Tingnan ang lahat ng mga set ng pag-aaral

BLS

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

How frequently do you administer rescue breaths?

1 breath per 6 seconds

Peds BLS algorithm: What is the first step?

1) verify scene safety

In which locations do most out-of-hospital cardiac arrests occur? a. healthcare clinics b. homes c. recreational facilities d. shopping centers

B. homes

As soon as the victim is identified as ________, the CPR coach will identify themselves and prompt [who to do what first]/

as soon as victim is identified as pulseless, the CPR coach will identify themselves and prompt the compressor to begin chest compressions

What are the rescuer actions in severe airway obstruction?

ask if they are choking - they nod yes take steps to relieve obstruction if becomes unresponsive, start CPR activate EMS after 2 mins of CPR if alone, or send someone to activate

Opioid-associated life-threatening emergency response sequence: Step 1: checked victim for response. shouted for help, activated EMS, sent for AED. Step 2: assess pt breathing -> not breathing normally Step 5:

assess for pulse for no more than 10 seconds

Opioid-associated life-threatening emergency response sequence: Step 1: checked victim for response. shouted for help, activated EMS, sent for AED. Step 2: assess what?

assess if pt is breathing normally

What is the role of the first rescuer in BLS?

assess scene safety check victim responsiveness send other rescuer to activate EMS and get AED

Where is the AED placed when it arrives?

at victim's side near rescuer who will operate it

Once the AED pads are placed on the person, what should you do next?

attach AED connecting cables to device if needed then CLEAR THE VICTIM and allow AED to analyze rhythm

Pressure, aching, tightness in chest heartburn or indigestion uncomfortable feeling in back, jaw, neck, shoulder N/V

atypical signs of a heart attack

How do you avoid gastric inflation?

avoid giving breaths too quickly, too forcefully, or with too much volume. deliver each breath over 1 second and just enough air to make the victim's chest rise

Special circumstances when using AEDs: victim has implanted defibrillator or pacemaker

avoid placing AED pad directly over device

What is the correct compression-to-ventilation ratio for a 7-year-old child when 2 or more rescuers are present? a. 15:1 b: 15:2 c: 20:2 d. 30:2

b. 15 compressions to 2 breaths

What is the correct chest compression depth for an infant? a. at least one fourth the depth of the chest or approximately 1 inch (2.5 cm) b. at least one third the depth of the chest or approximately 1.5 inches (4 cm) b. at least one third the depth of the chest or approximately 2 inches (5 cm) b. at least one third the depth of the chest or approximately 3 inches (7.6 cm)

b. at least one third the depth of the chest or approximately 1.5 inches (4 cm)

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt what do you do now?

determine if you witnessed sudden collapse yes or no

AED patches can be placed on what surfaces?

directly on skin NOT OVER: clothing, medication patches, implanted devices

What changes do you make in the BLS response if the victim is pregnant?

do not delay providing compressions! can manually move uterus to the pt's left (lateral uterine displacement - LUD to relieve pressure on pt's large blood vessels (have additional rescuers do this).

Avoid doing what during head tilt chin lift?

do not press deeply into soft tissue under chin to avoid blocking airway do not close pt mouth completely

Deliver each breath over how long? Resume chest compressions in how long?

each breath over 1 second resume compressions within less than 10 seconds

What actions are crucial for someone with a suspected heart attack?

early - recognition - EMS activation - transport by EMS - intervention

What rescue action increases the chances of survival from cardiac arrest caused by an arrhythmia? What are the 2 life-threatening arrhythmias that cause cardiac arrest?

early defibrillation pVT (pulseless VTach) and V fib

Successful outcomes of out-of-hospital cardiac arrests depend on ___ and ___.

early high-quality CPR and rapid defibrillation in the first few mins after arrest

Time is brain

early recognition limited scene time transport to stroke center

Pediatric in-hospital chain of survival

early recognition and prevention activation of emergency response high quality CPR advanced resuscitation post-cardiac arrest care recovery

Adult in-hospital chain of survival

early recognition and prevention activation of emergency response high quality CPR defibrillation post-cardiac arrest care recovery

Key to successful outcome of choking

early recognition of foreign body airway obstruction

What are the rescuer actions in mild airway obstruction?

encourage victim to continue coughing - do not interfere with their attempts if progresses to severe, activate EMS

Actions to help a stroke victime

evaluate victim for signs of stroke activate EMS find what TIME sx started remain with victim until advanced training arrives if they become unresponsive and is not breathing normally or is only gasping - give CPR

The mask should not apply pressure to the

eyes

How should the pt be positioned for CPR? What if they are facedown?

face up on firm, flat surface to ensure effective chest compressions if facedown, roll victim faceup. keep head, neck, torso in a line if suspect head/neck injury

How do you assess for: Face drooping Arm weakness Speech difficulty Time to phone 911

face: ask pt to smile arm: have pt raise both arms - look for drift speech: have pt repeat a simple sentence - is it repeated correctly time: call 911 asap and get to hospital immediately

T/F: The only drowning victims that need to be transported by EMS to ED were those who did not have a pulse and required CPR after drowning

false - all victims of drowning require transport

Peds BLS algorithm: 2 rescuers 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt what does each rescuer do now?

first rescuer: starts CPR 30: 2 breaths, switches to 15:2 when 2nd rescuer returns second rescuer: returns with AED

To show mutual respect, the team leader needs to speak how?

friendly, controlled voice and avoid shouting or aggression

To ensure proper fit of a BVM over a pt's face, it should extend from ___ to ___ on the victim and should cover ___ and __.

from bridge of nose to just above lower edge of chin cover nose & mouth

You assess pt's breathing and hear agonal gasping occurring at a slow irregular rate. What is your concern?

gasping is not normal breathing! sign of cardiac arrest

If you give breaths too quickly or with too much force, what can happen?

gastric inflation - air enters stomach rather than lungs

Actions for mild allergic rxn

get help remove victim from allergen ask about allergy hx consider PO antihistamine

What is the priority in cardiac arrest secondary to drowning?

