American Red Cross BLS

The BLS team is caring for a patient who just went into cardiac arrest. The team leader asks you to call the code team. Which statement demonstrates appropriate closed-loop communication?

"Got it. I'll call the code team."

The BLS team is caring for an unresponsive male patient who is not breathing normally but has a pulse. As directed by the team leader, you go into the waiting room to speak to the family or others who may be present. Which statement best demonstrates good communication skills by the team member?

"His condition has not improved; I'll give you all the information I can and if you need to me to re-explain anything, please let me know."

Amy performed high-quality chest compressions on Theo. What is the correct chest compression depth for a child?

*Select 2 inches

You would use pediatric AED pads for which children?

-2-year-old weighing 27 lbs -5-year-old weighing 43 lbs

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.

You are working as part of a BLS team, providing care to a patient in cardiac arrest. Which actions demonstrate critical thinking?

-Anticipating roles and functions as part of a team based on the patient's presentation and condition -Re-evaluating the situation for changes, interpreting these changes and modifying patient care accordingly -Determining a course of action based on assessment findings

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?

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

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

-Capnography -Visual observation -Feedback device -Chest compression fraction.

A 4-year-old child is in respiratory failure. Her central pulse rate is 65 bpm. Which of the following actions are appropriate?

-Deliver 1 ventilation every 2 to 3 seconds -Check the pulse and breathing about every 2 minutes

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.

When applying the AED pads, Ana-Lisa used an anterior/posterior placement. When should providers use this placement method for a child?

-If the manufacturer recommends the use of an anterior/posterior pad placement. -If the AED pads risk touching each other.

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

-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 -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 is lying on a metal surface, providing the AED pads do not touch the surface and no one is touching the patient during shock

You are performing CPR on an infant. A second provider prepares to apply the AED pads. Where should they place the pads?

-Middle of the infant's chest on the sternum -On the back between the scapulae

Select each answer option to reveal the corresponding image, then select Submit to choose the correct answer.

-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

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. -Adjust the bed or use a secure step or stool so you are at an appropriate working height. -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.

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?

-Provide smooth compressions at a rate of 100 to 120 compressions per minute and the death of at least 2 inches. -Allow the chest to fully recoil after each compression. -Avoid excessive Ventilations.

A 9-year-old child is in cardiac arrest. You and another provider are present. The child's parents/legal guardians are not present. You stay with the child to begin CPR. Which actions would be appropriate for the second provider to do?

-Retrieve AED and resuscitation equipment. -Activate EMS, rapid response or resuscitation team.

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.

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. -Team members should rotate roles every 2 minutes, which is generally during the AED analysis, to prevent compressor fatigue. -After the shock is delivered and the AED prompts shock delivered, the team should immediately resume CPR.

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?

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

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 and activation of emergency response system 3. Early High-quality CPR 4. Early Defibrillation 5. Integrated post-cardiac arrest care 6. Recovery

Vickie has arrived with the AED and will now begin to use it. What are the proper steps for using an AED?

1. Vickie turns on the AED. 2. Vickie attaches the AED pads while Dr. Dave and Stephanie continue CPR. 3. The team clears the patient during AED analysis and shock delivery. 4. The new compressor starts CPR immediately after shock is delivered or if no shock is advised.

Dr. Dave performed chest compressions at the proper depth. What is the correct chest compression depth for an infant?

1.5 inches

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

10 seconds

When performing multiple-provider CPR on an infant, the compression/ventilation ratio is ____: 2.

15

You and another provider are performing CPR on an infant who is in cardiac arrest. He does not have an advanced airway in place. You demonstrate appropriate technique for high-quality CPR by performing _____ compressions and 2 ventilations.

15

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

700 mL

You initiate CPR on an 11-year-old patient who shows signs of puberty, including breast development. Which CPR/AED guideline should you follow?

Adult

Peter Henderson: What do you do first?

Check for responsiveness.

You initiate CPR on a 15-month-old patient. Which CPR/AED guideline should you follow?

Child

Your adult patient is in respiratory arrest due to an opioid overdose. The team is delivering 1 ventilation every 6 seconds. You administered the recommended dose of naloxone. How often may this dose be repeated?

Every 2 to 3 minutes as needed.

