BLS Lesson 4: Basic Life Support for Children and Infants

You are caring for for a 6-month-old infant who is unresponsive, breathing and has a pulse. What should you do?

*All of the above.* Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/initial interventions. Perform secondary assessment as patient condition allows. Reassess patient, recognize issues and provide care as needed.

If Theo had an advanced airway in place during CPR, what would be the correct rate of ventilation delivery?

1 ventilation every 2 to 3 seconds

Vickie has arrived with the AED and will now begin to use it. What are the proper steps for using an AED?

1. Vickie turns on the AED. 2. Vickie attaches the AED pads while Dr. Dave and Stephanie continue CPR. 3. The team clears the patient during AED analysis and shock delivery. 4. The new compressor starts CPR immediately after shock is delivered or if no shock is advised.

Dr. Dave performed chest compressions at the proper depth. What is the correct chest compression depth for an infant?

1.5 inches

When the team switches roles, they should take less than __ seconds.

10

You and another provider are performing CPR on an infant who is in cardiac arrest. He does not have an advanced airway in place. You demonstrate appropriate technique for high-quality CPR by performing _____ compressions and 2 ventilations.

15

After the shock is delivered, Ana-Lisa will immediately resume chest compressions. Which compression-to-ventilation ratio should the team use?

15:2 Single: 30:2 Team: 15:2

When performing multiple-provider CPR on an infant, the compression/ventilation ratio is ____: 2.

15:2 Single: 30:2 Team: 15:2

You would use pediatric AED pads for which children?

5-year-old weighing 43 lbs 2-year-old weighing 27 lbs

A 5-year-old child experiences cardiac arrest and requires CPR. You ensure that high-quality CPR is administered when you compress the chest to which depth?

About 2 inches

Amy performed high-quality chest compressions on Theo. What is the correct chest compression depth for a child?

About 2 inches or 1/3 of chest depth.

A 9-year-old child is in cardiac arrest. You and another provider are present. The child's parents/legal guardians are not present. You stay with the child to begin CPR. Which actions would be appropriate for the second provider to do?

Activate EMS, rapid response or resuscitation team. Retrieve AED and resuscitation equipment.

You initiate CPR on an 11-year-old patient who shows signs of puberty, including breast development. Which CPR/AED guideline should you follow?

Adult

Olivia is unresponsive. Dr. Dave needs to assess for breathing, a pulse and life-threatening bleeding. Choose the recommended location to perform the pulse check.

Brachial artery

After determining an 8-year-old child is unresponsive, what is the best site to check for a pulse?

Carotid

Next, Amy must simultaneously check for breathing and a pulse. Choose the recommended location to perform the pulse check.

Carotid

You initiate CPR on a 15-month-old patient. Which CPR/AED guideline should you follow?

Child

A 4-year-old child is in respiratory failure. Her central pulse rate is 65 bpm. Which of the following actions are appropriate?

Deliver 1 ventilation every 2 to 3 seconds Check the pulse and breathing about every 2 minutes

Stephanie properly opened the airway and delivered ventilations. Which statement about delivering ventilations to an infant in cardiac arrest is true?

Deliver 2 ventilations that last about 1 second each and make the chest begin to rise. • Open the airway to a neutral position. • Avoid hyperextension or flexion in the neck. • Deliver 2 ventilations that last about 1 second and make the chest begin to rise. • Minimize interruptions in chest compressions to less than 10 seconds.

If Dr. Dave were alone and providing CPR, which would be the preferred technique?

Encircling thumbs technique

When providing multiple-provider CPR for an infant, which compression technique should the team use?

Encircling thumbs technique

You and another provider are performing CPR on a 6-month old infant. The provider performing chest compressions would use which technique?

Encircling thumbs technique

If the AED came equipped with adult AED pads only, Vickie should not use them. Instead, she should call for someone to bring pediatric AED pads and continue CPR until the new pads arrive. True or false?

False

When applying the AED pads, Ana-Lisa used an anterior/posterior placement. When should providers use this placement method for a child?

If the manufacturer recommends the use of an anterior/posterior pad placement. If the AED pads risk touching each other.

You are performing CPR on an infant. A second provider prepares to apply the AED pads. Where should they place the pads?

Middle of the infant's chest on the sternum On the back between the scapulae

You come upon a child who has collapsed. You determine they are in cardiac arrest. You are alone and have no immediate access to a phone or other form of communication. Which action would you do first?

Perform about 2 minutes of CPR, starting with chest compressions.

After determining that Theo is unresponsive, Amy must tell Joe to activate the rapid response team and get the AED and resuscitation equipment. Then, she must simultaneously check for breathing, pulse and life-threatening bleeding. To accurately assess breathing, she should open the airway to a ________ position using the head-tilt/chin-lift technique.

Slightly past-neutral

Amy recognized that Theo was in cardiac arrest and initiated CPR. If Amy had determined that Theo were in respiratory arrest with a central pulse of ≤ 60 bpm and signs of poor perfusion, which action would she take?

Start CPR immediately.

You are caring for a child who is in respiratory arrest with a central pulse of 55 bpm and signs of poor perfusion. What should you do?

Start CPR immediately.

What is the first step of the In-Hospital Pediatric Cardiac Chain of Survival?

Surveillance and prevention

The team continued to provide high-quality CPR until the rapid response team arrived and relieved them. In which situations would the team stop performing CPR?

Theo spontaneously moves. You should continue cycles of CPR/AED until: • The team leader tells you to stop. • You are presented with a valid DNR order. • Other trained providers arrive to relieve you. • You see signs of ROSC. • You are too exhausted to continue. • The situation becomes unsafe.

After Ana-Lisa took over compressions, Joe and Amy worked together to operate the BVM. Joe maintained an open airway and sealed the mask with both hands in the E-C position, while Amy delivered ventilations. This is the recommended technique for operating the BVM when enough providers are available. True or false?

True

At the same time, Amy should scan the body for life-threatening bleeding. True or false?

True

Dr. Dave should assess Olivia for breathing, a pulse and life-threatening bleeding for no more than 10 seconds. After recognizing that Olivia is in cardiac arrest, he should initiate CPR immediately, true or false?

True

For most infants and children up to the age of 17 years, you must obtain consent from the child's parent or legal guardian if they are present regardless of the child's level of consciousness. True or false?

True

If Theo were a smaller child or toddler, Amy could use a one-hand technique to perform high-quality chest compressions. True or false?

True

When drowning is suspected as the cause of cardiac arrest in a child or infant, deliver 2 initial ventilations before starting CPR. You may also consider delivering 2 initial ventilations before starting CPR on a child or infant with a primary respiratory etiology. True or False?

True

When performing single-provider CPR on Theo, Amy was correct to use a compression-to-ventilation ratio of 30:2. True or false?

True

When providing CPR to a child or infant with an advanced airway in place, one provider should deliver 1 ventilation every 2 to 3 seconds, while the other provider delivers continuous chest compressions without pausing for ventilations. True or false?

True

Vickie should use an anterior/posterior position for pad placement for Olivia, as shown here. True or false?

True Use anterior/posterior placement for infants with the anterior pad positioned in the middle of the chest and the posterior pad between the scapulae