get oxygen to brain, heart, and other tissues

What are the available resources in cardiac arrest in each setting: in-hospital out-of-hospital

in: healthcare personnel, ED resources, cardiac cath, ICU out: AED access, T-CPR, EMS teams then arrive w only the equipment they brought

Who composes the resuscitation teams in cardiac arrest in each setting: in-hospital out-of-hospital

in: various departments + multidisciplinary healthcare team out: lay rescuers to recognize, call for EMS, perform CPR + use AED, then EMS arrives to take over

Standard age definitions for BLS: An infant is how old? Children are how old? Adults are how old?

infant: < 1 y/o children: > 1 y/o - puberty adult: teens and older

Compression depth in infants or children vs adults and adolescents infants children adults and adolescents

infants: at least 1/3rd AP diameter of chest or 1.5 inches children: at least 1/3rd AP diameter of chest or 2 inches adults: at least 2 inches

Peds BLS algorithm: 2 rescuers 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. what do you do now?

look for no breathing or only gasping and check for pulse simultaneously - must feel it within 10 seconds

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) what do you do now?

look for no breathing or only gasping and simultaneously check pulse - is pulse definitively felt within 10 seconds?

Mouth to mouth and nose technique for infants

maintain airway with head tilt chin lift place mouth over infant's nose and mouth blow into infants nose and mouth, pause between breaths to inhale give enough breath to make chest rise may need to move infant's head through a range of positions to provide effective breaths. when airway is open, give breaths to make chest rise

Maintenance of an AED kit includes

maintaining battery replacing supplies - AED pads (adults & peds) replacing used equipment like pocket masks, gloves, razors, scissors

What is the risk of a blind finger sweep?

may push foreign body back into the airway, causing further obstruction and injury

Is this a mild allergic reaction or severe: stuffy nose, sneezing, itching around eyes itching of skin or mucous membranes raised, red rash on skin (hives)

mild

Is this mild or severe airway obstruction: good air exchange can cough forcefully may wheeze between coughs

mild

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. 3) checked for pulse & breathing -> normal breathing & pulse felt Now what?

monitor until EMS arrives

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) normal breathing, pulse felt what do you do now?

monitor until emergency responders arrive

The CPR coach can be blended into the current responsibilities of what rescuer?

monitor/defibrillator

Special circumstances when using AEDs: clothing and jewelry

move bulky clothes to expose chest. ok to leave jewelry on as long as it does not come into contact w AED pads

What drug can temporarily reverse the effects of respiratory depression that opioids can cause?

naloxone via IM (intranasal by advanced providers)

Which are recommended tx for drowning victim: clear airway of aspirated water use abdominal thrusts to remove water from breathing passages

neither are recommended

Where should the CPR coach stand?

next to defibrillator

Can you use child pads in a victim 8 y/o or older?

no! do not use child pads in this victim

To ensure knowledge sharing, team leaders should frequently ask for __ and ___.

observation and feedback

How to Perform a Head Tilt-Chin Lift

on hand on pt forehead, push w palm to tilt head back fingers of other hand under bony part of lower jaw near chin lift jaw to bring chin forward

Mouth to mouth breathing for infant victim

open airway w head tilt chin lift pinch nose closed w thumb & forefinger make mouth to mouth seal deliver breath

Mouth to mouth breathing for adults and children

open airway w head tilt chin lift pinch nose closed w thumb & index finger take regular breath and seal lips around victim's mouth deliver 1 breath over 1 sec

To reduce the time to shock delivery, what 2 steps must you do within 30 SECONDS after the AED arrives at the victim's side?

open carrying case & POWER ON AED (unless it turns on automatically when case is opened) Attach AED pads to victim's bare chest

What is the benefit of a compressor counting out loud?

other rescuer can give breaths efficiently and minimize interruption

If a pregnant woman is revived, she should be placed in what position?

place her on her left side to help improve blood flow to her heart

What is the E-C clamp technique?

place mask on face w narrow portion at bridg eof nose thumb + index finger make a C on one side of mask & pressing edges of mask to face other fingers lift angles of jaw (3 fingers form an E) to open airway and press face to maks

To avoid extending the infants head beyond the neutral position when opening the airway with head tilt chin lift, how can you ensure you have maximized the open airway?

position infant with neck in neutral position so that the external ear canal is level with the top of the infant's shoulder

How do you ventilate with a BVM a pt who has a stoma or tracheostomy tube?

position mask over stoma or tube and then use same technique for breathing. can connect device directly to tube. if chest does not rise, close victim's mouth.

How do you use a pocket mask?

position self at pt side place mask on victim's face - use the bridge of their nose as a guide for positioning seal pocket mask against their face - your index finger & thumb along top edge of mask - thumb of other hand on bottom edge of mask - remaining fingers of 2nd hand along bony margin of jaw and lift - head tilt chin lift to open airway - as you lift, press firmly and completely around edge of mask to seal

What is the appropriate technique for BVM ventilation if there is just 1 rescuaer?

position yourself above victim's head place mask on victim's face. use E-C clamp technique to hold maks in place head tilt chin lift squeeze bag - 1 breath over 1 second +/- supplemental O2

How to perform jaw thrust

position yourself at victim's head place on hand on either side of victim head place fingers under angle of victim's lower jaw and lift - displacing jaw forward if lips close - push lower lip w thumbs to open

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no normal breathing, pulse felt 3b) rescue breathing provided. pulse assessed - HR < 60 / min with signs of poor perfusion. what do you do now?

start CPR

If victim of cardiac arrest does not have a pulse, what is your tx?

start CPR 30:2 x 5 cycles then activate EMS use AED as soon as possible & follow prompts

What do you do if victim is in cardiac arrest and you suspect opioid overdose?

start CPR consider naloxone - but effect is unknown if victim also has cardiac arrest

Steps to give chest compressions to an infant via 2 finger technique: 1) place infant on firm, flat surface 2) place both thumbs where?

thumbs side by side in center of infant's chest on lower half of breastbone and use hands to encircle the infant's chest to support the back

After injection, note what?

time of injection

You have to ensure complete chest recoil between compressions why?

to allow blood to flow into the heart chest compression & chest recoil times should be at a ratio of 50/50. equal!

