CHAPTER 13: BLS RESUSCITATION

Performing One-Rescuer Adult CPR - Step1: - Step 2: - Step 3: - Step 4: - Step 5:

- Step 1: Take standard precautions. Establish unresponsiveness and call for help. Use your mobile phone if needed. - Step 2: Check for breathing and a carotid pulse for no more than 10 seconds. - Step 3: If breathing and pulse are absent, then perform CPR until an AED is available. Give 30 chest compressions at a rate of 100 to 120 per minute. - Step 4: Open the airway according to your suspicion of spinal injury. - Step 5: Give two ventilations of 1 second each and observe for visible chest rise. Continue cycles of 30 chest compressions and two ventilations until additional personnel arrive or the patient starts to move.

Performing Two-Rescuer Adult CPR Steps: - Step 1: - Step 2: - Step 3: - Step 4: - Step 5:

- Step 1: Take standard precautions. Establish unresponsiveness and take positions. - Step 2: Check for breathing and a carotid pulse. - Step 3: Begin CPR, starting with chest compressions. Give 30 chest compressions per minute. If the AED is available, then apply it and follow the voice prompts. - Step 4: Open the airway according to your suspicion of spinal injury. - Step 5: Give two ventilations of 1 second each and observe for visible chest rise. Continue cycles of 30 chest compressions and two ventilations (switch roles every 5 cycles (2 minutes) until ALS providers take over or the patient starts to move. Reanalyze the patient's cardiac rhythm with the AED every 2 minutes and deliver shock if indicated.

Performing Chest Compressions; Skill Drill 13-1: -Step 1: -Step 2: -Step 3:

- Step 1: Take standard precautions. Place the heel of one hand on the center of the chest (lower half of the sternum). - Step 2: Place the heel of your other hand over the first hand. - Step 3: With your arms straight, lock your elbows and position your shoulders directly over your hands. Depress the sternum at a rate of 100 to 120 compressions per minute, and to a depth of 2 inches to 2.4 inches (5 cm to 6 cm) using a downward movement. Allow the chest to return to its normal position, do not lean on the chest between compressions. Compression and relaxation should be an equal duration.

What is the maximum amount of time that should be spent checking for spontaneous breathing in an unresponsive child?

10 seconds.

What is the proper compression-to-ventilation ratio for adult two-rescuer CPR?

30:2 is the proper compression-to-ventilation ratio.

You respond to a call in which a 6-year-old was hit by a car. She is responsive but struggling to breathe. What position should you place her in?

Because the child is responsive, allow her to remain in whatever position is most comfortable.

Which of the following are effects of hyperventilation?

Both gastric distention and increased intrathoracic pressure are outcomes of hyperventilation.

Which intervention(s) would have the MOST positive impact on the cardiac arrest patient's outcome?

Early high-quality CPR and defibrillation are most likely to have a positive impact.

When performing CPR on an adult, you should compress the chest to what depth and at what a rate of compressions per minute?

For an adult, you should compress the chest to a depth of 2 to 2.4 inches (5 to 6 cm) and at a rate of 100 to 120 compressions per minute.

The AED gives a "no shock" message to a patient who is in cardiac arrest. What should you do?

In the case of "no shock," you should immediately resume CPR for approximately 2 minutes.

When performing CPR on an infant, which of the following is correct?

Perform infant chest compressions using two fingers in the middle of the sternum, just below the nipple line.

You are off duty and you come across an unresponsive child lying on the ground at a playground. She does not have a pulse and no one witnessed the collapse. What should you do?

You should do 5 cycles of chest compressions (about 2 minutes), then call 9-1-1. Because cardiopulmonary arrest in children is most often the result of respiratory failure, it is critical that you restore oxygenation.

When trying to clear a severe airway obstruction, who should get chest compressions instead of abdominal compressions?

You should perform chest thrusts on women in late stages of pregnancy and obese patients.

When you are performing CPR on an adult or child, approximately how often should you reassess the patient for return of respirations and/or circulation?

You should reassess after five cycles of chest compressions, or approximately every 2 minutes.

What is the preferred method of removing a foreign body in an unresponsive child?

You should treat a child older than 1 year as you would an adult: with abdominal thrusts.