CPR Questions

if AED determines shock is needed,

everyone stand clear, compressor hover hands over chest, press shock button after shock or no shock needed, begin CPR - continue for 2 minutes until reanalyzing, patient shows signs of ROSC, or other providers instruct to stop

If obstructed airway is found during visual survey,

follow obstructed airway treatment guideline

Upon entering Mr. Cohen's room, you find him on the ground, unresponsive. After immediately initiating the emergency response system, what is your next action according to the Adult In-Hospital Cardiac Chain of Survival?

Early CPR

delivering obstructed airway care for infants:

1. deliver 5 back blows: using heel of hand between scapulae; avoid hitting neck or head 2. if back blows don't work, deliver 5 chest thrusts: position between forearms, support head/neck and turn face up - lower infant on thigh with head lower than chest - place 2 fingers in center of chest, deliver 5 chest thrusts 1.5 inches deep continue to clear airwawy until: object is forced out, infant can cough, infant becomes unresponsive (perform CPR, checking after compressions for object)

You are providing compressions on a 6 month old who weighs 17 pounds. Which compression depth is appropriate for this patient?

1.5 inches

you are alone performing high-quality CPR when a second provider arrives to take over compressions. When switching roles, you should minimize interruptions in chest compression to less than how many seconds?

10 seconds

A 7 year old patient goes into sudden cardiac arrest. You initiate CPR and correctly perform chest compressions at which rate?

100-120/minute

A well-organized team response when performing high-quality CPR includes ensuring providers switch off performing compressions every ____ minutes.

2 minutes

The systematic and continuous approach to providing emergent patient care includes which 3 elements?

Assess Recognize Care

you perform a rapid assessment and determine that your patient is experiencing cardiac arrest. On the basis of findings, you bein CPR to improve patient's chances of survival. Which term refers to clear and rationally identifying the connection between information and actions?

Critical thinking

you are alone caring for a 4 month old infant who has gone into cardiac arrest. which is the most effective CPR technique to perform until help arrives.

Standing to the side of the infant, provide chest compressions using the 2 finger technique (center of chest just below the nipple line on sternum; 30 compressions at 1.5 inches deep at rate of 100-120/minute) and deliver ventilations with a pocket mask.

If unresponsive after shout-tap-shout test,

activate EMS, rapid response or resuscitation team and call for AED - ensure patient is in supine position on flat surface - open airway - simultaneously check for breathing and pulse for 5-10 seconds

do NOT use pediatric AED pads or energy levels on

adult/child older than 8 years or weighing more than 55 lbs

difference in shout-tap-shout test for adults/children vs. infants:

adults/child: shout, tap SHOULDER, and shout again infant: shout, tap BOTTOM of foot, and shout again

You are providing high quality CPR on a 6 year old patient (child) who weighs 44 pounds. The AED arrives. It does not have a pediatric setting and includes only adult AED pads. What should you do?

use the adult pads

perform alternate techniques (back blows, chest thrusts or airway management techniques) if...

you cannot reach far enough around patient they might be pregnant they are in bed or wheelchair abdominal thrusts are not effective in dislodging object

You and your colleagues have been providing high quality CPR for and using the AED on Mr. Sauer. While providing ventilations, you notice that Mr. Sauer moves and appears to breathing. What is the correst course of action?

stop CPR, check for breathing and pulse and monitor Mr. Sauer until the advanced cardiac life support team takes over

When setting up an AED on an ADULT,

1. expose the chest and wipe it dry 2. use an ANTERIOR/LATERAL pad placement (1 on upper right chest - other on left side along midaxillary line below armpit) 3. plug inconnector and press analyze - instruct everyone to stand clear while AED analyzes - as it analyzes, switch positions on the team - provider giving compressions should hover their hands above patient's chest

You are alone and caring for 9 month old infant with obstructed airway who becomes unresponsive. Which action should you perform first?

provide 30 chest compressions

While orienting a new medical assistant to the facility, you find a patient who is unresponsive in the exam room. You yell to the medical assistant to go get the AED. Which response by the medical assistant demonstrates closed-loop communication?