During rescue breaths or compressions of a victim of cardiac arrest due to drowning, the victim may want to vomit. What do you do?

turn victim to side, remove vomit w finger / cloth / suction (if within your scope)

What are signs of respiratory arrest?

unresponsive not breathing or only gasping still has pulse

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. 3) checked for pulse & breathing -> no breathing or only gasping & no pulse felt 4) started CPR 5) AED has arrived. Rhythm is NON SHOCKABLE. 6) CPR has resumed. Continue CPR until when?

until ALS providers take over or victim starts to move

Special circumstances when using AEDs: pregnant women

use AED as normal

What do you do if child pads are not available?

use adult pads, make sure they do not touch each other or overlap

To help prevent misunderstandings and keep everyone focused, all team members should

use clear, concise language speak loudly in a calm & confident tone

Special circumstances when using AEDs: victim has hairy chest

use razor from AED case to shave area or if you have a second set of pads, use first set to wax the chest lolol

If the AED you are using cannot deliver a pediatric dose, what can you do?

use the adult dose

What is the first step in BLS?

verify scene safety (make sure it is safe for you and the victim)

What are the actions to help a heart attack victim?

victim sit & remain calm activate EMS. get first aid & AED kit encourage pt to chew and swallow aspirin if unresponsive, not breathing, or only gasping - start CPR

Steps to give chest compressions to an infant via 2 finger technique: 1) place infant on firm, flat surface 2) place 2 fingers on the infant's chest 3) compressions at a rate of 100 - 120 /min 4) compress 1/3rd of AP diameter 5) allow for chest recoil 6) after every 30 compressions, head tilt chin lift and give 2 breaths 7) wait how many cycles of CPR and then activate EMS and get AED

wait 5 cycles of CPR

Shockable rhythms are treated how?

with defibrillation

If on an infant or child you do not definitely feel a pulse within ___ seconds, what do you do?

within 10 seconds start high-quality CPR starting with chest compressions

When checking for pulse in BLS, you are checking if a pulse is definitely felt within how long? where on the pt's body do you check for a pulse?

within 10 seconds feel for carotid pulse

Drugs that break up a clot must be given within how much time after the signs of a stroke first started?

within 3 hours

What populations are less likely to have the typical signs of a heart attack?

women elderly diabetes

Is respiratory arrest reversible in opioid-associated life-threatening emergencies?

yes!! if treated early

Can you use an AED on a child < 8 years of age?

yes, important to use an AED as early as possible

If there is a delay > 5-10 mins after giving first dose of epi pen,

consider 2nd dose if available

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no normal breathing, pulse felt 3b) rescue breathing provided. pulse assessed - HR not < 60 / min and no signs of poor perfusion. what do you do now?

continue rescue breathing, checking pulse every 2 mins. if no pulse, start CPR

continue to assess for responsiveness and breathing until victim is transferred to advanced care

What does the CPR coach do?

coordinates start of CPR coaches to improve quality of compressions state midrange targets like 110 / min instead of 100-120 /min coach to midrange targets & remind about compression-ventilation ratio minimize length of pauses in compression

What are the resuscitation constraints in cardiac arrest in both in and out of hospital settings?

crowd control family presence space constraints resources training patient transport device failures

What are the rate and depth for chest compressions on an adult? a. a rate of 60 -80 compressions / min and depth of 1 inch b. a rate of 80 -100 compressions / min and depth of 1.5 inches c. a rate of 120 -1400 compressions / min and depth of 2.5 inches d. a rate of 100-120 compressions / min and depth of at least 2 inches

d. a rate of 100-120 compressions / min and depth of at least 2 inches

For what age victim is the 2 thumb encircle hands technique recommended? a. a child younger than 3 years of age b. a child older than 3 years of age c. an infant older than 1 year d. an infant younger than 1 year

d. an infant younger than 1 year

What is the third link in the adult out-of-hospital chain of survival? a. advanced life support b. high quality CPR c. prevention d. defibrillation

d. defibrillation

Which of the following is a sign that someone is experiencing anaphylaxis? a. symptoms developing quickly but getting worse slowly b. presence of a medical alert bracelet or necklace c. person responding well to oral antihistamines d. life-threatening breathing or circulation problems

d. life-threatening breathing or circulation problems

Which of these is not an opioid? a. heroin b. hydrocodone c. morphine d. naloxone

d. naloxone

If you think someone might be having a stroke, what should be the first thing you do? a. start first aid on the individual b. wait an hour and then phone 911 c. give the person an injection of alteplase d. quickly check for signs of stroke

d. quickly check for signs of stroke

A 53 y/o M collapses and becomes unresponsive. You witness his collapse and are the first rescuer at the scene, where the man is lying motionless on the floor. The man doesn't respond when you tap his shoulders and shout "Are you ok?". What is your next best action? a. check his pulse b. start high quality CPR c. start providing rescue breaths d. shout for nearby help

d. shout for nearby help

What action should you take while the AED is analyzing the heart rhythm? a. check the pulse b. continue chest compressions c. give rescue breaths only d. stand clear of victim

d. stand clear of victim

A 53 y/o M collapses and becomes unresponsive. You witness his collapse and are the first rescuer at the scene, where the man is lying motionless on the floor. 1. What is the first action you should take in this situation? a. activate EMS b. start high-quality CPR, beginning w chest compressions c. start providing rescue breaths d. verify scene is safe for you and the victim

d. verify scene is safe for you and the victim

Which is an example of a mild foreign-body airway obstruction? a. cyanosis b. high pitched noise while inhaling c. inability to speak or cry d. wheezing between coughs

d. wheezing between coughs

What is the correct compression-to-ventilation ratio for a single rescuer of a 3-year-old child? a. 15:1 b: 15:2 c: 20:2 d. 30:2

d: 30 compressions to 2 breaths

After the resuscitation event, what should the team do?

debrief to discuss resuscitation, discuss certain actions and improve for the future. debriefing programs may improve pt survival after cardiac arrest

______: medical term for interrupting or stopping an abnormal heart rhythm by using controlled electrical shocks

defibrillation

Where do you hold the epi pen?

in your fist without touching either end bc that is where needle comes out of

We breathe in ___% oxygen, and we can breathe out ____% oxygen to our victims.

in: 21% O2 out: 17% O2

Which is the most common cause of cardiac arrest in children? a. cardiac problem b. congenital or acquired heart defect c. respiratory failure or shock d. infection and sepsis

c. respiratory failure or shock

How long do you hold the epi pen injector in place?

