BLS Section 2

How do you respond to 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.

Which intervention should the team perform next?

Deliver ventilations.

As you check Mrs. Bailey's breathing, you look to see whether her chest rises and falls, listen for escaping air and feel for breathing against the side of your cheek. Is this the correct course of action? Yes or No

Yes

Once the airway is open, you simultaneously check for breathing and a pulse. Is this the correct course of action? Yes or No

Yes

Is cardiac arrest different from a myocardial infarction?

Cardiac arrest is different from myocardial infarction (or heart attack); however, a myocardial infarction can lead to cardiac arrest.

You are about to start your morning rounds, when you hear a loud crash in Mrs. Bailey's room. When you enter her doorway, you see her lying on the floor with her walker tipped over next to her. You must first perform a visual survey. What actions should you take?

1. Scan the patient's room for any obvious hazards. 2. Observe for any signs of illness or injury, including life-threatening bleeding. 3. Determine whether any additional help is needed.

What are the 5 actions of the Cardiac Chain of Survival?

1. Surveillance and prevention 2. Recognition of a cardiac emergency and activation of the emergency response system 3. Early CPR to keep oxygen-rich blood flowing and to help delay brain damage and death 4. Early defibrillation to help restore an effective heart rhythm and significantly increase the patient's chance for survival 5. Integrated post-cardiac arrest care to optimize ventilation and oxygenation and treat hypotension immediately after the return of spontaneous circulation

What does Assess consist of?

A rapid assessment, which includes performing a visual survey, checking responsiveness, opening the airway and simultaneously checking for breathing and a pulse.

If someone is having atonal breaths how do you respond?

You need to care for the patient as if they are not breathing at all.

Rapid assessment of Mrs. Bailey's breathing reveals irregular, gasping breaths. You correctly identify this pattern of breathing as:

Agonal breaths

What are Agonal breaths?

Agonal breaths are isolated or infrequent gasps that occur in the absence of normal breathing in an unconscious patient. Which can occur after the heart has stopped beating and are considered a sign of cardiac arrest. These are breaths are not normal.

What is the three word system used in an emergency?

Assess, Recognize, and Care

You stop to check breathing and pulse and clearly state: I cannot locate a pulse. You recognize that Mr. Henderson is now experiencing which emergency condition?

Cardiac Arrest

While simultaneously checking for breathing and a pulse, you correctly adhere to which time interval?

At least 5 seconds but no more than 10

What does cyanotic mean?

Bluish or grayish color of the skin, nails, lips, or around the eyes.

How to respond to an Opioid Overdose

Call for help to activate EMS, the rapid response team or the resuscitation team, as appropriate, and call for an AED and naloxone.

How to respond to an Injury or Illness

If the patient is responsive (e.g., speaking, moaning, crying or moving around), obtain their consent to provide care, reassure them and take steps to find out what occurred. If the patient is unresponsive or experiencing an altered level of consciousness, is breathing normally and has a pulse, follow these steps: If you have not already done so, call for help to activate EMS, the rapid response team or the resuscitation team, as appropriate, and call for an AED. If you do not suspect a head, neck, spinal or pelvic injury, place the patient in a side-lying recovery position. If you suspect a head, neck, spinal or pelvic injury, maintain the patient in their current position. Avoid further moving the patient unless it is absolutely necessary. For example, if you need to leave the patient to call for help and/or get additional resources, place the patient in a side-lying recovery position. Monitor the patient until EMS, the rapid response team or the resuscitation team arrives.

What is an obstructed airway?

If the patient is responsive but cannot cough, speak or breathe, they are choking.

How do you determine if the patient has an opioid overdose?

If the patient is unresponsive and shows signs and symptoms of opioid overdose which include, pinpoint pupils, respiratory depression, unconsciousness or severe sleepiness

What is Cardiac Arrest?

If the patient is unresponsive, is not breathing normally (or only gasping) and does not have a pulse, they are in cardiac arrest.

What is Respiratory arrest?

If the patient is unresponsive, is not breathing normally (or only gasping) but has a pulse, they are in respiratory arrest.

What does care consist of?

Implement appropriate care based on your understanding of the patient's condition.

Mrs. Bailey is unresponsive. You suspect she may have a head injury. Which technique should you use to open Mrs. Bailey's airway?

Modified jaw-thrust maneuver.

How to respond to an obstructed airway?

Obtain consent and immediately begin care for an obstructed airway.

You are working with Mr. Henderson in the physical therapy center. He grimaces and says: I can't catch my breath Then he collapses to the ground. You notice he appears pale and cyanotic.

Perform the shout-tap-shout sequence.

What do you do after completing the Assess, Recognize, and Care response?

Reassess and Document

You note he is not breathing normally but has a pulse. What emergency condition is Mr. Henderson experiencing?

Respiratory arrest

What does checking for responsiveness consist of?

Shout-tap-shout sequence

What are you doing while doing the shout-tap-shout sequence?

Simultaneously check breathing and a carotid pulse for at least 5 seconds but no more than 10.

How to respond to cardiac arrest?

Start CPR within 10 seconds of recognizing cardiac arrest and use an AED when it is available.

What does performing a visual survey consist of?

The visual survey includes assessing for safety, obtaining an initial impression of the patient and determining the need for additional resources.

What does recognize consist of?

Using the findings collected during the rapid assessment to quickly recognize whether a life-threatening emergency is occurring and what condition the patient is experiencing.

The room is safe to enter. As you approach Mrs. Bailey you do not see any signs of life-threatening bleeding, but she appears unresponsive. Which action should you perform next?

Use the shout-tap-shout sequence to determine responsiveness.