CPR

Breaths With an Advanced Airway

Laryngeal mask airway, supraglottic airway device, and endotrachial tube are all more secure ways for providing breaths. These devices help prevent gastric distention, and airway obstruction.

Infant Unwitnessed

-check response -if there is no response or breathing --> check brachial pulse If you don't find a pulse, give 2 minutes of CPR before activating the emergency response system

Cardiac Arrest

occurs when the heart malfunctions and stops beating unexpectedly.

Begin CPR

Begin cycles of 30 compressions and 2 breaths (CPR), starting with compressions. -By starting compressions, you are initiating the C-A-B sequence, or chest compressions-airway-breathing sequence. -In the first few minutes of cardiac arrest, victims have oxygen remaining in the bloodstream, so starting CPR with compressions can pump that oxygenated blood to the victim's brain and heart. -After you give 30 compressions, open the victim's airway and deliver 2 breaths.

1. 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.

1. When should the rescuer operating the AED clear the victim?

The AED operator clears the victim before rhythm analysis and then clears the victim before delivering a shock.

Link between heart attack and cardiac arrest

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. But when sudden cardiac arrest occurs, heart attack is a common cause. Other conditions may also change the heart's rhythm and lead to cardiac arrest.

Bag-Mask Device

A bag-mask device is used to provide positive-pressure ventilation to a victim who is not breathing or not breathing normally. It consists of a bag attached to a face mask. If the bag is self-inflating, a bag-mask device may be used with or without an oxygen supply. If not attached to an oxygen flow, it provides about 21% oxygen from room air. Some bag-mask devices include a 1-way valve. The type of valve may vary from one device to another.

Heart Attack: What it is

A heart attack occurs when blood flow to part of the heart muscle is blocked. A heart attack occurs when 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. A heart attack is a "clot" problem.

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

After the AED gives the shock, rescuers should resume CPR immediately, beginning with chest compressions.

1. In 1-rescuer BLS for a child with unwitnessed cardiac arrest, activation of the emergency response system occurs _____, and the compression-to-ventilation ratio is____.

Answer: after 2 minutes of cpr; 30:2 If the 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. In 1-rescuer child CPR, the compression-to-ventilation ratio is 30:2.

How to perform Rescue Breathing

**use when a victim has a pulse but isn't breathing effectively. Adults: give breath every 5-6 seconds Children and infants: give breath every 3-5 seconds For everyone, breath should be over 1 second, making sure that the chest rises. *Check the victims pulse every 2 minutes.

Compression-to-ventilation ratio for infants:

1-rescuer: 30:2 2-rescuer: 15:2

Relief of Choking If the Victim Is Obese or Pregnant

If the victim is too large for you to wrap your arms around the waist, do chest thrusts instead of abdominal thrusts.

2. 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.

High-Quality CPR: Adult

Remember, high-quality CPR for adults includes these critical characteristics: --Push hard, push fast: Compress at a rate of 100 to 120/min, with a depth of at least 2 inches (5 cm). --Allow complete chest recoil, and do not lean on the chest after compressions. --Minimize interruptions in compressions to less than 10 seconds. --Give effective breaths that make the chest rise and avoid excessive ventilation.

How to Use a Pocket Mask

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

2. 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 During 2-rescuer CPR for an adult when an advanced airway is in place, the rescuer does not stop compressions to give breaths. The rescuer gives 1 breath every 6 seconds, which results in 10 breaths per minute.

2. A man sitting at a table in the cafeteria stands up suddenly, clutching his throat with his thumb and fingers. The rescuer interprets this as the universal sign for choking and goes over to help. Which actions would be appropriate for the rescuer to do?

The man is experiencing a severe airway obstruction. The rescuer should ask the man if he is choking and then take steps to immediately relieve the obstruction by using abdominal thrusts, repeating thrusts until the object is expelled or the man becomes unresponsive. If the man becomes unresponsive, the rescuer should shout for help, gently lower the man to the ground, and begin CPR, starting with chest compressions.

