BLS Lesson 3: Basic Life Support for Adults

The Cardiac Chain of Survival describes six actions that, when performed in rapid succession, increase the patient's likelihood of surviving sudden cardiac arrest. Place the links of the In-Hospital Adult Cardiac Chain of Survival in the correct order.

1. Surveillance and prevention 2. Recognition of cardiac emergency & Activation of the emergency response system 3. Early high-quality CPR 4. Early defibrillation 5. Integration post-cardiac arrest care 6. Recovery

Joanne and Valerie switched to operating the BVM. While Joanne sealed the mask, Valerie depressed the bag. This is the preferred technique for BVM ventilation. True or false?

True

Joanne correctly applied the AED pads using the anterior/lateral position. However, if Mr. Goodman had a pacemaker or ICD, she would adjust pad placement as necessary to avoid placing the AED pads directly over the pacemaker or ICD. True or false?

True

The team leader assigns roles, supports the team, monitors the delivery of CPR and makes adjustments in real time. The team members deliver expert care within their assigned roles, assist others as needed (as long as they can maintain their own assigned responsibilities) and communicate effectively with the team leader and each other. True or false?

True

You demonstrate high-quality CPR by keeping interruptions in CPR to less than _____ seconds.

10

Mr. Goodman is unresponsive. Valerie must now simultaneously check for breathing and a pulse for no more than ___.

10 seconds

Kirron arrived and took over compressions. To ensure high-quality CPR, providers should switch off giving compressions every ___ minutes or sooner if the provider giving compressions is fatigued.

2

What is the correct volume of air to deliver during BVM ventilations?

400 to 700 mL

You are working as part of a high-performance BLS team. Which roles would you and the other providers most likely fill?

AED operator Compressor Airway manager/ventilator Team leader

You are caring for a pregnant patient (30 weeks gestation) in cardiac arrest. The patient's fundus is above the umbilicus. Which of the following steps are appropriate?

Activate maternal and neonatal resuscitation teams. Provide continuous high-quality CPR and left uterine displacement. Make sure AED pads do not incorporate any breast tissue. Perform resuscitative cesarean delivery (RCD), if trained, within 5 minutes from the time of arrest.

You are working with a BLS team performing CPR on a 62-year-old female patient. Which actions demonstrate high-quality CPR?

Allow for full chest recoil after each compression. Deliver smooth ventilations that last about 1 second each and make the chest begin to rise. Compress the chest at a rate of 100 to 120 per minute.

Valerie has established that Mr. Goodman is in cardiac arrest and she has exposed the chest. She must immediately begin CPR while Joanne retrieves and sets up the AED. Which actions should the team take to ensure that they are providing high-quality CPR?

Avoid excessive ventilations. Minimize interruptions in compressions to less than 10 seconds. Allow the chest to fully recoil after each compression. Provide smooth compressions at a rate of 100 to 120 compressions per minute and a depth of at least 2 inches.

You are evaluating the quality of CPR provided by the BLS team. Which methods could you use for this evaluation?

Chest compression fraction Capnography Feedback device (depth: 2.4 inches) Visual observation

To minimize interruptions in chest compressions, what should Valerie do during the AED analysis and shock?

Clear the patient and prepare to resume CPR immediately after the shock is delivered or if no shock is advised.

You are providing care for an adult patient in respiratory arrest. Which actions demonstrate appropriate care?

Deliver 1 ventilation every 6 seconds. Continue to check breathing and pulse every 2 minutes. If pulse becomes absent, start CPR.

You arrive with an AED and prepare to apply the pads while the BLS team continues to provide CPR. You apply the pads using the anterior/lateral pad placement.

Patient's upper right chest, below the right clavicle to the right of the sternum Patient's lower left chest along the midaxillary line, a few inches below the left armpit

You have been performing multiple-provider CPR and using an AED on an adult patient in cardiac arrest. The patient is now showing signs of return of spontaneous circulation (ROSC). Which action(s) would the team perform?

Stop CPR/AED. Check for breathing and a carotid or femoral pulse. Monitor the patient until the advanced cardiac life support team takes over.

After the resuscitation event, the BLS team conducted a debriefing session to ensure continuous resuscitation quality improvement. Which observation or data point suggests a need for improvement?

The chest compression fraction (CCF) was 35%. Chest compression fraction (CCF) of at least 60% is needed to promote optimal outcomes, and the goal should be 80%.

An adult patient with an endotracheal tube (ET) in place experiences cardiac arrest and requires CPR. Which of the following statements are true when performing high-quality CPR with an ET tube in place?

The providers deliver 1 ventilation every 6 seconds. The providers perform continuous compressions without pausing for ventilations.

You and another provider have recognized that an adult patient is in cardiac arrest. An advanced airway is not in place. Which actions demonstrate appropriate care?

Begin CPR immediately after identifying cardiac arrest. Use a compression-to-ventilation ratio of 30:2.

You and another provider are delivering ventilations with a bag-valve-mask (BVM) resuscitator to an adult patient in cardiac arrest. Which of the following statements are correct?

Ensure that the chest begins to rise. Hold the mask in place with the E-C hand position. Seal the mask and open the airway by lifting the jaw into the mask. Bag-valve-mask (BVM) ventilations should be performed as a two-person technique to provide a better seal and ventilation volume.

A 60-year-old male patient, Bill Goodman, is scheduled for a follow-up appointment at an outpatient cardiac rehab center attached to a hospital. He is waiting with his wife, Maria. [Visual: Outpatient Cardiac Rehab] [Visual: Man rocks, clutching arm.] Mrs. Goodman: You feeling OK? Mr. Goodman: I'm OK. Mrs. Goodman: You don't look so good. Mr. Goodman: I don't know. I'm just a little... Mrs. Goodman: Well, what's wrong? Why are you holding your arm like that? Mr. Goodman: I need to go to the— Mr. Goodman is exhibiting signs and symptoms of which condition?

Heart attack

Identify the situations in which it is safe to use an AED.

If the patient is lying on a metal surface, providing the AED pads do not touch the surface and no one is touching the patient during shock If the patient is wearing jewelry or has body piercings, providing the AED pads are not placed directly over any metallic jewelry or piercings If the patient has a pacemaker or implantable cardioverter-defibrillators (ICDs), providing the AED pads are not placed directly over the device If the patient is pregnant, providing the AED pads do not incorporate any breast tissue

After performing a rapid assessment on an adult patient, you determine they are unresponsive, breathing and their pulse is present. You suspect they have a head and neck injury. What actions should you take?

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

An adult patient suffers cardiac arrest in bed and requires CPR. When compressing the patient's chest, which technique promotes high-quality CPR?

Place one hand on top of the other and interlace your fingers or hold them up so that they are not resting on the patient's chest. Place down a CPR board or activate the system in the bed to ensure a firm CPR surface. Position yourself so your shoulders are directly over your hands. Adjust the bed or use a secure step or stool so you are at an appropriate working height.

You and a team of trained providers are performing CPR on an adult patient. One team member has gone to get additional resources and the AED. Which of the following statements are true about AED use?

The compressor should continue providing compressions until the AED pads are applied and the AED prompts that it is analyzing. After the shock is delivered and the AED prompts shock delivered, the team should immediately resume CPR. Team members should rotate roles every 2 minutes, which is generally during the AED analysis, to prevent compressor fatigue.

When Joanne returns with the AED, what is her first step?

Turn on the AED and follow the prompts.