CHAPTER 38
Defibrilltion
***TX for Vfib and pulseless VTach*** It is an unsynchronizeed shock that depolarizes all myocardial fibers simultaneously 2 types: biphasic and monophasic
PEA
***TX is uninterrupted CPR for 2 min w/ Epi***
hazards bag mask
Gastric inflation:Can be avoided by providing low to moderate inspiratory flows (<30 mL (delvier 500 mL Vt) Barotrauma, potential but not likely Average leak : 20-40% (which reduce the risk of barotrauma)
Propranolol for what rhythm
MI (0.1 mg divided into 3 doses at 2-3 min intervals) Unstable angina (0.1 mg divided into 3 doses at 2-3 min intervals) SVT (0.1 mg divided into 3 doses at 2-3 min intervals)
Providing artificial ventilation
Must provide O2 w/in 4-6 min Mouth,nose or stoma During resuscitation do not do too fast as can create gastric inflation and increase in intrathoriac pressure Wehn mouth to mouth fails on second attempt check for FBAO
Suspected opiate emergency
Normal BLS procedure Administer intranasal nalaxone
Oropharyngeal airway mgmt
OPA Designs: Guedel and Berman. Each type has an external flange, a curved body that conforms to the shape of oral cavity and one or more channels. Berman uses 2 parrellell side channels
Function AED
Only recommend shock, do not deliver There is rhythm recognition Rhythm is checked after 5 cycles
Contraindications to CPR
Only when PT is obviously dead When valid DNR
Contraindications for CPR
PT is biologically dead DNR
Sinus bradycardia
Pacemaker therapy used (electrical pacing)
If successive efforts to open a hospitalized patient's obstructed airway fail, which of the following emergency procedures might be considered? 1. laryngoscopy 2. transtracheal catheterization 3. cricothyrotomy 4. tracheotomy a. 2 and 4 b. 1, 2, and 3 c. 3 and 4 d. 1, 2, 3, and 4
Page (800) Answer is D 1. laryngoscopy 2. transtracheal catheterization 3. cricothyrotomy 4. tracheotomy a. 2 and 4 b. 1, 2, and 3 c. 3 and 4 d. 1, 2, 3, and 4
Neck and spine injuries mouth to mouth
Use the jaw thrust maneuver
Most common rhythm w/ SCA
VFIB
Epinephrine is for what rhythms
Vfib (1 mg every 3-5 min) Asystole (1 mg every 3-5 min) PEA (1 mg every 3-5 min) Brady (2-10 mcg every minute)
Lidocaine for what rhythms
Vfib (1st dose 1-1.5 mg/kg, 2nd dose 0.5-.75 mg/kg) Vtach (1st dose 1-1.5 mg/kg, 2nd dose 0.5-.75 mg/kg)
Amiodarone is for what rhythms
Vfib (after epi administered, 1st dose 300 mg bolus, 2nd dose 150) Vtach (after epi administered, 1st dose 300 mg bolus, 2nd dose 150) Tachy w/ pulse algorithm (1st dose 150 mg bolus over 10 min, repeat as necessary if VT occurs. follow w/ maitence of 1 mg/min over 6 hrs)
Cycles of compression to ventilation and depth of compression (adult, child, infant)
5 breaths, 2" adult 5 breaths, 1/3 AP diameter or 2" child n/a, at least 1/3 AP diameter of 1.5" infant
What does PT do when airway completely obstructed
AKA: Universal distress signal for foreign body obstruction PT will clutch at throat
Evaluating effectiveness of foreign body removal
Confirmed expulsion Clear breathing or ability to speak ROC Return normal color If successive attempts to clear unsuccessful use Magill forceps to remove
Back blows and chest thrusts procedure
1. Back blows administered to infant more efficiently child stradeled over one arm head lower than body 2. Use flat portion of hand to lay child and blows to back between shoulder bladed 3. If back blows do not work use 5 chest thrusts (chest thrusts performed same location as cardiac compressions) 4. Try to clear airway between attempts, visually inspect oral cavity
Steps to administer BLS by individual
1. Check for movement/response and no breathing/gasping ***LOC*** 2. Activate emergency response. Find AED if available 3. If no AED, start CPR (30:2) 4. Open airway/check breathing 5. If not breathing provide 2 breaths w/ chest rise 6. Resume CPR 7. AED arrives w/ response team
Mouth to mouth infant/children
1. Create tight seal over nose and mouth 2. Child between 1 y/o to adult use same technique as adult to ventilate 3. Provide breath over 1 sec. 4. Remove your mouth and allow child to exhale passively 5. After 2 breaths assess pulse 6. After initial attempt to ventilate fails, repeat effort
Procedure for providing chest compressions, infants
1. Lower half of sternum for compressions. Proper placement w/ imagining line across chest connecting nipples. Place finger on this line (sternum), place middle and ring finger next to index finger. Raise index finger and perform compressions 2. Compress 1.5", rate at least 100
PT post care after survival