3 seconds then pull straight out and rub injection spot x 10 seconds

How deep do you compress on a child?

1/3rd the AP diameter of the chest

What is the universal rate for compressions in all cardiac arrest victims?

100 -120 /min

15 compressions

BVM ventilation is most effective during CPR when

2 rescuers provide it together: 1 to open airway and seal mask while the other squeezes bag

What is the preferred compression technique for infants when 2 rescuers provide CPR?

2 thumb encircling hands technique

Peds BLS algorithm: 1) Scene safety has been verified. 2) What do you do next?

2) check for responsiveness shout for nearby help activate EMS

1) You have verified scene safety. Now what?

2) check for responsiveness. shout for help. activate EMS response via mobile device. get AED. tap victim's shoulders, shout "Are you ok?" If no response, activate EMS & get AED

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. 3) checked for pulse & breathing -> no breathing or only gasping & no pulse felt 4) starting CPR ____ compressions and ____ breaths when do you use AED?

30 compressions 2 breaths AED as soon as possible

What type of CPR can be provided in this scenario: a rescuer with more training such as a police officer trained in BLS who finds an adolescent in cardiac arrest

30:2 CPR (means 30 chest compressions and 2 rescue breaths)

Adult pads are for cardiac arrest victims ____ y/o.

8 y/o and older

The goal time from initial contact to treatment intervention for a suspected heart attack is what?

90 minutes

What happens right before the AED advises a shock?

AED tells you to CLEAR the victim - make sure no one is touching victim by saying like "Everybody clear" then you can press the shock button!

For infants, pad placement is common where?

What are the 2 common placements for AED pad placement and explain each.

Anterolateral placement: one pad directly below right collarbone. other pad to the side of left nipple w top edge a few inches below armpit AP placement: one pad on victim's left chest between breastbone and nipple, and other pad on left side of victim's back, next to the spine

What CCF (chest compression fraction - proportion of time that rescuers perform chest compressions during CPR) increases the likelihood of ROSC, shock success, and survival to hospital discharge? With good teamwork, rescuers can often achieve a CCF of

CCF of at least 60% good teamwork : CCF > 80%

Check rhythm to see if it is a shockable rhythm

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. 3) checked for pulse & breathing -> no breathing or only gasping & no pulse felt 4) started CPR 5) AED has arrived. Rhythm is SHOCKABLE. 6) 1 shock given then CPR resumed. What do you do now?

Continue until ALS providers take over or victim starts to move

Before you start CPR, what do you ensure has been done?

EMS or backup is activated AED and equipment are retrieved/being retrieved

How frequently do you check pulse?

Every 2 mins

What are the warning signs of stroke?

Face drooping Arm weakness Speech difficulty Time to phone 911

What type of CPR can be provided in this scenario: a single rescuer with limited training or who has training but limited equipment witnesses a cardiac arrest in a middle-aged man

Hands only CPR (chest compressions only)

What is the gold standard tx for ischemic stroke?

IV alteplase

Who provides initial support in cardiac arrest in each setting: in-hospital out-of-hospital

In: appropriate surveillance, monitoring, and prevention w responsive primary provider teams out: depends on community and EMS providers for support

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. Now what?

Look for no breathing or only gasping & simultaneously check if pulse is definitely felt within 10 seconds

What type of CPR can be provided in this scenario: when several rescuers are present such as 3 emergency responders who are called to assist a woman in cardiac arrest

Multirescuer-coordinated CPR a high performance team who is highly trained does this!! - 1 rescuer does chest compressions - 1 rescuer does 2 breaths w BVM - 1 rescuer uses AED & is CPR coach!!

Is it ok to use child pads for an adult?

No, shock won't be enough for an adult. Better to give high quality CPR

1) verified scene safety 2) checked for responsiveness. shouted for help. activated EMS response via mobile device. got AED. 3) checked for pulse & breathing -> no normal breathing but pulse felt Now what?

Provide rescue breathing: 1 breath / 6 seconds check pulse q2 mins - start CPR if no pulse if suspect opioid OD - give naloxone

What is preferred for infants: AED or manual defibrillator? If neither a manual defibrillator or an AED with a ped dose attenuator is available, what do you use?

a manual defibrillator is preferred to an AED for infants if neither is available, can use an AED without a pediatric dose attenuator

Deliver chest thrusts for infant choking relief how often?

a rate of 1 per second

How often should rescue breaths be given in infants and children when a pulse is felt? a. 1 breath every 2 - 3 seconds b. 1 breath every 3 - 5 seconds c. 1 breath every 5 - 6 seconds d. 1 breath every 8 - 10 seconds

a. 1 breath every 2 - 3 seconds

Which victim of a severe airway obstruction should receive abdominal thrusts? a. an average size 27 y/o M b. a woman who is obviously pregnant c. an obese 50 y/o M d. an average size 9 month old infant

a. an average size 27 y/o M

What action should you take when more rescuers arrive? a. assign tasks to other rescuers and rotate compressors every 2 mins or more frequently if needed to avoid fatigue b. continue CPR while AED is attached even if you are fatigued c. wait for the most experienced rescuer to provide direction to the team d. direct the team to assign a Team Leader and roles while you continue CPR

a. assign tasks to other rescuers and rotate compressors every 2 mins or more frequently if needed to avoid fatigue