How to Open the Airway for Breaths

Use the head tilt-chin lift to open the airway. Follow these steps on an adult: Step 1: Place one hand on the victim's forehead, and push with your palm to tilt the head back. Step 2: Place the fingers of the other hand under the bony part of the lower jaw, near the chin. Step 3: Lift the jaw to bring the chin forward. This lifts the victim's tongue away from the back of the throat, relieving a possible airway obstruction.

3. Adult AED pads deliver a higher shock dose, but a higher shock dose is preferred to no shock for infants and children less than 8 years of age.

true Although adult pads deliver a higher shock dose, a higher shock dose rather than no shock is preferred for infants and children less than 8 years of age.

How to use a bag-mask device for infants.

watch for chest rise. position yourself by infants head make sure there is a tight seal for the mask to the face. adjust head until see chest rise.

Infant Witnessed

-Check response and breathing -Activate the emergency response system and get an AED

IF A CHOKING INFANT BECOMES UNRESPONSIVE

shout for help lay infant on a hard flat surface perform CPR, WITH SEARCHING FOR OBJECT EVERY TIME YOU HAVE TO GIVE BREATHS. if you are alone, AFTER 5 CYCLES OF CPR (2 MINUTES), activate the emergency response system.

High-Quality CPR: Infant

---Push hard, push fast: Compress at the rate of 100 to 120/min, with a depth of at least one third the AP diameter of the chest, or about 1½ inches (4 cm). ---Allow complete chest recoil, and do not lean on the chest after compressions. ---Minimize interruptions in compressions to less than 10 seconds. ---Give effective breaths that make the chest rise and avoid excessive ventilation.

Critical points of using the bag mask

--Give 2 breaths after every set of 30 compressions. --Deliver each breath over 1 second, with just enough volume to make the chest rise. --Avoid excessive ventilation. Breaths should each be delivered over 1 second, with just enough force to produce visible chest rise. Rescuers should avoid excessive ventilation. Pause about 1 second between each breath. Actually seeing the chest rise with each breath is the best way to ensure that breaths are effective.

1-Rescuer Infant BLS (differences)

--If witnessed, activate the emergency response system and get an AED; then begin CPR. Use the AED as soon as it is available. --If not witnessed begin CPR immediately. After about 2 minutes, if you're still alone, activate the emergency response system and get an AED. --Check the brachial artery pulse in infants. Chest compression technique: ----Placement: For 1 rescuer, place 2 fingers in the center of the infant's chest, just below the nipple line, at the lower half of the sternum. Do not press the tip of the sternum. ----Depth: Compress at least one third the depth of the chest, or about 1 1/2 inches (4 cm). Compression-to- Ventilation Ratio Without an Advanced Airway Use a 30:2 ratio for 1 rescuer.

High-Quality CPR: Child

--Push hard, push fast: Compress at the rate of 100 to 120/min, with a depth of at least one third the AP diameter of the chest, or about 2 inches (5 cm). --Allow complete chest recoil, and do not lean on the chest after compressions. --Minimize interruptions in compressions to less than 10 seconds. --Give effective breaths that make the chest rise and avoid excessive ventilation.

Minimize Interruptions in Compressions When Using an AED

--When 2 or more rescuers are present, one rescuer should continue chest compressions while the other powers on the AED, attaches the pads, and operates the AED. --Rescuers should continue with high-quality CPR until the AED delivers a clear prompt to clear the victim for analysis. --If no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions.

AED Pad Placement

1. 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. 2. 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.

2-Rescuer Child BLS Sequence

1. Check for scene safety and then check the child for a response. If there is no response, the other rescuer activates the emergency response system and gets the AED. 2. Check for breathing and a pulse; take at least 5 but no more than 10 seconds. 3. If there is no breathing or only gasping and no pulse is felt within 10 seconds, begin CPR immediately. Perform cycles of compressions and breaths (30:2 ratio), starting with compressions. ---If there is normal breathing and a pulse, monitor until the emergency responders arrive. ---If there is no normal breathing but the child has a pulse, provide rescue breathing with 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute. Add compressions if the pulse remains 60 or less per minute with signs of poor perfusion. Activate the emergency response system (if not already done) after 2 minutes. Continue rescue breathing, and check the pulse about every 2 minutes. If there is no pulse, begin CPR. 4. Use the AED as soon as it arrives. When the second rescuer is available to help with CPR, use a compression-to-ventilation ratio of 15:2.

