BLS Section 3

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Ventilation: For a patient in respiratory arrest deliver?

1 ventilation every 5 to 6 seconds; each ventilation should last about 1 second and make the chest begin to rise. Check the pulse and breathing about every 2 minutes. If you find no pulse, begin CPR.

Which of the following correctly depicts the anterior/lateral position for AED 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

The AED arrives, and you attach the pads appropriately and clear the area. When the AED is analyzing or delivering a shock, what should you do?

Hover your hands over the patient's chest, taking care not to touch the patient.

Signs of ROSC

such as patient movement or normal breathing.

You enter your patient's room and find them lying supine in bed seemingly unresponsive. After performing a rapid assessment and determining your patient is in cardiac arrest, you call for additional resources and an AED. How soon after recognizing cardiac arrest should you begin compressions?

Begin chest compressions within 10 seconds

How often do you switch off with other care providers during CPR?

Every 2 minutes

What is ROSC

Return of spontaneous circulation

Is it safe to use an AED on a patient who is pregnant?

Yes

What ventilation methods can you use?

Pocket mask ventilations Bag-valve-mask resuscitator ventilations Mouth-to-mouth ventilations Mouth-to-nose ventilations

Which of these actions are appropriate ways to minimize interruptions in chest compressions?

Continue compressions while the AED pads are placed. Remain in position with the hands a few inches above the patient's chest during shock delivery. Switch positions while the AED analyzes.

When you simultaneously check for breathing and a pulse, you note the patient is not breathing normally but has a pulse. What should you do next?

Deliver 1 ventilation every 5 to 6 seconds, each lasting about 1 second, while checking for breathing and pulse about every 2 minutes.

If the patient is not breathing normally and has no pulse, you must perform single-provider CPR. What should you do?

Perform 30 chest compressions at a rate of 100 to 120 per minute. Then deliver 2 ventilations, each lasting about 1 second, with a pocket mask or mouth-to-mouth.

When delivering ventilations during CPR, if the chest does not rise after the first breath, what do you do?

Reopen the airway, make a seal and try a second ventilation. If the second ventilation is not successful, move directly back to compressions and check the airway for an obstruction before attempting subsequent ventilations. If an obstruction is found, remove it and attempt ventilations. Never perform a blind finger sweep.

You will switch "compressor" roles with Ryan during the AED analysis. What actions should the team do during the analysis to ensure the switch occurs in less than 10 seconds?

Ryan should hover his hands a few inches over the patient's chest, preparing to take over compressions. You and Amanda should clear the patient while preparing to deliver ventilations and operate the AED. After the shock is delivered or if no shock is advised, Ryan should immediately begin compressions—he does not need to wait for the AED prompt shock delivered.

Ratio for Single Care providers vs Multiple providers

Single 30:2 Multiple 30:2

What should you do if ROSC is achieved?

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

Which is the correct technique for delivering ventilations to a patient in cardiac arrest?

The provider should deliver 2 ventilations that last about 1 second each and make the chest begin to rise.

Providers are preparing to deliver ventilations to a patient in cardiac arrest. One provider seals the mask with both hands in the E-C hand position and simultaneously opens the airway to a past-neutral position. The other provider depresses the bag. How much volume should be administered?

The provider should supply 400-700 mL, depressing the bag halfway.

After exposing the patient's chest, how should your hands be positioned?

Two hands, one on top of the other, fingers interlaced

Is it safe to use an AED on a patient who has body piercings?

Yes but avoid placing the AED pads directly over any metallic jewelry or piercings.

If capnography were in use, an ETCO2 level of ___ would indicate to the team that there could be a problem with the quality of chest compressions.

below 10 mmHg

Ventilation: For a patient in cardiac arrest deliver?

deliver 2 ventilations that last about 1 second each and make the chest begin to rise.

When drowning or other hypoxic event is suspected as the cause of cardiac arrest?

deliver two initial ventilations before starting CPR.

Now that your hands are positioned correctly, where should you place them on the patient's torso?

the center of the patient's chest on the lower half of the sternum.

You are ready to apply AED pads to a patient who has a transdermal medication patch. What should you do?

Before applying AED pads, remove the transdermal medication patch with a gloved hand and wipe away any remaining medication from the skin.

Chest Compressions for adults:

Provide smooth compressions at a rate of 100 to 120. Compress the chest to a depth of at least 2 inches (5 cm). Allow the chest to fully recoil after each compression. If using a feedback device, make sure the compressions are no more than 2.4 inches (6 cm) deep.

You and the team delivered one shock to the patient, then performed about 2 minutes of CPR. You have been performing compressions and are starting to fatigue. What should you do?

You should anticipate a compressor change and verbalize the coordination plan to switch. You should switch off compressions when the AED analyzes again.

Amanda returns and announces the code team is on the way and Ryan returns stating, "I have the AED and BVM." After providing 2 minutes of ventilations, you open the airway and simultaneously check for breathing and a pulse. The patient is not breathing normally and does not have a pulse. What should the team do next?

You should immediately perform 30 chest compressions, while Amanda prepares to deliver 2 ventilations. Ryan should set up the AED, attach the pads and tell everyone to "clear" as the AED begins to analyze.


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