You come upon a child who has collapsed. You determine they are in cardiac arrest. You are alone and have no immediate access to a phone or other form of communication. Which action would you do first?

Perform about 2 minutes of CPR, starting with chest compressions.

After determining that Theo is unresponsive, Amy must tell Joe to activate the rapid response team and get the AED and resuscitation equipment. Then, she must simultaneously check for breathing, pulse and life-threatening bleeding. To accurately assess breathing, she should open the airway to a ________ position using the head-tilt/chin-lift technique.

Slightly past-neutral

Amy recognized that Theo was in cardiac arrest and initiated CPR. If Amy had determined that Theo were in respiratory arrest with a central pulse of ≤ 60 bpm and signs of poor perfusion, which action would she take?

Start CPR immediately.

You are caring for a child who is in respiratory arrest with a central pulse of 55 bpm and signs of poor perfusion. What should you do?

Start CPR immediately.

What is the first step of the In-Hospital Pediatric Cardiac Chain of Survival?

Surveillance and Prevention

You are part of a team providing BLS care to a patient in cardiac arrest. The code team has been notified and has just arrived on the scene. Which person is responsible for communicating information about the patient's status to the code team?

The person who is acting as the team leader

At the same time, Amy should scan the body for life-threatening bleeding. True or false?

True

Chest thrusts were not effective. You should now attempt a series of 5 back blows and 5 chest thrusts to clear the airway. True or false?

True

Dr. Dave should assess Olivia for breathing, a pulse and life-threatening bleeding for no more than 10 seconds. After recognizing that Olivia is in cardiac arrest, he should initiate CPR immediately, true or false?

True

For most infants and children up to the age of 17 years, you must obtain consent from the child's parent or legal guardian if they are present regardless of the child's level of consciousness. True or false?

True

If Theo were a smaller child or toddler, Amy could use a one-hand technique to perform high-quality chest compressions. True or false?

True

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

Vickie should use an anterior/posterior position for pad placement for Olivia, as shown here. True or false?

True

When caring for a patient in cardiac arrest due to opioid overdose, you should prioritize high-quality CPR over naloxone administration. True or false?

True

When performing single-provider CPR on Theo, Amy was correct to use a compression-to-ventilation ratio of 30:2. True or false?

True

When providing CPR to a child or infant with an advanced airway in place, one provider should deliver 1 ventilation every 2 to 3 seconds, while the other provider delivers continuous chest compressions without pausing for ventilations. True or false?

True

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, "Go get the AED!" Which response by the medical assistant demonstrates closed-loop communication?

"I'll go get the AED."

Olivia is unresponsive. Dr. Dave needs to assess for breathing, a pulse and life-threatening bleeding. Choose the recommended location to perform the pulse check.

*Brachial artery (upper right arm)

After determining an 8-year-old child is unresponsive, what is the best site to check for a pulse?

*Select L/R Carotid Artery

Next, Amy must simultaneously check for breathing and a pulse. Choose the recommended location to perform the pulse check.

*Select L/R Carotid Artery

You enter an adult patient's room to provide routine care. Noticing the patient slumped over in the recliner, you perform a quick visual survey. This includes which of the following actions?

- Determining the need for additional resources - Obtaining an initial impression of the patient - Checking for life-threatening bleeding

An adult patient is unresponsive. You have opened their airway and are simultaneously checking for breathing and a pulse. To check for breathing, which actions are appropriate to do?

- Listen for escaping air. - Look to see whether the chest rises and falls. - Feel for breathing against the side of your cheek.

You have determined that your patient is unresponsive. What steps of the rapid assessment should you do next?

- Simultaneously check breathing and a pulse for no more than 10 seconds. - Quickly scan down the body looking for blood or other signs and symptoms that might not have been seen during the initial impression

Which statement(s) are true about your duty to act?

- When a patient experiences a life-threatening emergency in your practice setting, you have a duty to act. - Although a duty to act may not always exist outside your practice setting, being prepared and willing to respond is essential. - Your facility's specific protocols and your scope of practice may determine your appropriate actions.

In addition to EMS, you immediately request which resources? Select all that apply.

-AED -Resuscitation equipment -Naloxone

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 -Team leader -Airway manager/ventilator

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.

After the second dose of naloxone, Liz almost immediately makes some sudden movements. Jamal should perform which action(s)? Select all that apply.