2-Rescuer Infant BLS

1. Check scene safety first. 2. Responsiveness: If the infant is unresponsive, shout for nearby help. The first rescuer remains to help the victim while the second rescuer activates the emergency response system and retrieves the AED and emergency equipment. 3. Breathing and pulse check: Look for no breathing or only gasping, and check for a pulse. The pulse and breathing checks can be done simultaneously. Is a pulse definitely felt within 10 seconds? ---If there is normal breathing and a pulse, monitor until the emergency responders arrive. ---If there is no normal breathing but a pulse, provide rescue breathing with 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute. Add compressions if the pulse remains 60 or less per minute with signs of poor perfusion. Activate the emergency response system (if not already done) after 2 minutes. Continue rescue breathing, and check the pulse about every 2 minutes. If there is no pulse, begin CPR. ---If there is no breathing or only gasping, and no pulse: Begin CPR. The first rescuer begins CPR with a 30:2 compressions-to-breaths ratio. When the second rescuer returns, use a 15:2 compressions-to-breaths ratio. Use the AED as soon as it is available. 4. Once the AED arrives, check the rhythm: ---If the rhythm is shockable, give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move. ---If the rhythm is nonshockable, resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move.

1-Rescuer Infant BLS Sequence

1. Check scene safety first. 2. Responsiveness: If the infant is unresponsive, shout for nearby help and activate the emergency response system. 3. Breathing and pulse check: Look for no breathing or only gasping, and check for a pulse. The pulse and breathing checks can be done simultaneously. Is a pulse definitely felt within 10 seconds? ---If there is normal breathing and a pulse, activate the emergency response system, if not already done. Return to the infant and monitor until emergency responders arrive. ---If there is no normal breathing but a pulse, provide rescue breathing with 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute. Add compressions if the pulse remains 60 or less per minute with signs of poor perfusion. Activate the emergency response system (if not already done) after 2 minutes. Continue rescue breathing, and check the pulse about every 2 minutes. If there is no pulse, begin CPR. ---If there is no breathing or only gasping, and no pulse, in a witnessed sudden cardiac arrest, first activate the emergency response system (if not already done), get the AED, and then begin CPR. In a nonwitnessed sudden cardiac arrest, begin CPR immediately with cycles of 30 compressions and 2 breaths. After about 2 minutes, if you're still alone, activate the emergency response system and get the AED (if not already done). 4. Once the AED arrives, check the rhythm: --If the rhythm is shockable, give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move. --If the rhythm is nonshockable, resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move.

Critical components of adult chest compression

1. Ensure That the Victim Is on a Firm Surface: -----Compressions pump the blood in the heart to the rest of the body. To make compressions as effective as possible, place the victim on a firm surface, such as the floor or a backboard. 2. The Importance of Chest Recoil: Chest recoil allows blood to flow back into the heart. Incomplete chest recoil is inefficient because it reduces the blood flow back to the heart created by chest compressions. It is also important to avoid leaning on the chest between compressions. 3. Compression Rate, Depth, and Compression-to-Ventilation Ratio: To ensure high-quality CPR, it is important to perform compressions with the correct rate, depth, and compression-to-ventilation ratio. Push hard and fast: -Rate: Compress at a rate of 100 to 120/min. -Depth: Compress at a depth of at least 2 inches (5 cm). -Ratio: The compression-to-ventilation ratio for adults is 30:2. 4. Minimizing Interruptions in Chest Compressions: It is important to minimize interruptions in chest compressions to less than 10 seconds, because each time you stop compressions, the blood flow to the heart and brain decreases significantly, minimizing the chances for return of spontaneous circulation. Once you resume compressions, it takes several compressions to increase blood flow to the heart and brain back to the same levels.