1. Maintain body temp 32-36 degrees c for at least 24 hrs 2. actively prevent fever 3. ID and treat coronary symptoms 4. Avoid and immediately correct hypotension and hypoxemia by using highest O2 5. Optimize vent 6. reduce risk for multi organ injury 7. Assist w/ rehab services
Steps involved for early defibrillation
1. Most common initial rhythm, VFIB 2. TX, elec. defribillation 3. Success diminshes rapidly over time 4. VFIB tends to convert to asystole w/in minutes
Procedure for providing chest compressions, children
1. PT in supine position, firm surface 2. Identify the lower half of sternum ***use only one hand to compress*** use other hand to maintain position of airway 3. Compress chest 1.5", depress 1/3 of AP diameter
Procedure for providing chest compressions, adult
1. PT supine, firm surface 2. Choose position close to the PT upper chest so that weight of your body used for compressions 3. Identify lower half of sternum, heel on hand, place other hand on top, lock arms 4. Compression w/ weight of body 5. Compress sternum 2", minimum rate 100 but do not exceed 120 6. If CPR needs to be interrupted restart compressions ASAP
Techniques for inserting OPA
1. Tongue displaced from roof of mouth w/ tongue depressor (most common) 2. Jaw lift technique. Airway is rotated 180 degrees before insertion: grasp the angle of the lower jaw, lift w/ both hands and displace mandible forward while tilting the head back (when neck or spinal injury suspected)
Bag mask device use
1. Use an O2 resevior of adequate size 2. O2 flow 10-15 mL 3. Appropriate Vt for 1 sec 4. Longest possible bag refill time
1. If PT has pulse but is not breathing 2. If PT has no pulse
1. Ventilation must be started immediately 8-10 BPM 2. Chest compressions w/ 30:2
Rescue breathing w/ pulse
10-12/min 1 breaths every 5-6 sec adult 12-20/min 1 breath every 3-5 sec (if palpable pulse >60)child 40-50/min 1 breath every 1-1.5 sec (if palpable pulse >60)infant
Vtach
140-120 BPM VT is managed w/ amiodarone, procainamide, sotalol For PT w/ sustainned VT along w/ other symptoms, cardioversion
SVT
160-220 BPM Regular rate/rhythm Normal QRS ***If PT is critically ill or unstable, TX is cardioversion***
Compressions to vent ratio (adult, child, infant)
30:2, adult 1 or 2 rescuers 30:2 child, 1 rescuer, 15:2 2 rescuers 3:1, infant 1 rescuer w/ 90 compressions to 30 breaths to equal 120
Procedure for FBAO
Abdominal thrust Chest thrust on PT that are pregenant or obese Follow up each with visual check of removal ***If victim becomes unresponsive begin CPR*** Each time mouth is opened during compressions and ventilation should look into PT mouth to see if FBAO has become dislodged. This should take no longer that 6 seconds w/ breaths
Where to check pulse (adult, child, infant)
Adult, carotid artery Child, Carotid or femoral Infant, brachial
Hand placement (adult, child, infant)
Adult: hell of 1 hand on sternum center of chest. Second hand on top of first Child: Lower half of sternum w/ heel of 1 hand or 2. Do NOT compress over xiphoid Infant: Sternum w/ 2 fingers placed just below nipple line, centered
Checking for pulse adult, children
Adults and children over 1, carotid and femoral Infants brachial artery
ACLS
Advanced care and life support
Treating FBAO
Attempt to remove obstruction only if it can be seen If air exchange present PT should be advised to cough, if worsens EMS activated
Chest compressions near drowning
Because of hypoxemia us the ABC approach ***Airway, breath, compression*** Move victim to firm surface
Atropine for what rhythm
Bradycardia (1st dose 1 mg bolus, repeat every 3-5 min, max 3 mg)
OPA, what can cause and contraindications
Can cause: gag reflex, vomiting, laryngeal spasms Contraindicated for conscious and semiconscious PT or trauma surgery to mouth area
ET intubation
Can maintain PT airway, prevent aspiration, permit suctioning, deliver O2 and ventilation, route for drug administration Ventilator should be set to 10 bpm during CPR and 6-8 for PT w/ COPD (to prevent PEP) **Do not exceed 12 BPM***
CPR
Cardiopulmonary resuscitation Compression lower half of sternum 100-120 compressions per minute 2" Very important to have complete upstroke
Providing chest compressions for neo-nates
Chest compressions indicated if HR falls below 60 BPM despite ventilation Before beginning chest compressions ensure that neonate is being ventilated properly Lower 1/3 of sternum 1/3 AP diameter 90 compressions and 30 breaths for 120 events per minute Rescuer encircles chest w/ both hands, compress w/ 2 thumbs just below intermammory line
Cardioversion