If a victim of cardiac arrest has an implanted pacemaker or defibrillator, what special steps should you take? a. avoid placing the AED pad directly over the implanted device b. avoid using the AED to prevent damage to the implanted device c. turn off the implanted device before applying AED pads d. consider using pediatric pads to decrease the shock dose delivered

a. avoid placing the AED pad directly over the implanted device

You are performing abdominal thrusts on a 9 y/o child when she suddenly becomes unresponsive. After you shout for nearby help, what is the most appropriate action to take next? a. begin high-quality CPR, starting which chest compressions b. check for pulse c. continue performing abdominal thrusts d. Provide 5 back slaps followed by 5 chest thrusts

a. begin high-quality CPR, starting which chest compressions

Which action can rescuers perform to potentially reduce the risk of gastric inflation? a. delivering each breath over 1 second b. giving rapid, shallow breaths c. using a bag-mask device for delivering ventilation d. using the mouth-to-mask breathing technique

a. delivering each breath over 1 second

What does the stroke acronym F.A.S.T. stand for? a. face drooping, arm weakness, speech difficulty, time to phone 911 b. falling down, arm weakness, slurring words, time to start first aid c. falling down, arm tingling, speech difficulty, time to phone 911 d. face drooping, arm tingling, sudden weakness, time to start CPR

a. face drooping, arm weakness, speech difficulty, time to phone 911

Where on the body should you administer an epinephrine injection? a. on the person's thigh about halfway between the hip and the knee b. on the person's torso about halfway between the hip and the ribs c. on the person's arm about halfway between the elbow and the wrist d. on the person's neck about halfway between the ear and the shoulder

a. on the person's thigh about halfway between the hip and the knee

What is the appropriate action to demonstrate closed-loop communication when the Team Leader assigns you a task? a. repeat back to the team leader the task assigned to you b. nod your head as an acknowledgment of the assigned task c. start performing the assigned tasks, but do not speak, to minimize noise d. wait for the Team Leader to address you by name before you acknowledge the task

a. repeat back to the team leader the task assigned to you

Several rescuers respond, and you ask them to activate the emergency response and retrieve the AED and emergency equipment. As you check for a pulse and breathing, you notice that the man is gasping for air and making "snorting" sounds. You do not feel a pulse. What is your best next action? a. start high-quality CPR, beginning with chest compressions b. monitor victim until additional, more experienced help arrives c. provide rescue breathing by delivering 1 breath every 6 seconds d. find someone to help by retrieving the nearest AED

a. start high-quality CPR, beginning with chest compressions

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt 4) you did witness sudden collapse what do you do now?

activate EMS (if not already done so) and retrieve AED/defibrillator

Actions to help with severe allergic rxn

activate EMS. get epi pen give or help person inject epi pen send for AED give 2nd dose of epi if sx continue and advanced care has not arrived in 5 -10 mins start CPR if pt becomes unresponsive and is not breathing or is only gasping save a sample of what caused the reaction

Adult out-of-hospital chain of survival

activation of emergency response high quality CPR defibrillation advanced resuscitation post-cardiac arrest care recovery

What is the ventilation rate if an advanced airway is in place for: adults infants & children

adult: 1 breath every 6 seconds infant and child: 1 breath every 2-3 seconds

In adults, cardiac arrest is often sudden and frequently results from ____. In children, cardiac arrest is often secondary to ___.

adults - cardiac cause children - 2ndary to resp failure or shock

Abdominal thrusts are used to relieve choking in [adults/ children / infants].

adults and children. NO INFANTS

What breathing technique is indicated for: adults and children infant (which is preferred?)

adults and children: mouth to mouth infants: mouth to mouth and nose (preferred) or mouth to mouth

Chest compressions for high quality CPR should be at what depths for: - adults - children - infants

adults: 2 inches - 2.4 inches max children: 1/3rd depth of the chest ~approx 2 inches infants: 1/3rd depth of the chest ~approx 1.5 inches

after every 30 compressions, head tilt chin lift and give 2 breaths

When can you give effective breaths when there is an airway obstruction?

after giving 30 compressions - removing any object visible in mouth

High quality CPR includes compressing within 10 seconds of recognizing cardiac arrest at a rate of 100-120/min at an appropriate depth depending on adult/child/infant. After each compression, allow for.....? Limit interruptions between compressions to less than how long? Deliver each breath over how long? What is a sign of an effective breath?

allow for complete chest recoil after each compression limit interruptions to < 10 seconds between compressions Deliver each breath over 1 second. watch chest rise

Who is responsible on the team to stop someone else from making a mistake?

anyone on team, regardless of role

What is the effect of too much opioid in the body?

depresses natural drive to breathe -> can result in respiratory arrest and cardiac arrest

What is the correct compression depth for a child? a. at least one fourth the depth of the chest or approximately 1 inch (2.5 cm) b. at least one third the depth of the chest or approximately 1.5 inches (4 cm) b. at least one third the depth of the chest or approximately 2 inches (5 cm) b. at least one third the depth of the chest or approximately 3 inches (7.6 cm)

b. at least one third the depth of the chest or approximately 2 inches (5 cm)

You encounter an unresponsive 56-year-old woman who has been taking hydrocodone for postsurgical pain. She is not breathing and has no pulse. You notice that her medication bottle is empty and suspect an opioid-associated life-threatening emergency. A colleague activates EMS and is retrieving the AED and naloxone. What is the most appropriate action for you to take? a. wait for the naloxone to arrive before doing anything b. begin CPR, starting with chest compressions c. provide 1 rescue breath every 6 seconds until naloxone arrives d. provide rapid defibrillation with the AED

b. begin CPR, starting with chest compressions

Which of the following populations is most likely to show atypical signs of a heart attack, like SOB and dizziness? a. white, middle-aged men b. individuals with diabetes c. younger-aged individuals d. people who are overweight

b. individuals with diabetes

If you suspect that an unresponsive victim has head or neck trauma, what is the preferred method for opening the airway? a. head tilt chin lift b. jaw thrust c. head tilt neck lift d. avoid opening airway

b. jaw thrust

Which is the preferred technique for giving rescue breaths to an infant? a. mouth to mouth b. mouth to mouth and nose c. mouth to nose d. any method is acceptable

b. mouth to mouth and nose

Which step is one of the universal steps for operating an AED? a. shaving victim's hairy chest b. placing pads on victim's bare chest c. removing victim from water d. finding the victim's implanted pacemaker

b. placing pads on victim's bare chest

How are rescue actions for cardiac arrest due to drowning different from the rescue actions for sudden cardiac arrest? a. unlike sudden cardiac arrest, the priority in drowning is to give the person CPR b. unlike sudden cardiac arrest, the priority in drowning is to give the person oxygen c. unlike sudden cardiac arrest, the priority in drowning is to locate an ambulance d. unlike sudden cardiac arrest, the priority in drowning is to give chest compressions

b. unlike sudden cardiac arrest, the priority in drowning is to give the person oxygen

