BLS
When an advanced airway is in place, chest compressions should be provided at a rate of ____ to ____ per minute.
100 to 120
When providing rescue breaths to a child or infant victim, you should give 1 breath every ____ to ____ seconds.
2 to 3
assigning your team members to individual roles and outlining what each member needs to do during the resuscitation attempt is an example of what element of high-performance team dynamics?
Clear roles and responsibilities
You and your team have initiated compressions and ventilation. The AED was attached, and "no shock" was advised. Your team has continued CPR for 1 minute. You tell your team in a respectful, clear, and calm voice " Leslie, during the next analysis by the AED, I want you and Justin to switch positions and I want you to perform compressions for the next cycle" Lesli replies, " Got it. Next time the AED analyzes, I will switch with Justin and assume the role of the compressor." This is an example of which element of high-performance team dynamics?
Closed-loop communication
CARDIAC ARREST IN A PREGNANT PATIENT
High-quality CPR can increase the mother's and the infant's chance of survival. -perform compressions and use an AED as you would for any cardiac arrest victim. Shock from the AED will not harm the infant -if additional rescuers are present and rescuers are trained, perform continuous lateral uterine displacement, in addition to high-quality BLS -if the woman is revived, place her on her left side. This may help improve blood flow to her heart and therefore, to the infant
CHOKING IN OBESE and PREGNANT VICTIMS
If the victim is too large for you to wrap your arms around the waist: - wrap your arms around his or her chest - perform chest thrusts instead of abdominal thrusts
What are common administration routes for naloxone?
Intramuscular Intravenous Intranasal
How can you achieve a high chest compression fraction?
Minimize pauses in chest compressions
How is CPR performed differently when an advanced airway is in place?
No pauses for ventilations (compressions are continuous at 100 to 120/min)
OPIOID-ASSOCIATED LIFE-THREATENING EMERGENCY:
Opioid-associated life-threatening emergency is a condition that can cause a person to stop breathing but still have a pulse.
CHOKING IN INFANTS
Step 1: - First sit or kneel with the infant in your lap. - Hold the infant facedown and resting on your forearm, with the head slightly lower than the chest. - support the head and jaw with your hand. Step 2: - Rest your forearm on thigh to provide support. - 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. Step 3: - Place your free hand on the infant's back, supporting the head with palm of your hand. This will cradle the infant as you turn the infant over faceup. - Keep the infant's head lower than chest, and deliver up to 5 quick downward chest thrusts. -- Do this at a rate of about 1 per second, each with intention of creating enough force to dislodge the foreign body. - Repeat the sequence until the object is removed or the infant becomes unresponsive.
HOW TO USE A POCKET MASK
Step 1: - position yourself at the victim's side. - place the pocket mask on the victim's face, using the bridge of the nose as a guide for correct positioning. Step 2: - seal the mask against the face. - using your hand that is closer to the top of victim's head, place your index finger and thumb along the top edges of the mask. - place the thumb of your other hand along the bottom edge of the mask. Step 3: - place the remaining fingers of your second hand along the bony margin of the jaw and lift the jaw - perform a head tilt-chin lift to open airway Step 4: - while you lift the jaw, press firmly and completely around the outside edge of the mask to seal the pocket mask against the face. Step 5: - deliver each breath over 1 second. - enough to make the victim's chest rise.
ABDOMINAL THRUSTS: ADULTS and CHILDREN
Step 1: Stand or kneel behind the victim and place your arms around the victim's waist; with one hand, locate the navel. Step 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 well below the breastbone. Step 3: Grasp your fist with the other hand and press your fist into the victim's abdomen with a quick, forceful upward thrust. -- Repeat thrusts until the object is expelled from the airway or the victim becomes unresponsive.
When performing abdominal thrusts on adults and children, in which direction should your thrusts be directed?
Upward
MINIMIZING INTERRUPTIONS WHILE USING AN AED
When 2 or more rescuers are present, - One rescuer should continue chest compressions while the other operates the AED. Rescuers should continue high-quality CPR - Until the AED delivers a prompt to clear the victim for analysis. If NO shock is advised, - Immediately resume CPR, starting with chest compressions.
What is the indication for mouth-to-mouth rescue breaths?
When a barrier device is not available
When a choking infant becomes unresponsive, what is one thing you need to do differently when performing CPR?
check the airway for the obstructing object
If a choking victim is too large for you to wrap your arms around the waist, you should perform ____ thrusts?
chest
How does CPR differ in an unresponsive adult chocking victim?
the airway is checked for the obstructing object
as team leader you notice that your compressor is pushing too fast. It is important to correct actions that are incorrect, but it is also important to be tactful when delivering this correction to a colleague. This is an example of what element of team dynamics?
Constructive intervention
What is a sign of severe airway obstruction?
Inability to speak
OPIOID-ASSOCIATED LIFE-THREATENING EMERGENCY: Naloxone is a medication that can temporarily reverse the effects of opioid overdose.
