BLS -promed
after checking for breathing and a pulse, you verify that the child is not breathing normally but has a pulse. his airway is not obstructed. how do you deliver rescue breaths.
1 breath every 2 to 3 seconds, or about 20 to 30 breaths per minute
after checking for breathing and a pulse, you find that the patient is not breathing normally but has a pulse and needs rescue breathing. what is the correct ventilation rate?
1 breath every 6 seconds, or about 10 breaths per minute
how are breaths delivered using a bag-mask device?
1 breath over 1 second, while watching the chest rise.
what are the recommended compression to ventilation ratio for infants and children?
1 rescuer: 30:2 2 or more rescuers: 15:2
assigning your team members to individual roles and outlining what each member needs to do during the resuscitation attempt is an example of what elements of high-performance team dynamics?
clear roles and responsibilities
what are examples of effective team dynamics?
clear roles and responsibilities constructive intervention debriefing knowledge sharing
you and your team have initiated compressions and ventilation. the AED was attached, and "no shock" was advised. your team has continues 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 "leslie replies "got it, next time the AED analyzes. i will switch with justin and assume the role of compressor". this is an example of which element of high-performance team dynamics?
closed-loop communication
the AED detects a shockable rhythm and advises a shock. after delivering 1 shock, you and your partner immediately resume CPR by using what ratio and which compression technique?
complete cycles of 15 compressions and 2 breaths, and use the 2 thumb-encircling hands technique
what does a chest compression feedback device monitor?
compression rate chest recoil compression depth
which of the following are resuscitation triangle roles in a high performance team?
compressor airway AED/monitor/defibrillator
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 are the examples of effective team dynamics?
constructive intervention knowledge sharing clear roles and responsibilities debriefing
as you are providing CPR, your colleague arrives, turns on the AED, and follows the prompts. the AED analyzes the rhythm and does not advise a shock. After you immediately resume CPR, how do you continue treating the patient?
continue CPR until prompted by the AED to allow a rhythm heck, the code team arrives, or the patient starts to move.
Heart rate >60/min
continue rescue breathing, check pulse every 2 minutes, if no pulse start CPR
you are still performing CPR as a single rescuer. the AED detects a shockable rhythm and advises a shock. after delivering 1 shock, you immediately resume CPR with what ratio of compressions to breaths?
cycles of 30 compressions and 2 breaths.
what action can you take as a team during and after a resuscitation attempt that helps individual team members perform better and brings awareness to system strengths and deficiencies?
debriefing
while performing high-quality CPR, when do pauses in compressions typically occur?
defibrillation compressor switches intubation pulse checks rhythm analysis
when should the rescuer operating the AED clear the victim?
during analysis & before shock delivery
to avoid fatigue, when should team roles alternate providing compressions?
every 5 cycles or 2 minutes
The infant is unresponsive when you tap her foot and shout, "Are you OK?" She could be in cardiac arrest. What is your next step?
for 5 to 10 seconds, look for no breathing or only gasping while simultaneously checking the brachial pulse
the child is unresponsive after you tap his shoulders and shout "are you ok?" he could be in cardiac arrest. what is your next step?
for 5 to 10 seconds, look for no breathing or only gasping while simultaneously checking the carotid pulse.
you check the child's pulse after 2 minutes of providing rescue breaths and cannot feel a pulse. you immediately begin CPR. after performing CPR for 2 more minutes, the child still does not have a pulse and you are still alone. what is your next step?
get and use an AED
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. what is the next action the rescuer should take?
give 1 rescue breath every 6 seconds
no normal breathing and a pulse is felt
give rescue breaths every 2-3 seconds (20-30 breaths per minute), assess pulse rate for no more than 10 seconds
what is the recommended depth of compressions in infants?
approximately 1 1/2 inches (4cm)
when performing high-quality CPR on a child, what is the correct depth of compressions?
approximately 2 inches (5cm)
when using a pocket mask, where should the rescuer be positioned?
at the side of the victim
what is the correct approach for AED pad placement for infants and children less than 8 years of age?
as indicated on the pad packages
during CPR on a child, interruptions to chest compressions should be limited to no more than ______ seconds
10
when an advanced airway is in place, chest compressions should be provided at a rate of _____ to _____ per minute.
100-120
when providing rescue breaths to a child or infant victim, you should give 1 breath every ____ to ____ seconds.
2-3
when providing rescue breaths to a child or infant victims you should give 1 breath every ___ to ___ seconds.
2-3
You should deliver ___ back slaps and ___ chest thrusts to a chocking infant who is responsive
5, 5
rescue breathing: adults, children, and infants
Adults -give one 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 Children and infants -give 1 breath every 2 or 3 seconds (20 to 30 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
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
mouth to mouth and nose breathing: Infants
Step 1: open the infants airway with a head tilt- chin lift step 2: place your mouth over the infants mouth and nose to create and airtight seal. step 3: give one breath, blowing for about 1 second. watch for the chest to rise as you give the breath.