"I'll go get the AED."

Obstructed airway care prep for adults and children before abdominal thrusts:

1. verify patient is choking; if able to speak to you or coughing forcifull, encourage to keep coughing; if unable to speak to you, call for additional resources 2. obtain consent from patient or legal guardian if child

You and your colleages are performing CPR on a 6 year old child. What is the compression to ventilation during multiple provider CPR?

15:2 for both children and infants in multiple provider CPR

when providing CPR with multiple providers, switch positions every:

2 minutes; taking less than 10 seconds compressor calls for position change by saying "switch" in place of number 1 in compression cycle

you are preparing to deliver ventilations to adult patient experiencing respiratory arrest. You should give 1 ventilation every:

5-6 seconds for an adult (3-5 seconds for child or infant)

difference when checking for breathing/pulse check for adults, children and infants:

ADULTS: open airway PAST neutral and check for breathing and carotid/femoral pulse for 5-10 seconds CHILD: open airway SLIGHTLY PAST neutral and check for breathing and carotid/femoral pulse for 5-10 seconds INFANT: open airway to NEUTRAL and check for breathing and BRACHIAL pulse for 5-10 seconds

you are working in an OB/GYN office when your patient, Mrs. Tribble, suddenlyl goes into cardiac arrest. While preparing the AED, your colleague reminds you that Mrs. Tribble is 28 weeks pregnant. Which statement is true regarding use of AED on pregnant patient?

AED use is safe for pregnant patients

You and your coworker Jake are operating a BVM during multiple provider CPR on an adult. You manage the airway while Jake delivers ventilations. Which statement correctly describes the appropriate technique for operating the BVM?

Seal the mask with 2 hands using the E-C technique

if normal breathing/pulse not present...

follow appropriate Respiratory Arrest guidelines: Adult: deliver 1 ventilation every 5-6 seconds with each lasting 1 second; check pulse & breathing every 2 minutes (if no pulse, begin CPR) CHILD/INFANT: deliver 1 ventilation every 3-5 seconds with each lasting 1 second; check pulse & breathing every 2 minutes (pulse 60 bpm or less, begin CPR)

You and another provider are caring for a patient who is in cardiac arrest. You suspect that the patient has overdosed to an opioid. When should you administer intranasal naloxone?

after initiating CPR

during resuscitation, team leader assigns team roles and tasks to each member. You recognize that a task has been overlooked. Which is the most appropriate action?

alert the team leader immediately and identify for them what task has been overlooked

if patient becomes unresponsive during obstructed airway care, (adults/children)

call for AED, immediately begin CPR with chest compressions after each set of compressions & before ventilations, open patient's mouth and look for object - if seen, remove it using finger sweep ( do not perform blindly) attempt 2 ventilations and continue CPR cycles

can hold infant in recovery position by:

carefully positioning infant face-down along forearm on knee, then support infant's head & neck with other hand while keeping infant's mouth and nose clear

you and 2 nurses have been performing CPR on a 72 year old patient, Ben Phillips. When Mr. Phillips shows signs of ROSC, where should you perform the pulse check?

carotid or femoral artery

if you deem the situation safe after performing a visual survey,

check for responsiveness (shout-tap-shout)

you enter Ms. Evers's room and notice her lunch splattered on the floor. She is slumped over the bedside table and does not appear to be breathing. You perform a visual survey and determine that the scene is safe. Which is the next appropriate action?