Countershock is synchronized w/ hearts elec activity Elec used is less than that of defibrillation PT has organized arrythmia ***SVT, a flutter, afib, monophornic w/ pulse If arrythmia is not causing seerious signs/symptoms drug therapy used first
When to stop life saving efforts
DNR Objectvie signs of irrevisible death
Breathlessness
Exists if no movement of breath or only gasping is present Evaluation should take no longer than 3-5 sec
Cardiac output is produced by
External chest compressions 1/4 of the normal cardiac output Arterial systolic blood pressure between 60-80 mmHg
NPA
Generally used when OPA cannot May also be used when jaws cannot be seperated ***seizure*** Generally limited to adults Appropriate length can be measured from PT earlobe to tip of nose To insert, PT head is tilted slightly backward. Lubricated. Position perpindicular to frontal plane of victims face If obstruction present in one nare, try the other Check for proper placement with tongue depressor but is usually stabilized by its own flange
Head tilt chin lift or jaw thrust maneuver
Head tilt chin lift: is primary maneuver (when spinal trauma not suspected) Jaw thrust is mainly used for those individuals with spinal injury
Abdominal thrusts
Heimlich maneuver 1. If PT sitting/standing wrap arms around waist 2. make fist w/ one hand and place thumb side midline on abdomen above navel and below xiphoid 3. Grasp fist w/ other hand and thrust 4. Repeat until obstruction removed
When to administer Dopamine
Hypotension w/ signs/symptoms: shock, bradycardia (5-20 mcg/kg/min)
PT care after resuccitation
Identify and treat underlying issue lessen ischemia-reperfusion injury and avoid secondary organ injury make appropriate appraisal of prognosis for post care TX
Determining pulselessness
If PT unresponsive and not breathing or gasping do not bother to check for pulse When checking for pulse take no longer than 10 seconds Immediately proceed with chest compressions ***Pulse and rhythm checks should not be done after a shock until at least 5 cycles of CPR have been performed***
Biphasic defibrillator
Initial energy of 120 - 200 j (adults) 2-4 j for infants and children 1 pad placed below clavicle just to the right of upper portion of sternum the other side behind heart
Vfib
Irregular,widened, poorly defined QRS complex Cardiac output during VF is zero Hypoxia sets in along with seizures If not treated immediately or corretced it is fatal
End tidal and CPR
Less than 10 mmHg associated w/ poor outcome Sharp increase suggests return of ROSC Decreased suggests worsening quality of CPR (need to switch provider of CPR)
How to choose correct size for OPA
Place OPA on side of PT face w/ flange even with PT mouth. Measure from corner of mouth to the angle of the jaw following the natural curve of airway
CPR should only be stopped for what 3 reasons
Pulse check Transportation Advanced life support
Most common rhythm after after initial cardiac arrest (after VFIB)
Pulseless ventricular rhythm Immediate CPR and delivery of shock before pulseless ventricular rhythm deteriorates into asystole
Pharyngeal airway
Restore airway patency and maintain vent especially when bagging (2) types: oropharyngeal and nasopharyngeal
ROSC
Return of spontaneous circulation
Adenosine for what rhythm
SVT (6 mg 1-2 sec via IV followed w/ saline. Repeat 2x's 12 mg every 1-2 min)
Bag mask devices
Should deliver Vt adequate to produce rise in chest ***6-7mL/kg or 400 - 500 mL over 1 sec*** Deliver every 6 sec w/ 1 sec inspiratory time After restoration of perfusing rhythm vent rate should be 10-12 BPM w/ 1 sec inspiratory time
SCA
Sudden cardiac arrest Leading cause of death in the US
Soltalol for what rhythm
Tachy w/ pulse algorithm (100 mg over 5 min)
Procainamide for what rhythm
Tachy w/ pulse algorithm (20-50 mg/min until arrhythmia is gone)
Support for oxygenation
The highest possible concentration of O2 should be administered
What is the recommended upper time limit for any intubation attempt performed during CPR? a. 10 seconds b. 30 seconds c. 60 seconds d. 90 seconds
a. 10 seconds (page 802)
What is the initial energy level for a biphasic defibrillation of an adult patient? a. 120 to 200 J b. 200 to 300 J c. 300 to 360 J d. 400 J
a. 120 to 200 J (page 809)
You enter a man's room and find him collapsed on the floor in a prone position. He is totally unresponsive, and there is no breathing. To properly institute procedures to secure his airway, what must you do first? a. Employ the log-roll technique to obtain a proper position. b. Try to lift the patient and place him back on the bed. c. Go to the nursing station and get an oral intubation tray. d. Wait for the crash cart and cardiac arrest team to arrive.