If a manual defibrillator is not available for an infant victim, which action should you take? a. perform high-quality CPR b. use an AED equipped with a pediatric dose attenuator c. cut the adult pad to fit the infant d. wait for advanced care to arrive

b. use an AED equipped with a pediatric dose attenuator

You notice someone showing all the signs of a severe allergic reaction. What is the first and most important action you should take? a. call an advanced responder b. use the epinephrine device c. give the person an oral antihistamine d. locate an external defibrillator

b. use the epinephrine device

What maneuvers are used to relieve a choking infant?

back slaps and chest thrusts

What device provides positive pressure ventilation?

bag valve mask

What is the standard precaution when giving breaths during CPR? Which is the preferred device?

barrier device - preferred is pocket masks but can use a face shield

For a child, you may use what type of compressions?

big child: 2 hands small child: 1 hand

Because in infants and children, cardiac arrest may not be sudden and is often caused by respiratory complications, what is an effective way of distributing oxygen to the heart and brain?

both compressions and breaths

Pulse check in an infant - what artery - what do you use to check - how long do you check it for

brachial artery pulse place 2-3 fingers on inside of upper arm press fingers down and feel for pulse for 5 - 10 seconds max

What is the ratio of chest compressions to breaths when providing CPR to an adult? a. 10 compressions to 2 breaths b. 15 compressions to 2 breaths c. 30 compressions to 2 breaths d. 100 compressions to 2 breaths

c. 30 compressions to 2 breaths

Which victim would need only rescue breathing? a. agonal gasping with no pulse b. breathing with a weak pulse c. no breathing and a pulse d. no breathing and no pulse

c. no breathing and a pulse

You are attempting to rescue a person who has experienced drowning. What do you do if there are no signs of breathing? a. attempt to clear the airway of aspirated water b. perform abdominal thrusts to remove any water c. open the airway and administer rescue breaths d. use spinal stabilization regardless of neck injury

c. open the airway and administer rescue breaths

What is the most appropriate first step to take as soon as the AED arrives at the victim's side? a. press the analyze button b. apply the pads c. power on the AED d. press the Shock button

c. power on the AED

What is CCF? a. the force you use to compress the chest b. compression to ventilation ratio c. proportion of time that rescuers perform chest compressions during CPR d. another term for chest recoil

c. proportion of time that rescuers perform chest compressions during CPR

Your roommate uses opioids. You find him unresponsive with no breathing, but he has a strong pulse. You suspect an opioid overdose. A friend is phoning 911 and looking for the naloxone autoinjector. What action should you take? a. remain with your roommate until naloxone arrives and administer it immediately b. begin CPR, starting with chest compressions c. provide rescue breathing: 1 breath every 6 seconds d. provide rapid defibrillation with an AED

c. provide rescue breathing: 1 breath every 6 seconds

A team member plays what role in closed-loop communication?

confirm understanding of assigned task via verbal acknowledgement tell team leader when you have finished a task

After performing high-quality CPR for about 5 mins, the team leader frequently interrupts chest compressions to check for a pulse. Which action demonstrates constructive intervention? a. ask another rescuer what he thinks should be done b. say nothing that contradicts the team leader c. suggest resuming chest compressions without delay d. wait until debriefing session afterward to discuss it

c. suggest resuming chest compressions without delay

The Team Leader asks you to perform bag-mask ventilation during a resuscitation attempt, but you have not perfected that skill. What would be an appropriate action to acknowledge your limitations? a. pick up the bag-mask device and give it to another team member b. pretend you did not hear the request and hope the team leader chooses someone else to do it c. tell the team leader you are not comfortable performing that task d. try to do it as best you can and hope another team member will see you struggling and take over

c. tell the team leader you are not comfortable performing that task

What should you do when using an AED on an infant or a child younger than 8 years of age? a. never use adult AED pads b. use adult AED pads c. use adult AED pads if the AED does not have child pads d. use adult AED pads, but cut them in half

c. use adult AED pads if the AED does not have child pads

What is important to remember about AED pad placement on infants? a. ensure that pads overlap each other in very small infants b. place 1 adult pad on the chest c. you may need to place 1 pad on the chest and 1 on the back, according to the diagrams on the pads d. if child AED pads are not available, do not use AED

c. you may need to place 1 pad on the chest and 1 on the back, according to the diagrams on the pads

A team leader plays what role in closed-loop communication?

call each member by name and make eye contact when giving an instruction do not assign addtl tasks until sure team member understands instruction

Actions to help victim of cardiac arrest due to drowning

call for help & activate EMS move victimeout of water check breathing. if no breathing, open airway & give 2 rescue breaths check for pulse after 2 breaths.

Pulse check in a child - what artery - what do you use to check - how long do you check it for

carotid or femoral pulse carotid - 2-3 fingers next to trachea femoral - 2-3 fingers in inner thigh midway between hip and pubic bone just below hip crease 5- 10 seconds

After you relieve choking in an unresponsive victim, what do you do?

check for responsiveness check for breathing and pulse confirm EMS activation provide high quality CPR or rescue breathing

Peds BLS algorithm: 2 rescuers 1) scene is safe. what does each rescuer do now?

check for responsiveness shout for nearby help 1st rescuer: stays with child 2nd rescuer: activates EMS and gets AED

Opioid-associated life-threatening emergency response sequence: step 1

check for victim response shout for help activate EMS if alone - get naloxone and AED. if more rescuers, have them get that stuff

Peds BLS algorithm: 2 rescuers 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt 4) you started 2 rescuer CPR 30:2 until 2nd rescuer returned w AED, and you switched to 15:2 what do you do now?

check rhythm for shockable rhythm

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt 4) you did not witness sudden collapse 5) you started 1 rescuer CPR 6) confirmed EMS is activated and AED is retrieved what do you do now?

check rhythm, is it shockable?