check for responsiveness with tap-shout-tap (then you would open the airway and simultaneously check breathing and pulse)

positions during multiple-provider infant CPR:

compressor will stand at the infant's feet, the ventilator will stand at the infant's side, and the provider maintaining the airway will stand at the infant's head

if life threatening bleeding is detected during the visual survey,

control hemorrhage with any available resource (including use of tourniquet or hemostatic dressing)

if no pulse/no breathing and drowning or hypoxic event is suspected cause of cardiac arrest,

deliver 2 initial ventilations before starting CPR

if no normal breathing/no pulse,

follow Cardiac Arrest guidelines first exposing chest: ADULT: position heel of hand in center of chest on lower half of sternum, shoulders over hands with elbows locked - compress 2-2.5 inches at rate of 100-120/minute (30:2 ratio to ventilations) CHILD: position heel of hand in center of chest on lower half of sternum, shoulders over hands with elbows locked - compress 2 inches at rate of 100-120/minute (30:2 ratio to ventilations or 15:2 with multiple providers) INFANT: 1 provider: stand to side of infant, use 2 finger technique in center of chest below nipple line (30:2) / multiple providers: stand at infant's feet, use encircling thumbs technique placing both thumbs on center of infant's chest below nipple line (15:2) --> compress at 1.5 inches at 100-120/minute

obstructed airway care for infants preparation:

if infant is crying/coughing forcifully, allow to continue but be prepared; if coughing weakly: - obtain consent from legal guardian if present - position for back blows: place forearm along back, crading back of head with hand, place other forearm along front, supporting jaw with thumb & fingers, hold in face down position along forearm using thigh for support keeping head lower than body

airway management technique

if you are in a healthcare facility and abdominal thrusts, back blows or chest thrusts are not effective, use combination of basic or advanced airway management techniques based on level of training

when setting up an AED on a child/infant,

infant up to 1 year old: use pediatric pads if available (if not use adult), always use ANTERIOR/POSTERIOR pad placement (1 to center of infant's chest - on sternum - 1 to infant's back between scapulae) Children 8 or younger & weigh less than 55 lbs: use pediatric pads and ANTERIOR/LATERAL placement or ANTERIOR/POSTERIOR placement if AED pads risk touching each other on child's chest Children older than 8 years or weigh more then 55 lbs: use adult pads nd ANTERIOR/LATERAL pad placement

You suspect that an unresponsive patient has sustained a neck injury. Which technique should you use to open the patient's airway?

modified jaw-thrust maneuver

What is a reason you would choose to perform chest thrusts instead of abdominal thrusts for a patient with an obstructed airway?

patient is in a wheelchair

The first step of rapid assessment is...

perform a visual survey

If normal breathing and pulse are present,

place in age-appropriate recovery position if no suspected head, neck, spinal or pelvic injury & monitor until EMS, rapid response or resuscitation team arrives

chest thrusts (adults/children)

position yourself behind patient like abdominal thrusts place thumb side of fist against center of patient's chest on lower half of sternum cover fist with other hand and pull straight back with inward thrust if chest thrusts do not dislodge, use 5 back blows and 5 chest thrusts

Back Blows (for adults/children)

position yourself to side & slightly behind patient provide support by placing one arm diagonally across chest bend patient forward at wais so upper body is parallel to ground use heel of other hand, give 5 firm back blows between scapulae if blows do not dislodge object, use series of 5 back blows and 5 abdominal/chest thrusts

For ventilations, use:

single-provider: an appropriately sized pocket mask multiple provider: BVM

How is a child defined in terms of CPR care?

someone from age 1 to onset of puberty

when performing abdominal thrusts for obstructed airway (adults/children):

stand behind patient with 1 foot in front of other (in between patient's feet if possible); may need to kneel if young child or wheelchair - use fingers to find just above navel, make fist with hand and place thumb side of fist against middle of abdomen - grab fist with other hand - give quick inward & upward thrusts continue to clear airway until object is forced out, patient can cough, or patient becomes unresponsive

The code team has arrived to take over resuscitative efforts. Among the members of the BLS team, whose role is it to communication to the code team the patient's status and the care already provided?

team leader

You are providing care for Mrs. Bove, who has an endotracheal tube in place. How does this affect compressions and ventilations?

the team should provide ventilations at rate of 1 ventilation every 6 seconds without pausing the compressions (30:2 ratio is thrown out here)