-Check responsiveness and assess for breathing and a pulse. -Suction the airway if Liz vomits. -Reassess Liz for any changes in condition.

An adult patient with a suspected opioid overdose is in respiratory arrest. Which of the following actions are most appropriate?

-Check the pulse and breathing about every 2 minutes. -Administer naloxone, if your facility's protocol allows. -Provide 1 ventilation every 6 seconds.

A patient is suspected of an opioid overdose. Which findings would most likely support this suspicion?

-Pinpoint pupils -Respiratory depression -Unconsciousness

If Theo had an advanced airway in place during CPR, what would be the correct rate of ventilation delivery?

1 ventilation every 2 to 3 seconds

What is the correct rate of ventilation delivery for a child or infant in respiratory arrest or failure?

1 ventilation every 2 to 3 seconds

What is the correct ventilation rate for a pediatric patient in respiratory arrest?

1 ventilation every 2 to 3 seconds

When the team switches roles, they should take less than __ seconds.

10

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

10

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 compressions 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 to 120 compressions per minute

After the shock is delivered, Ana-Lisa will immediately resume chest compressions. Which compression-to-ventilation ratio should the team use?

15:2

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

15:2

An infant has an obstructed airway and back blows have been ineffective. You attempt chest thrusts. To about which depth would you perform the chest thrusts?

1½ inches

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

2

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 minutes

How long should Jamal wait before administering the second dose of naloxone?

2 to 3 minutes

An adult patient becomes unresponsive while you are attempting to clear their obstructed airway. After gently lowering them to the ground and providing 30 compressions, you open the patient's mouth and look for an object. If you do not see the object, which action should you attempt next?

2 ventilations

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

6 seconds

Which statement about bag-valve-mask (BVM) resuscitators is true?

A two-person technique is the preferred methodology for bag-valve-mask (BVM) ventilations as it provides better seal and ventilation volume.

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

About 1½ inches

A 5-year-old child experiences cardiac arrest and requires CPR. You ensure that high-quality CPR is administered when you compress the chest to which depth?

About 2 inches

After immediately initiating the emergency response system, what is the next link in the Adult In-Hospital Cardiac Chain of Survival?

After immediately initiating the emergency response system, what is the next link in the Adult In-Hospital Cardiac Chain of Survival?

During a resuscitation, the 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.

You are caring for for a 6-month-old infant who is unresponsive, breathing and has a pulse. What should you do?

All of the above.

After providing initial care, which actions must you implement?

All the Above

You and two 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?

At the carotid or femoral artery

After performing a rapid assessment on an adult patient, you determine that they are not breathing, their central pulse is absent and they have no life-threatening bleeding. You recognize that the patient is experiencing:

Cardiac arrest

You recognize that Mr. Henderson is now experiencing which emergency condition?

Cardiac arrest

What should you do now?

Carefully lower Mrs. Clark to a firm, flat surface. Then immediately begin CPR, starting with chest compressions.

After determining an adult patient is unresponsive, what is the best site to check for a pulse?

Carotid artery

What is the correct area of the chest to perform chest thrusts?

Center of the chest on the lower half of the sternum

An adult in the waiting room has collapsed to the floor. During your visual survey, you determine that the scene is safe, the patient appears unresponsive and they do not appear to have life-threatening bleeding. What is your next step?

Check for responsiveness.

You enter Ms. Evers's room and notice she is slumped over in her chair and appears unresponsive and cyanotic. You do not see signs of life-threatening bleeding. Which is the next appropriate action?

Check for responsiveness.

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.

A young adult is brought into the emergency department by his mother. He is responsive but experiencing an altered level of consciousness with risk of progressing to a life-threatening condition due to an opioid overdose. Immediate care for this patient includes:

Consider naloxone administration.

What is the best course of action?

Continue performing cycles of 30 compressions and 2 ventilations, checking for an object before each set of ventilations.

Acting as the team leader during a resuscitation event, you use all available resources (including people, equipment and procedures) to promote effective and efficient teamwork and reduce the likelihood of human error. You are demonstrating which skill?

Crew resource management

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

Critical thinking

The nurse assesses a responsive adult and determines she is choking. Which intervention should the nurse implement?