How to use an AED

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. --Choose adult pads for victims 8 years of age and older. --Attach the adhesive AED pads to the victim's bare chest. Follow the placement diagrams on the pads. 3. "Clear" the victim and analyze the rhythm. --When the AED prompts you, clear the victim during analysis. Be sure that no one is touching the victim, not even the rescuer in charge of giving breaths. --Some AEDs will tell you to push a button to allow the AED to begin analyzing the heart rhythm; others will do that automatically. The AED may take a few seconds to analyze. 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.

How to Perform Abdominal Thrusts on an adult or child who is choking (IF THEY ARE RESPONSIVE)

1. Stand or kneel behind the victim and place your arms around the victim's waist; with one hand, locate the navel. 2. Then, 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.

How to Perform Mouth-to-Mouth Breathing: Infant

1. Start by holding the infant's airway open with a head tilt-chin lift. --Pinch the noise closed with your thumb and index finger (using the hand that's on the infant's forehead). 2. Take a regular breath and seal your lips around the infant's mouth, creating an airtight seal. --Give 1 breath and blow for about 1 second. Watch for the chest to rise as you give the breath. --If the chest does not rise, repeat the head tilt-chin lift. 3. Give a second breath, blowing for about 1 second, while watching for the chest to rise. --If you are unable to ventilate the infant after 2 attempts, promptly return to chest compressions.

Mouth-to-Mouth Breaths

1. Start by holding the victim's airway open with a head tilt-chin lift. Pinch the nose closed with your thumb and index finger (using the hand that's on the victim's forehead). 2. Then take a regular breath and seal your lips around the victim's mouth, creating an airtight seal. Give 1 breath and blow for about 1 second. Watch for the chest to rise as you give the breath. If the chest does not rise, repeat the head tilt-chin lift. 3. Give a second breath, blowing for about 1 second, while watching for the chest to rise. If you're unable to ventilate the victim after 2 attempts, promptly return to chest compressions.

AED for Infants and Children Less Than 8 Years of Age Overview

1. Turn on the AED 2. Attach AED pads to victim's bare chest 3. clear the victim and analyze the heart rhythm 4. If a shock is advised, clear the victim and deliver the shock. If no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions. ***a manual defibrillator is to be used ***Pads are placed in the middle of the chest and the middle of the back. *** can use adult pads on an infant but they can't overlap or touch each other, and cpr is preferred over shocking with adult pads

2-Rescuer Adult BLS Sequence

1. Verify scene safety. 2. Check for responsiveness: If the victim is unresponsive, shout for nearby help. --The first rescuer remains with the victim. --The second rescuer activates the emergency response system and retrieves the AED and emergency equipment. 3. Look for no breathing or only gasping and check the pulse (simultaneously). Is a pulse definitely felt within 10 seconds? --If there is normal breathing and a pulse, monitor until emergency responders arrive. If there is no normal breathing but the victim has a pulse, provide rescue breathing. 4. If there is no breathing or only gasping and no pulse, begin CPR (cycles of 30 compressions and 2 breaths). Use the AED as soon as it is available 5. When the AED arrives, check the rhythm. Is the rhythm shockable? --Yes: Give 1 shock. Resume CPR immediately for about 2 minutes and follow the AED prompts. Continue until ALS providers take over or the victim starts to move. --No: Resume CPR immediately for about 2 minutes and follow the AED prompts. Continue until ALS providers take over or the victim starts to move.