a. Employ the log-roll technique to obtain a proper position.
What is the best way to increase CPR survival rates in the field? a. Provide early defibrillation. b. Start intravenous access immediately. c. Get the patient to a hospital. d. Immediately intubate the patient.
a. Provide early defibrillation.
Should the initial attempt to ventilate fail, which of the following actions would you suggest? a. Reposition the victim's head and repeat the effort. b. Place a handkerchief over the victim's mouth and continue. c. Use the jaw-thrust maneuver instead of the head-tilt and chin-lift. d. Immediately perform the Heimlich maneuver (abdominal thrusts).
a. Reposition the victim's head and repeat the effort. (page 795)
After successive abdominal thrusts, the patient becomes unconscious and the airway still appears obstructed. What is the next appropriate action? a. Rescuer should move the patient to the ground, activate EMS system, and begin CPR. b. Halt efforts to clear the airway and decompress the stomach. c. Try to remove the obstructing material manually (finger sweep). d. Immediately apply a series of strong back blows to the patient.
a. Rescuer should move the patient to the ground, activate EMS system, and begin CPR. (page 799)
Which of the following arteries should be palpated in pulseless infants? a. brachial b. Radial c. Carotid d. Femoral
a. brachial
What is the major complication associated with manual removal of foreign material from the airway? a. forcing the object deeper into the airway b. lacerating upper airway structures c. causing gagging and reflex bradycardia d. increasing the possibility of infection
a. forcing the object deeper into the airway
What is the ideal route for the administration of most drugs used in emergency life support situations? a. peripheral intravenous line b. intramuscular injection c. direct intracardiac injection d. endotracheal tube
a. peripheral intravenous line (page 809)
For which of the following arrhythmias is an electronic pacemaker indicated? a. symptomatic bradycardia b. sinus tachycardia c. first-degree heart block d. ventricular fibrillation
a. symptomatic bradycardia (page 812)
At the onset of adult mouth-to-mouth ventilation, what should the practitioner provide? a. two 700- to 1000-ml breaths (1 second each), with deflation pause b. two 400- to 700-ml breaths ( to 1.0 second each), without deflation pause c. four 400- to 700-ml breaths ( to 1.0 second each), with deflation pause d. two 700- to 1000-ml breaths (1 second each), without deflation pause
a. two 700- to 1000-ml breaths (1 second each), with deflation pause BOOK STATES: 500-600mL breaths over 1 sec.and allow PT to exhale passively
A patient is having frequent premature ventricular contractions and runs of ventricular tachycardia. Which of the following drugs would be considered for this patient? 1. procainamide 2. epinephrine HCl 3. isoproterenol HCl 4. amiodarone a. 1, 2, and 3 b. 2 and 4 c. 1 and 4 d. 1, 2, 3, and 4
c. 1 and 4 (page 807)
AED
automated external difibrillator
After successful initiation of mouth-to-mouth ventilation on an adult in respiratory arrest, you confirm the presence of a good pulse. At this point you would continue ventilation at what rate? a. 8 to 10 breaths/min b. 10 to 12 breaths/min c. 12 to 15 breaths/min d. 15 to 20 breaths/min
b. 10 to 12 breaths/min (page 795)
What is the proper rate of external chest compressions for infants? a. 80/min b. 100/min c. 120/min d. 140/min
b. 100/min (page 792) c. 120/min (page 790)
When properly performed, mouth-to-mouth (expired air) ventilation provides about how much oxygen? a. 20% b. 16% c. 12% d. 30%
b. 16%
During single-rescuer adult CPR, what is the proper ratio of compressions to ventilation? a. 30 compressions for every breath b. 30 compressions for every two breaths c. 5 compressions for every breath d. 5 compressions for every two breaths
b. 30 compressions for every two breaths
During an attempt to insert a nasopharyngeal airway in a patient, you encounter an obstruction to further movement. What is the most appropriate action at this time? a. Use a stylet to force the nasopharyngeal airway in place. b. Attempt to pass the airway through the opposite naris. c. Use a tongue depressor to push the airway posteriorly. d. Use Magill forceps to help guide the airway in place.
b. Attempt to pass the airway through the opposite naris.
