest compressions should be delivered at a depth of at least one third the anteroposterior diameter of the chest, or about 1½ inches (4 cm)

True

T/F A rescuer should give breaths at the rate of 1 breath every 6 seconds during 2-rescuer CPR for an adult when an advanced airway is in place.

True

T/F A victim's chest is covered in perspiration. The rescuer would need to quickly dry the chest before applying the AED pads.

True

T/F Before attaching the AED pad to a victim with a medication patch on his chest, the rescuer should quickly remove the patch and wipe the area clean first.

True

T/F Rescue breathing is providing breaths to a victim who has a pulse but is not breathing.

True

T/F When delivering back slaps to an infant who is choking, the rescuer should use the heel of the hand and forcefully deliver the slap between the infant's shoulder blades.

True

T/F When giving CPR to an infant who is choking and becomes unresponsive, the rescuer should look for the object in the back of the throat each time the airway is opened.

True

T/F When they are available, the rescuer should use child pads with a pediatric dose attenuator for infants and children less than 8 years of age.

True

Ture or false: Sudden cardiac arrest is a leading cause of death.

True 360,000 out-of-hospital cardiac arrests occur annually in the United States. Fast action can save lives.

AED for infants and children what consideration regarding the pads?

Use child pads if available which reduces shock dose but do not use child pads on adults See if the AED has a pediatric dose attenuator Make sure pad placement is according to pacakage as some use the anteposterior placement instead

When does a heart attack occur?

When blood flow to part of the heart muscle is blocked, a clot forms in a blood vessel carrying oxygenated blood to the heart muscle. If the blocked vessel is not reopened quickly, the muscle normally nourished by that vessel begins to die.

Sudden cardiac arrest occurs with or without warning?

Without

If a victim nods that he or she is choking and cannot talk should you act or not?

YES

Can conditions other than heart attack lead to cardiac arrest?

Yes anything that may change the hearts rhythm

Infant applies to what ages?

Younger than a year but not a newborn.

Clearing an object from a responsive infant's airway requires what kind of maneuvers?

a combination of back slaps and chest thrusts

Basic Life Support is the foundation for saving lives after _______________ _______________

cardiac arrest

What is the universal sign of choking?

clutching the neck with both hands

If there breathing and pulse what should you do?

monitor until emergency responders arrive

What are signs of severe airway obstructions?

signs of poor air exchange and breathing: 1. silent cough 2. inability to speak or breathe 3. cyanosis

How do you perform chest compressions on an infant?

with 2 fingers in center of infants chest just below nipple line

Differences between one or two rescurer CPR with infants

with 2 rescuer CPR use the two thumb-encircling technique Also the 15:2 compressions/breaths

How soon after symptoms appear can sudden cardiac arrest occur?

within minutes of onset of symptoms