1-Rescuer BLS Sequence: Child

1. check scene safety first 2. Responsiveness: Once you've established that the victim is unresponsive, shout for nearby help and activate the emergency response system via mobile device. 3. Breathing and pulse check: Look for no breathing or only gasping, and check for a pulse. The pulse and breathing checks can be done simultaneously. Is a pulse definitely felt within 10 seconds? ---IF THERE IS NORMAL BREATHING AND A PULSE, activate the emergency response system, if not already done. Return to the victim and monitor until emergency responders arrive. ---IF THERE IS NO NORMAL BREATHING BUT THE VICTIM HAS A PULSE, provide rescue breathing with 1 breath every 3 to 5 seconds, or about 12 to 20 breaths per minute. Add compressions if the pulse remains 60 or less per minute with signs of poor perfusion. Activate the emergency response system (if not already done) after 2 minutes. Continue rescue breathing, and check the pulse about every 2 minutes. If there is no pulse, begin CPR. ---IF THERE IS NO BREATHING OR ONLY GASPING, AND NO PULSE, in a witnessed sudden cardiac arrest, activate the emergency response system (if not already done) and get the AED or defibrillator, and then begin CPR. In a nonwitnessed sudden cardiac arrest, begin CPR immediately with cycles of 30 compressions and 2 breaths. After about 2 minutes, if still alone, activate the emergency response system and retrieve the AED (if not already done). 4. Once the AED arrives, check the rhythm: --IF THE RHYTHM IS SHOCKABLE, give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move. --IF THE RHYTHM IS NONSHOCKABLE, resume CPR immediately for about 2 minutes (until prompted by the AED to allow a rhythm check). Continue until ALS providers take over or the victim starts to move.

Chain of Survival: Child/pediatric

1. prevention of cardiac arrest. 2. CPR 3. rapid activation of emergency response system 4. advanced life support 5. integrated post cardiac arrest care

Initial BLS Steps for Adults

1. scene safety: verify scene safety first 2. Check for responsiveness: Establish that the victim is unresponsive. 3. Shout for nearby help and activate the emergency response system via mobile device, if appropriate. Then get the AED and emergency equipment or send someone to do so. 4. Breaking and pulse check: Look for no breathing or only gasping, and check for a pulse. You can check breathing and pulse simultaneously. Is a pulse definitely felt within 10 seconds? ---If there is normal breathing and a pulse: Monitor until emergency responders arrive. ----If there is no normal breathing, but the victim has a pulse: Provide rescue breathing by giving 1 breath every 5 to 6 seconds, or about 10 to 12 breaths per minute; check the pulse about every 2 minutes. ----If there is no breathing or only gasping, and no pulse: Begin CPR with cycles of 30 compressions and 2 breaths. Use the AED as soon as it is available.

Team Dynamics Roles

Airway: --Opens and maintains the airway --Provides ventilation Timer/Recorder: --Records the time of interventions and medications (and announces when these are next due) --Records the frequency and duration of interruptions in compressions --Communicates these to the Team Leader (and the rest of the team) Compressor: --Assesses the patient --Does 5 cycles of chest compressions --Alternates with AED/Monitor/Defibrillator every 5 cycles or 2 minutes (or earlier if signs of fatigue set in) AED/Monitor/Defibrillator: --Brings and operates the AED/monitor/defibrillator --Alternates with Compressor every 5 cycles or 2 minutes (or earlier if signs of fatigue set in), ideally during rhythm analysis --If a monitor is present, places it in a position where it can be seen by the Team Leader (and most of the team) Team Leader: --Every resuscitation team must have a defined leader --Assigns roles to team members --Makes treatment decisions --Provides feedback to the rest of the team as needed --Assumes responsibility for roles not assigned Administer Medications: --An ALS provider role --Administers medications

AED

An AED is a lightweight, portable device that analyzes the heart rhythm to identify the presence of an arrhythmia that responds to shock therapy. Sudden cardiac arrests are triggered by abnormal heart arrhythmias. Two life-threatening arrhythmias that can cause cardiac arrest are pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF), where the heart's electrical impulses suddenly become chaotic and ineffective.

2. In 2-rescuer BLS for a child with unwitnessed cardiac arrest, activation of the emergency response system occurs _____, and the compression-to-ventilation ratio is____.

Answer: initially while getting the AED; 15:2 If the rescuer encounters an unresponsive infant or child and other rescuers are available, the first rescuer should remain with the victim and initiate the resuscitation attempt while the second rescuer activates the emergency response system and retrieves the AED.

Relief of Choking in a Responsive Infant

Clearing an object from a responsive infant's airway requires a combination of back slaps and chest thrusts. Abdominal thrusts are not appropriate. STEPS: 1. If you find an infant choking, and he or she is RESPONSIVE, 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. Note: If it is easy to do, remove clothing from the infant's chest. 2. Support the head and jaw with your hand. Avoid compressing the soft tissues of the infant's throat. 3. Rest your forearm on your 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. 4. Place your free hand on the infant's back, supporting the head with the palm of your hand. This will cradle the infant between your 2 forearms as you 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—just below the nipple line, over the lower half of the breastbone. Do this at the rate of about 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.