After successful resuscitation, the heart rate of neonate being ventilated with 100% oxygen drops to 50/min. What should you do now? a. Assess the infant's peripheral pulses. b. Begin external chest compressions at 120 or more per minute. c. Continue to observe the infant for signs of shock. d. Begin external chest compressions at 50/min.
b. Begin external chest compressions at 120 or more per minute. (page 790)
Which of the following statements is true about the use of oxygen during advanced cardiac life support (ACLS)? a. Expired air ventilation is sufficient during provision of ACLS. b. The highest possible FIO2 should be applied as quickly as possible. c. Lack of oxygen (hypoxia) has little effect on other ACLS procedures. d. An FIO2 of 0.5 is most optimal for avoiding toxicity.
b. The highest possible FIO2 should be applied as quickly as possible
What is the best way to avoid gastric distention during artificial ventilation? a. Hyperextend the neck before each artificial breath. b. Use inspiratory breaths with low to moderate flows. c. Apply pressure over the cricoid during inspiration. d. Apply constant pressure to the lower abdomen.
b. Use inspiratory breaths with low to moderate flows.
Which of the following is the drug of choice for a patient with stable ventricular tachycardia? a. sodium bicarbonate b. amiodarone c. atropine d. epinephrine
b. amiodarone (page 811)
What is the preferred method of securing a patent airway during CPR? a. oropharyngeal airway b. endotracheal tube c. tracheostomy tube d. nasopharyngeal airway
b. endotracheal tube (page 802)
For chest compressions to be effective, in what position must the patient be placed? a. horizontal prone, on a firm surface b. horizontal supine, on a firm surface c. horizontal supine, on a soft surface d. sitting, with the neck fully extended
b. horizontal supine, on a firm surface
What is the leading cause of death in the United States? a. chronic pulmonary disease b. sudden cardiac arrest c. motor vehicle trauma d. airway obstruction
b. sudden cardiac arrest
What is the maximum energy level for defibrillation of children and infants? a. 1 J/kg b. 2 J/kg c. 3 J/kg d. 4 J/kg
d. 4 J/kg (page 809)
During CPR, a properly positioned endotracheal tube can do which of the following? 1. Isolate and protect the lower airway from aspiration. 2. Permit suctioning of the trachea and mainstem bronchi. 3. Facilitate positive-pressure ventilation and oxygenation. 4. Provide a route for administration of selected drug agents. a. 1, 2, and 3 b. 3 and 4 c. 1, 2, 3, and 4 d. 1 and 4
c. 1, 2, 3, and 4
Which of the following are legitimate reasons for discontinuing basic life support measures? 1. if spontaneous breathing and a palpable pulse return 2. if a physician pronounces the arrest victim dead 3. if advanced life support measures become available a. 2 and 3 b. 1 and 2 c. 1, 2, and 3 d. 1 and 3
c. 1, 2, and 3
Causes of ventricular fibrillation include which of the following? 1. damage to the sinoatrial node 2. digitalis overdose 3. severe hypoxia 4. myocardial infarction (MI) a. 2 and 4 b. 1, 2 and 3 c. 2, 3, and 4 d. 1, 2, 3, and 4
c. 2, 3, and 4
When are oropharyngeal airways contraindicated? 1. when foreign body obstruction already exists 2. in patients who are unconscious or comatose 3. in cases of oromaxillary or mandibular trauma a. 1, 2, and 3 b. 1 and 3 c. 3 d. 1 and 2
c. 3 (page 802)
What is the first step in basic life support? a. Open the airway. b. Activate the EMS system. c. Determine unresponsiveness. d. Restore circulation.
c. Determine unresponsiveness. (page 789)
When coming upon an accident victim outside the hospital setting who appears unconscious, what should a practitioner immediately do? a. Tilt the head and lift the chin to open the airway. b. Begin external cardiac (chest) compressions. c. Look for any obvious head or neck injuries. d. Move the victim to a flat, hard surface.
c. Look for any obvious head or neck injuries.