Witnessed vs unwitnessed collapse: Children and Infants
Witnessed Collapse: -If you are along 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: -If you are alone, start CPR with cycles of 30:2-If you are not alone, send someone to get the AED and begin CPR immediately. Use the AED as soon as it is available. -After about two minutes, if you are still along, activate the emergency response system and get an AED if not already done.-Use the AED as soon as it is available.
what are the special considerations for defibrillation in children less than 8 years old?
a manual defibrillator is preferred for infants less than 1 year of age. if child pads are not included, use adult pads. use smaller- sized pads, if available.
as you arrive at the patient's side, you assign individual roles, outlining what each member needs to do during the resuscitation attempt. which team members are responsible for the following roles? a. assess the patient and provide compressions b. operates the AED and alternates with the compressor after every 5 cycles or 2 minutes to avoid fatigue c. provides ventilation
a. compressor b. monitor/ defibrillator c. airway
as you arrive at the patients side, you assign individual roles outlining what each member needs to do during the resuscitation attempt. which team members are responsible for the following roles? a. assesses the patient and provides compressions: b. operates the AED and alternated with the compressor after every 5 cycles or 2 minutes to avoid fatigue c. provides ventilation
a. compressor b. monitor/defibrilator c. airway
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
You tap and shout to check for responsiveness, but the patient does not respond. what is your next step after calling for help?
check for breathing and a pulse
When a choking infant becomes unresponsive, what is the 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 _____ thrust
chest
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
what is recommended to minimize interruptions in compressions when using an AED?
if no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions. when 2 or more rescuers are present, one rescuer should continue chest compressions while the other prepares the AED. continue with high-quality CPR until an AED prompts to clear
relief of choking: unresponsive infant
if the 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 expectation: 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 bling finger swap - if you are alone, after 2 minutes or 5 cycles of CPR, activate the emergency response system.
after 4 minutes of rescue breathing, no pulse is present during a pulse check. what immediate actions should be taken?
immediately begin CPR and turn on the AED
what is a sign of severe airway obstruction?
inability to speak
what are common administration routes for naloxone?
intravenous intramuscular intranasal
you witnessed the collapse of a child. you are the only rescuer and do not have a mobile phone. after confirming no breathing and no pulse, what is your Next step?
leave the victim to activate the emergency response system and get the AED.
Where should AED pads be placed in the anterolateral placement for adults and children 8 years or older?
left side fo the chest left side of the back
what are the correct actions to take for scene safety and assessment?
look for no breathing and only gasping and check pulse check for responsiveness verify scene safety activate the emergency response system and get an AED
during CPR on a child, you should place 1 or 2 hands over the ______ of the _______________.
lower half, breastbone
How can you achieve a high chest compression fraction?
minimize pauses in chest compressions
Mouth-to-Mouth Breaths: adults, children, and infants
mouth-to-mouth breathing is a quick and effective way to provide oxygen to a victim when a barrier mask is not available each breath you take contains 21% oxygen. when you provide a rescue breath. the air you breathe into a victim contains about 17% oxygen. step 1: hold the victims airway open with a head tilt- chin tilt pinch the nose closed with your thumb and index finger step 2: take a regular breath and seal your lips around the victims mouth, creating an airtight seal. give 1 breath and blow for 1 second watch for the chest to rise as you give each breath. step 3: give a second breath (blowing for about 1 second) while watching for chest rise.
how is CPR performed differently when an advanced airway is in place?
no pauses for ventilation
CPR
performs cycles of 30 compressions and 2 breaths when a second rescuer arrives, perform cycles of 15 compressions and 2 breaths use the AED as soon as it is available. after about 2 minutes, if still alone, activate the emergency response system and retrieve the AED (if not already done)
You check the infant's pulse every 2 minutes and detect that the heart rate is less than 60 /min with signs of poor perfusion. While your colleague begins CPR, what action do you need to take?
power on the AED, follow the prompts, and use the child pads
The infant isn't breathing normally but has a pulse. What do you need to do?
provide rescue breaths, with 1 breath every 2 to 3 seconds
after an AED delivers a shock, what should the rescuers do next?
resume CPR, starting with chest compressions
once the AED arrives, check the rhythm:
shockable rhythm: give 1 shock, resume CPR immediately for 2 minutes (until prompted by the AED to allow a rhythm check) non-shockable rhythm: resume CPR immediately for 2 minutes (until prompted by the AED to allow a rhythm check) continue CPR until ALS providers take over or the child starts to move.
Where should AED pads be placed in the anteroposterior placement for adults and children 8 years and older?
side of the left nipple below the right collarbone
Heart rate <60 with sign of poor perfusion
start CPR
which team role make treatment decisions and assigns roles?
team leader
how does CPR differ in an unresponsive adult chocking vicitm?
the airway is checked for the obstructing object
when performing chest compressions for an infant in a 2-rescuer situation, you should put 2 _________ in the center of the chest, on the lower half of the breast bone
thumbs
which team role keeps track of interruptions in compressions?
timer/recorder
when performing abdominal thrusts on adults and children, in which direction should your thrust be directed?
upward
what are the components if a pulse check in an unresponsive victim?
use 2 or 3 fingers to locate the pulse feel the pulse in the groove to the side of the trachea assess for a pulse for at least 5 but no more than 10 seconds
after turning on the AED, you follow the prompts. you know to use child pads for infants and for children younger than 8 years, but the pediatric pads are unavailable. what should you do?
use the adult pads
what is the indication for mouth-to-mouth rescue breaths?
when a barrier device is not available
no breathing or only gasping and no pulse is felt
witnessed: activate the emergency response system, retrieve the AED and begin CPR. unwitnessed: begin CPR immediately