2. 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.

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

FALSE. For a child, the compression technique is the same as for an adult. The rescuer should use 2 hands (heel of one hand with the heel of the other hand on top of the first hand). For a very small child, 1-handed compressions may be used to achieve the desired compression depth.

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

False When compressing an infant's chest, a 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.

5 Links in the Adult chain of survival

First link: Surveillance, prevention, and treatment of prearrest conditions Second link: Immediate recognition of cardiac arrest and activation of the emergency response system Third link: Early CPR with an emphasis on chest compressions Fourth Link: Rapid defibrillation Fifth link: Multidisciplinary post-cardiac arrest care

1. 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.

Relief of Choking in an Unresponsive Adult or Child

IF the choking victim becomes unresponsive, send someone to activate the emergency response system. Move the person to the ground and begin CPR **each time you open the airway to give breaths, look for the obstructing object in the back of the throat. If you see an object that can easily be removed, carefully remove it. DON'T PERFORM A BLIND FINGER SWEEP BECAUSE THIS COULD CAUSE THE OBJECT TO GET LODGED FURTHER DOWN THEIR THROAT.

1. Check your knowledge of 2-rescuer adult BLS by answering this question. You and your colleague respond to an adult male victim who is unresponsive. After assessing that the victim is not breathing and has no pulse, what do you instruct your colleague to do?

It's important to get advanced providers and an AED on their way. For shockable cardiac arrest, the sooner defibrillation occurs, the better the victim's chance of survival.

Opioid-Associated Life-Threatening Emergency: When to Give Naloxone

Naloxone is a medication that can reverse the effects of opioids and may restore normal breathing. COMMON WAYS TO GIVE NALOXONE: INTRAVENOUS, INTRANASAL, AND INTRAMUSCULAR. in a patient is unresponsive, not breathing normally, BUT DOES HAVE A PULSE, you should deliver a rescue breath every 5-6 seconds for adults or every 3-5 seconds for children and infants then you can give naloxone.

1. Your adult friend suddenly collapses at home, and you determine that he needs CPR. You begin CPR, starting with chest compressions, and are about to deliver breaths by using the mouth-to-mouth technique. You open your friend's airway with a head tilt-chin lift. Which action should you do next?

Pinch the nose closed and seal your lips around his mouth before delivering a breath. To deliver mouth-to-mouth breaths, after opening the victim's airway with a head tilt-chin lift, pinch the nose closed with the thumb and index finger. Next, take a regular (not deep) breath, and seal the lips around the victim's mouth, creating an airtight seal. Then deliver 1 breath over 1 second, watching for the chest to rise.

2. An infant is unresponsive and not breathing but has a strong pulse. Emergency medical services has been notified. There is no barrier device readily available. When attempting to deliver breaths by using the mouth-to-mouth-and-nose technique, the rescuer notices that the chest does not rise. What would be the most appropriate next step?

Repeat the head tilt-chin lift and try to give a breath that makes the chest rise To deliver breaths by using the mouth-to-mouth-and-nose technique, maintain a head tilt-chin lift to keep the airway open. Then, place your mouth over the infant's mouth and nose and create an airtight seal, and blow into the infant's nose and mouth (pausing to inhale between breaths), just enough to make the chest rise with each breath. If the chest does not rise, repeat the head tilt-chin lift to reopen the airway, and try to give a breath that makes the chest rise. It may be necessary to move the infant's head through a range of positions to provide effective breaths. When the airway is open, give breaths that make the chest rise.