- Common routes of administration for naloxone include intravenous, intramuscular, and intranasal.
Rescue Breathing: Children and Infants
- Give 1 breath every 2 to 3 seconds (20 to 30 breaths/min). - Give each breath over 1 second, and make sure there is chest rise with each breath. - During rescue breathing, check the victim's pulse every 2 minutes.
Rescue Breathing: Adults
- Give 1 breath every 6 seconds (10 breaths/min). - Give each breath over 1 second and make sure there is visible chest rise with each breath. - During rescue breathing, check the victim's pulse every 2 minutes.
OPIOID-ASSOCIATED LIFE-THREATENING EMERGENCY: For a person who is unresponsive and not breathing normally but has a pulse:
- Give 1 rescue breath every 6 seconds in an adult. - Give 1 rescue breath every 2 to 3 seconds in a child or infant. - Then, if you local protocol allows, give naloxone. Don't delay breaths to give naloxone.
CHOKING: UNRESPONSIVE ADULTS or CHILDREN
- If a choking victim becomes unresponsive, send someone to activate the emergency response system. - Lower the victim to the ground. - Perform CPR with 1 exception: each time you open the airway to give breaths, look for the obstructing object. - If you see an object that can be easily removed, carefully remove with your fingers. DO NOT DO A BLIND FINGER SWEEP.
WITNESSED COLLAPSE: CHILDREN and INFANTS
- If you are alone with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Use the AED as soon as it is available. - If you are Not alone, send someone to get the AED and begin CPR immediately. Use the AED as soon as it is available.
UNWITNESSED COLLAPSE: CHILDREN and INFANTS
- If you are alone, start CPR with cycles of 30:2. - If you are Not alone, send someone to the the AED and begin CPR immediately. Use the AED as soon as it is available. - After about 2 minutes, if you are still alone, activate the emergency response system and get an AED if not already done. - Use the AED as soon as it is available.
When an advanced airway is in place:
- Perform continuous compressions at 100 to 120/min. - Give 1 breath every 6 seconds for adults - Give 1 breath every 2 to 3 seconds for a child or infant - No pauses in compressions to give breaths
A bag-mask device:
- Provides positive-pressure ventilation. - Consists of a bag attached to a face mask. - May include a 1-way valve.
If infant becomes unresponsive:
- Shout for help and send someone to activate the emergency response system. - Place the infant on a hard, flat surface. - Begin CPR with 1 exception, each time you open the airway to give breaths, look for the obstructing object. - If you see an object that can be easily removed, carefully remove it with your fingers. DO NOT DO A BLIND FINGER SWEEP. - If you are alone, after 2 minutes or 5 cycles of CPR, activate the emergency response system.
What are the special considerations for defibrillation in children less than 8 years of age?
- a manual defibrillator is preferred for infants less than 1 year of age (YES/TRUE). - use smaller-sized pads, if available (YES/TRUE) - if child pads are not included, use adult pads (YES/TRUE) - always place both pads on the chest (NO/FALSE) - use smaller-sized pads for infants, not children (YES/TRUE)
What does a chest compression feedback device monitor?
- compression depth - compression rate - chest recoil
SIGNS of CHOKING: ADULTS and CHILDREN: With a SEVERE airway obstruction, the victim will show signs of poor air exchange and difficulty breathing such as:
- silent cough - inability to speak or breathe - cyanosis (turning blue) An adult or older child may clutch the neck with both hands, making the universal choking sign. If the victim nods that they are choking, you must act.
What are examples of effective team dynamics?
-clear roles and responsibilities -knowledge sharing -debriefing -constructive intervention
When providing rescue breaths to an adult victim, you should give ____ breath(s) every ____ seconds.
1 breath(s) every 6 seconds
What is the correct sequence of actions for performing mouth-to-mouth-and-nose breaths for an infant?
1. Perform a head tilt-chin lift 2. Place your mouth over the infant's mouth and nose to create an airtight seal 3. Give one breath, blowing for about 1 second, watching for chest rise
Your adult friend suddenly collapse at home, and you determine she needs CPR. You begin CPR, starting with chest compressions, and are about to deliver breaths by using mouth-to-mouth breaths. You open the airway with a head tilt-chin lift. What is the sequence of your next actions?
1. Pinch the nose and seal your lips around the victim's mouth 2. Give 1 breath and blow for about 1 second 3. Watch for chest rise while giving the breath 4. Give a second breath (blowing for about 1 second, watching for chest rise)
Advanced Airways:
A laryngeal mask airway, supraglottic airway device, and endotracheal tube are types of advanced airways.
Which of the following are resuscitation triangle roles in a high-performance team?
Airway, Compressor, AED/Monitor/Defibrillator
You respond to a collapsed pregnant female as the only rescuer. You follow the BLS sequence that she is unresponsive, is not breathing, and has no pulse. She is visibly pregnant. You activate the emergency response system. What is your next action?
Begin chest compressions