Which of the following arteries should be palpated in pulseless adults and children older than 1 year of age? a. brachial b. radial c. carotid d. femoral
c. carotid
What is the primary indication for dobutamine HCl in advanced cardiac life support? a. ventricular tachycardia b. ventricular fibrillation c. decreased cardiac contractility d. systemic hypertension
c. decreased cardiac contractility
Which of the following best describes the position of a correctly sized and properly inserted oropharyngeal airway? a. distal tip at the base of tongue, flange inside anterior teeth b. distal tip at level of uvula, flange extending outside the teeth c. distal tip at the base of tongue, flange outside the teeth d. distal below the epiglottis, flange extending outside the teeth
c. distal tip at the base of tongue, flange outside the teeth (page 802)
A patient in the emergency department exhibits signs of acute upper airway obstruction and is concurrently having severe seizures that make it impossible to open the mouth. In this case, what would be the adjunct airway of choice? a. oropharyngeal airway b. oral endotracheal tube c. nasopharyngeal airway d. tracheostomy tube
c. nasopharyngeal airway
What is the most common cause of airway obstruction in unconscious patients? a. foreign body lodged in the upper airway b. oral or nasal secretions blocking the pharynx c. tongue falling back into the pharynx d. severe spasm of the laryngeal musculature
c. tongue falling back into the pharynx
CABD
circulation, airway, breathing, defibrillation
In order to deliver as high a concentration of oxygen as possible with a manual resuscitator, what would you do? 1. Use the highest recommended oxygen input flow. 2. Use the longest possible refill time. 3. Connect an oxygen reservoir to the bag. a. 1 and 2 b. 2 and 3 c. 1 and 3 d. 1, 2, and 3
d. 1, 2, and 3
Which of the following are differences between cardioversion and defibrillation? 1. In cardioversion, the countershock is synchronized with the R wave. 2. In defibrillation, more energy is applied. 3. In cardioversion, the countershock is synchronized with the R wave. 4. In defibrillation, more energy is applied. a. 1 b. 1 and 2 c. 2 d. 3 and 4
d. 3 and 4 (page 809 and 812)
During two-person CPR applied to an adult, what is the proper ratio of compressions to ventilation? a. 5 compressions for every two breaths b. 30 compressions for every breath c. 5 compressions for every breath d. 30 compressions for every two breaths
d. 30 compressions for every two breaths
To help open the airway of a conscious adult with complete airway obstruction, what would you do? a. Apply back blows, followed by chest thrusts. b. Try to ventilate the victim at a high rate. c. Decompress the stomach with epigastric pressure. d. Apply repeated strong abdominal thrusts.
d. Apply repeated strong abdominal thrusts. (page 799)
Which of the following is FALSE about oropharyngeal airways? a. Incorrect placement can worsen airway obstruction. b. They all consist of a flange, body, and channel(s). c. They should only be used by trained personnel. d. They are contraindicated in children and infants.
d. They are contraindicated in children and infants.
What is the primary drug agent used to treat idioventricular rhythms, nodal bradycardia, and sinus arrest? a. sodium nitroprusside b. procainamide HCl c. dopamine HCl d. atropine sulfate
d. atropine sulfate (page 811)
Most sudden deaths of cardiac origin are due to which of the following? a. cardiac tamponade b. ventricular aneurysm c. mitral stenosis d. cardiac arrhythmias
d. cardiac arrhythmias (page 805)
Which of the following is not a major hazard associated with abdominal thrusts? a. rupture of abdominal viscera b. laceration of abdominal viscera c. rupture of thoracic viscera d. increased intracranial pressure
d. increased intracranial pressure (page 800)
On inspection of an electrocardiographic rhythm strip, you note the following occurring in sustained "bursts" over 2 to 3 minutes: a rate of 195; regular rhythm; P waves and PR intervals not easily discernible; normal QRS complexes (a few are widened). What is most likely the problem? a. ventricular tachycardia b. premature ventricular contractions c. atrial fibrillation d. supraventricular tachycardia (SVT)
d. supraventricular tachycardia (SVT) (page 806)
During properly performed external chest compression on an adult, how should the heel of the hand be positioned? a. three finger widths above the xiphoid tip, middle of sternum b. two finger widths below the manubrium, upper sternum c. one finger width below the intermammary line, midsternal line d. two finger widths above the xiphoid tip, lower half of sternum
d. two finger widths above the xiphoid tip, lower half of sternum (page 791)
FBAO
foreign body airway obstruction