What are the 2 key components of CPR? what is the third component?

chest compressions breaths/breathing airway

For witnessed SUDDEN cardiac arrest, what is an effective way of distributing oxygen to heart and brain in infants and children?

chest compressions alone

Peds BLS algorithm: 2 rescuers 1) what do you do first?

chest for scene safety

How do you adjust tx of choking in pregnant and obese victimes?

chest thrusts instead of abdominal thrusts

What is the compression to ventilation ratio for 2 rescuers in: - child - infant - adults

child & infant: 15:2 adult: 30:2

give 1 shock resume CPR x 2 mins or until prompted by AED to allow for neck rhythm check continue until ALS providers arrive or child starts to move

give 1 shock, resume CPR for 2 mins or until prompted by AED. continue until ALS arrives or child starts to move

The first and most important action for a drowning victim is to do what?

give rescue breaths ASAP to increase chance of survival

gives 1 shock. resume CPR for 2 mins until prompted by AED to allow for rhythm check

What are the 2 methods to open a victim's airway? Which is used if you suspect a head or neck injury?

head tilt chin lift - 2nd line for head/neck injury if jaw thrust does not work jaw thrust - 1st line for head/neck injury.

Heart attack vs sudden cardiac arrest

heart attack: blood flow problem to heart muscle cardiac arrest: rhythm problem when heart develops an abnormal rhythm. causes heart to quiver or stop. deadly!

What is the leading cause of death in the US for men and women?

heart disease

How do you position your hands and body to perform chest compressions?

heel of one hand in center of chest on the lower half of the sternum/breastbone heel of other hand on top of first hand straighten arms and position shoulders directly over your hands

Steps to relieve choking in a responsive infant

hold infant in your lap, facedown with head slightly lower than chest. resting on your forearm. support head and jaw with your hand. rest your forearm on your thigh or lap use heel of your hand to deliver up to 5 back slaps between shoulder blades then place free hand on infant's back, support the back of their head while other hand is supporting their face and jaw. cradling infant between 2 forearms. turn infant over while supporting head and neck. faceup. keep head lower than trunk provide 5 downward chest thrusts in middle of chest (same as chest compressions) repeat sequence of back slaps and chest thrusts until infant moves or becomes unresponsive

What is the function of an AED?

identify abnormal heart rhythm that needs a shock & delivers the shock

if still alone after about 2 mins, activate EMS and retrieve AED if not already done

Special circumstances when using AEDs: victim has transdermal medication patch

if time allows, remove patch & wipe, then place pad. use gloves to avoid medication transfer to your hands!!

What is a sign that the obstruction has been removed if you do not physically see the object?

if you can feel air movement and see chest rise when you give breaths

What is the first and foremost impt action for someone with suspected anaphylaxis ?

immediate injection of epi

If the AED prompts no shock advised, you should

immediately resume CPR starting with chest compressions x 5 cycles or 2 mins. then AED will prompt repetition of rhythm analyzing & shocking if applicable

Steps to give chest compressions to an infant via 2 finger technique: 1) place infant on firm, flat surface 2) place 2 fingers where on the infant's chest?

in center of chest just below nipple line on lower half of breastbone

What type of breathing device is recommended for a pt who is either not breathing or not breathing normally?

positive pressure ventilation device - bag valve mask

prevent deterioration - check for responsiveness - open and reposition airway - consider administering naloxone - transport to hospital

In peds, early ID of respiratory or circulatory problems and appropriate tx helps with what?

preventing progression to cardiac arrest

Pediatric out-of-hospital chain of survival

prevention activation of emergency response high quality CPR advanced resuscitation post-cardiac arrest care recovery

if you are unable to ventilate victim the victim after 2 attempts of mouth to mouth, do what?

promptly return to chest compressions

What is a benefit of summarizing information aloud?

provide ongoing record of tx. reevaluate victim status, interventions, team progress. helps team respond to changing condition

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no normal breathing, pulse felt what do you do?

provide rescue breathing 1 breath every 2-3 seconds or about 20 - 30 breaths/min. assess pulse for no more than 10 seconds

If victim of cardiac arrest is not breathing normally but has a pulse, what is your tx?

provide rescue breathing only and recheck for pulse every 2 mins

What do you do if you suspect an opioid-associated life-threatening emergency and victim has a definite pulse but is not breathing normally?

provide rescue breaths give naloxone per package directions and per local protocol monitor for response

What is the purpose of a PAD program?

public access defibrillation - reduce time to defibrillation by placing AEDs in public places and training laypeople to use them

Special circumstances when using AEDs: victim has water/sweat on them or is in water

pull victim out of water, wipe off chest. ok to use if lying on snow or in small puddle

If you have difficulty pushing deeply down during compressions, do what? (technique is helpful for rescuers w joint conditions like arthritis)

put one hand on breastbone to push chest grasp wrist of that hand w other hand to support first hand as you push down

What are the 4 criteria for anaphylaxis?

quick onset & rapidly worsening skin changes (flushing, itching) and swelling of lips, tongue, face life threatening airway, breathing, or circulation problems 2+ body systems involved

Steps to give chest compressions to an infant via 2 finger technique: 1) place infant on firm, flat surface 2) encircle hands 3) compressions at a rate of 100 - 120 /min 4) compress 1/3rd of AP diameter 5) allow for chest recoil 6) after every 15 compressions, head tilt chin lift and give 2 breaths 7) continue compressions and breaths at a ratio of ___ for 2 rescuers. can switch roles every ____. continue CPR until AED arrives, ALS arrives, or infant breathes/ moves/responds

ratio of 15:2 switch every 2 mins

What is the purpose of a pediatric dose attenuator?

reduce a shock dose by about 2/3rds to shock a pediatric pt typically, an attenuator delivers the reduced shock via child pads. often comes preconnected to ped pads

If chest does not rise when giving mouth to mouth, what do you do?

repeat head tilt chin lift and give a second blow

______: giving breaths to an unresponsive victim who has a pulse but is not breathing

rescue breathing

BVM ventilation technique with 2 rescuers

rescuer 1: above victim, open airway and positions BVM rescuer 2: at victim's side, squeezes bag

Explain the roles of the two rescuers in two-rescuer CPR

rescuer 1: at victim's side, chest compressions. rescuer 2: at victim's head, open airway, give breaths.