Cycles of 5 back blows and 5 abdominal thrusts

Stephanie properly opened the airway and delivered ventilations. Which statement about delivering ventilations to an infant in cardiac arrest is true?

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

If Dr. Dave were alone and providing CPR, which would be the preferred technique?

Encircling Thumbs Technique

When providing multiple-provider CPR for an infant, which compression technique should the team use?

Encircling Thumbs Technique

You and another provider are performing CPR on a 6-month old infant. The provider performing chest compressions would use which technique?

Encircling thumbs technique

Your adult patient is in respiratory arrest due to an opioid overdose. The team is delivering 1 ventilation every 6 secs. You administered the recommended dose of naloxone. How often may this dose be repeated?

Every 2 to 3 minutes as needed

If the AED came equipped with adult AED pads only, Vickie should not use them. Instead, she should call for someone to bring pediatric AED pads and continue CPR until the new pads arrive. True or false?

False

A child with an obstructed airway becomes unresponsive. Which action would be most appropriate to do first?

Gently lower the child to the ground and immediately begin CPR, starting with chest compressions.

Mr. Goodman is exhibiting signs and symptoms of which condition?

Heart attack

An infant has an obstructed airway but is responsive. Which technique should you use when administering back blows to the infant?

Heel of the hand between the scapulae

You have assessed your patient and recognized that they are in cardiac arrest. You should begin CPR __________.

Immediately

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 should the team do after Jenna completes 30 chest compressions?

Open Mrs. Clark's mouth, look for an object and perform a finger sweep if an object is seen.

While on break in the cafeteria, a person sitting at a nearby table begins choking. The person looks panicked and frightened. You go over to help and note that the person is not able to breathe, speak or cough. You summon additional resources and obtain consent. Which action would you do next?

Perform a series of 5 back blows and 5 abdominal thrusts until the person can cough forcefully, speak, or breathe; or they become unresponsive.

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

Provide 30 chest compressions.

Which action is the priority?

Provide care for respiratory arrest, starting with ventilations.

You are working in an OB/GYN office when your patient, Mrs. Tribble, suddenly goes into cardiac arrest. She is 28 weeks pregnant and her fundus is above the umbilicus. Which statement is true regarding CPR and AED use for a pregnant patient?

Providers should perform high-quality CPR and continuous left uterine displacement (LUD) until the infant is delivered, even if ROSC is achieved.

What emergency condition is Mr. Henderson experiencing?

Respiratory arrest

After performing a rapid assessment on an adult patient, you determine that they have ineffective ventilation and a central pulse. You recognize that the patient is experiencing:

Respiratory failure

How is a child defined in terms of CPR/AED care?

Someone from the age of 1 to the onset of puberty

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 or kneeling at the side of the infant with your hips at a slight angle, provide chest compressions using the encircling thumbs technique and deliver ventilations with a pocket mask or face shield.

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

Team leader

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%.

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 a rate of 1 ventilation every 6 seconds without pausing compressions.

The team continued to provide high-quality CPR until the rapid response team arrived and relieved them. In which situations would the team stop performing CPR?

Theo spontaneously moves.

After Ana-Lisa took over compressions, Joe and Amy worked together to operate the BVM. Joe maintained an open airway and sealed the mask with both hands in the E-C position, while Amy delivered ventilations. This is the recommended technique for operating the BVM when enough providers are available. True or false?

True

After administering naloxone, Jamal should check for responsiveness and assess for breathing and a pulse. True or false?

True

As part of the rapid and primary assessments, you should use the opioid overdose triad. This includes pinpoint pupils, respiratory depression, and unconsciousness or severe sleepiness.

True

When drowning is suspected as the cause of cardiac arrest in a child or infant, deliver 2 initial ventilations before starting CPR. You may also consider delivering 2 initial ventilations before starting CPR on a child or infant with a primary respiratory etiology. True or False?

True

After providing care, it is important to reassess the patient and the effectiveness of your interventions to determine if you need to implement another appropriate care measure. True or false?

True.

You should perform early assessment for life-threatening bleeding during the initial impression and the breathing and pulse check. True or false?

True.

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

Turn on the AED and follow the prompts.

You are providing high-quality CPR on a 6-year-old patient 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 AED pads.

What is the correct way to perform back blows?

Using the heel of your hand, firmly strike between the scapulae.