Heart Attack: What happens

Signs of a heart attack may appear immediately or last weeks or longer, and may include Severe discomfort in the chest or other areas of the upper body Shortness of breath Cold sweats Nausea/vomiting Typically, during a heart attack, the heart continues to pump blood. The longer the person with a heart attack goes without treatment, the greater the possible damage to the heart muscle. Occasionally, the damaged heart muscle triggers an abnormal rhythm that can lead to sudden cardiac arrest. Heart attack symptoms in women can be different from those in men, and women may be more likely to experience Pain in the jaw, arms, back, or neck Light-headedness Nausea/vomiting

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

Signs of a severe airway obstruction include clutching the throat with the thumb and fingers to make the universal choking sign; inability to speak or cry; poor or no air exchange; weak, ineffective cough or no cough at all; high-pitched noise while inhaling or no noise at all; increased respiratory difficulty; and possible cyanosis (turning blue).

1-Rescuer Adult BLS Sequence Overview

Step 1: Verify scene safety Step 2: Check for responsiveness. If the victim is unresponsive, shout for nearby help. Activate the emergency response system and get the AED (or send someone else to do so). Step 3: Look for no breathing or only gasping and check the pulse (simultaneously). Is a pulse definitely felt within 10 seconds? If there is normal breathing and a pulse, monitor until emergency responders arrive. If there is no normal breathing but the victim has a pulse, provide rescue breathing. Step 4: If there is no breathing or only gasping and no pulse, begin CPR (cycles of 30 compressions and 2 breaths). Use the AED as soon as it is available. Step 5: When the AED arrives, check the rhythm. Is the rhythm shockable? Yes: Give 1 shock. Resume CPR immediately for about 2 minutes and follow the AED prompts. Continue until ALS providers take over or the victim starts to move. No: Resume CPR immediately for about 2 minutes and follow the AED prompts. Continue until ALS providers take over or the victim starts to move.

Sudden Cardiac Arrest: what it is

Sudden cardiac arrest occurs when the heart develops an abnormal rhythm and can't pump blood. Sudden cardiac arrest results from an abnormal heart rhythm. This abnormal rhythm causes the heart to quiver so it can no longer pump blood to the brain, lungs, and other organs. Sudden cardiac arrest is often a "rhythm" problem. Sudden cardiac arrest is a leading cause of death. Nearly 360,000 out-of-hospital cardiac arrests occur annually in the United States. Fast action can save lives.

3. 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 If the choking infant becomes unresponsive, the rescuer should immediately begin CPR, starting with chest compressions. Each time the airway is opened, the rescuer should look for the object in the back of the throat. If the object is seen and can easily be removed, the rescuer should remove it.

1. 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 The rescuer should deliver up to 5 back slaps forcefully between the infant's shoulder blades, using the heel of the hand, delivering each slap with enough force to attempt to remove the obstruction. 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.

2. 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 When performing chest compressions on an infant, the rescuer pushes hard and fast at a depth of at least one third the anteroposterior diameter of the chest, or about 1½ inches (4 cm).

2. 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. If the 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.

Differences from 1-rescuer to 2-rescuer

The technique for giving compressions regarding hand placement and finger placement. 2-rescuer uses the 2 thumb-encircling hands technique ----place both thumbs side by side in the center of the chest on the lower half of the infants breast bone. --compress 1.5 inches.

How to Provide Breaths With an Advanced Airway

When an advanced airway is in place during 2-rescuer CPR, the technique for CPR changes. 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). (NO PAUSES ALLOWS BLOOD FLOW AND OXYGEN DELIVERY TO THE BRAIN TO REMAIN HIGH)

Sudden Cardiac Arrest: What happens

Within seconds, the person becomes unresponsive and is not breathing or is only gasping. Death occurs within minutes if the victim does not receive immediate lifesaving treatment.

1-Rescuer Child BLS:

a child is someone from age 1-puberty (armpit hair, or breast development). When performing compressions, can use one or 2 hands. Compressions should go atleast 1/3 the depth of the chest, or about 2 inches (5 cm). The chest must recoil completely between compressions. 1- rescuer: for any age: compression-ventilation ration is 30:2 2-rescuer team for a child: 15:2 1-rescuer unwitnessed: 5 cycles of CPR BEFORE leaving to activate emergency response system/before calling for help. 1-rescuer witnessed: immediately activate emergency response system

Infant

infant means someone younger than 1 year, excluding the newly born.