______: when normal breathing stops, preventing essential oxygen supply and CO2 exchange. lack of O2 to the brain eventually causes a person to become unresponsive

respiratory arrest

resume CPR for 2 mins or until prompted again by AED to allow for rhythm check

resume CPR for 2 mins or until prompted by AED and continue until ALS providers arrive or child starts to move

resume CPR x 2 mins or until prompted by AED to allow for neck rhythm check continue until ALS providers arrive or child starts to move

What is ROSC and what are signs of this?

return of spontaneous circulation breathing, coughing, or movement and a palpable pulse or measurable blood pressure

Team dynamics during a resuscitation attempt includes what 3 elements?

roles and responsibilities communication debriefing

What is the compression to ventilation ratio for single rescuers in: - child - infant - adults

same for all 3, 30: 2

How do you check for breathing in BLS?

scan chest for rise and fall for no more than 10 seconds if breathing - then monitor until EMS arrives if no breathing or just gasping - start CPR

A responsive victim, after choking relief, should be encouraged to do what?

seek medical attention

What is closed-loop communication?

sender gives message receiver repeats it back sender confirms it was heard correctly helps prevent misunderstandings and treatment

Is this a mild allergic reaction or severe: swelling of airway, trouble breathing, wheezing hives, itching, flushing, swelling of lips, tongue, face signs of poor perfusion - inc in HR, skin color changes, cool skin, LOC, hypotensive stomach cramping, diarrhea

severe

Is this mild or severe airway obstruction: clutching throat w thumb and fingers making universal choking sign unable to speak or cry poor or no air exchange weak cough or no cough at all high pitched noise while inhaling or no noise increased resp difficulty possible cyanosis

severe

Cardiac arrest in a drowning victim is caused by

severe lack of oxygen in the body (asphyxial arrest)

Which is longer: chest compression or chest recoil times?

should be about equal to allow blood to flow into heart between compressions

Steps for choking relief in an unresponsive adult or child

shout for help - send someone to activate EMS lower victim to ground start CPR w chest compressions. no need to check for pulse each time you open airway to give breaths, open their mouth wide and look for object - remove with fingers if easy to remove - continue CPR if do not see anything activate EMS if you're alone after 2 mins of CPR or 5 cycles

Steps to relieve choking in an unresponsive infant

shout for help. send someone to activate EMS place infant on firm flat surface start CPR w compressions each time you open airway, look for object. remove it if visible activate EMS after 2 mins if you're alone

Epi injections are given where?

side of thigh - halfway between hip and knee via clothing or bare skin

Chest discomfort + discomfort in other areas of upper body + SOB + cold sweat + N/V + lightheadedness

signs of a heart attack

When do you switch from only rescue breathing to CPR in an infant or a child?

signs of poor perfusion in an infant despite effective rescue breathing infant/child heart rate is < 60 /min with signs of poor pe rfusion when a pulse is no longer felt

For infants, single rescuers use what type of compressions? what if multiple rescuers are present?

single rescuers: 2 finger or 2 thumb encircling hands multiple: 2 thumb encircling hands technique may use heel of one hand if can't compress enough

What are the signs of an opioid OD?

slow, shallow or no breathing choking or gurgling sounds drowsiness or loss of consciousness small constricted pupils blue skin, lips, nails

Do not use an epipen if

solution is discolored clear window on autoinjector is red

Abdominal thrust steps with victim standing or sitting

stand or kneel behind victim, wrap your arms around their waist and make a fist w one hand place thumb side of fist against their abdomen in the midline slightly above navel grasp fist w other hand and press into abdomen w a quick forceful upward thrust repeat until object expelled or victim becomes unresponsive

start CPR

start CPR + ventilation use AED when available consider naloxone

Peds BLS algorithm: 1) scene is safe. 2) EMS activated, help called for, pt unresponsive. 3) no breathing or only gasping, pulse not felt 4) you did not witness sudden collapse what do you do now?

start CPR - as 1 rescuer you do cycles of 30 compressions to 2 breaths. If 2nd rescuer arrives, switch to cycles of 15 compressions and 2 breaths. use AED as soon as it is available

Start compressions within ____after recognizing cardiac arrest at a rate of _____ .

start within 10 seconds at a rate of 100- 120 / min

What is the compression rate if an advanced airway is in place?

still 100 - 120/min - but CONTINUOUS without pauses for breaths

If an infant becomes unresponsive while attempting choking relief, what do you do?

stop slaps and start CPR with chest compressions

support ventilation - open and reposition airway before giving rescue breaths provide rescue breathing or BVM reassess pulse and breathing every 2 mins. if no pulse - give CPR give naloxone

When only 2 rescuers are available, switch the compressor how often? taking how long to switch?

switch every 5 cycles or 2 mins. take less than 5 seconds to switch - switch when AED is analyzing rhythm

Why is it important to minimize interruption to chest compressions?

takes several compressions to bring blood flow back up to levels before interruption. more interruption = the lower blood supply to brain and critical organs

What conditions can result in problematic opioid use?

taking more drug than prescribed or not prescribed for you combining opioids w alcohol or other drugs medical conditions like reduced liver function or sleep apnea > 65 y/o

What program enables the general public to perform high-quality CPR and early defibrillation?

telecommunicator-assisted CPR (T-CPR)

What are signs of poor perfusion?

temperature (cool extremities) altered mental state (decline in consciousness) pulses (weak pulses) skin (pale, mottling, later is cyanotic)

What is a chain of survival?

the actions that must take place to give cardiac arrest victims the best chance of survival

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