BLS Course
When there is an unresponsive patient showing signs and symptoms of opioid overdose, what resources should you request immediately?
Naloxone AED Resuscitation equipment EMS
what is problem solving?
the ability to use readily available resources to find solutions to challenging or complex situations or issues that arise.
When performing back blows on an adult or child, where should you place the heel of your hand?
the center of the back ; between the scapulae.
Now that your hands are positioned correctly, where should you place them on the patient's torso in order toperform chest compressions (adults)?
the center of the patient's chest on the lower half of the sternum.
What should you do after providing care?
-reassess the patient and the effectiveness of your interventions to determine next steps based on your findings - document the events that took place, the care you provided, and the facts you discovered
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? a) ¼ inch b) ½ inch c) 1 inch d) 1½ inches
d) 1½ inches
What is agonal breathing?
irregular, isolated, infrequent gasps that that occur in an unconscious patient
compression-to-ventilation ratio
the # of compressions and ventilations delivered during CPR varies for adults, children, and infants.
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
Mrs. Bailey is unresponsive. You suspect she may have a head injury. Which technique should you use to open Mrs. Bailey's airway?
jaw-thrust maneuver
Feedback Devices
technology that is used to gather data about CPR performance and provide real-time feedback collect objective data such as the rate at which compressions and ventilations are being delivered, the depth of compressions and the amount of chest recoil guide providers to adjust techniques
If Theo (6 years old) had an advanced airway in place during CPR, what would be the correct rate of ventilation delivery?
1 ventilation every 2-3 seconds
When performing abdominal thrusts, you should perform quick, 1) _________ and 2)______ thrusts. When performing chest thrust pull 3)______________ __________, performing quick 4)____________ thrusts into the patient's chest
1) inward 2) upward 3) straight back 4) inward
The assessment of breathing and pulse should be done for no more than ____ seconds
10
To ensure high-quality CPR, providers should switch off giving compressions every ___ minutes or sooner if the provider giving compressions is fatigued.
2
What is the MINIMUM coronary perfusion pressure (CPP) needed to achieve the return to spontaneous circulation (ROSC)?
20 mmHg
CPR Rate for Adults, Children, and Infants
ALL: 100-120
ARC stands for what?
Assess Recognize Care
What are the causes of cardiac arrest in pregnancy?
B.A.A.C.C. T.O. L.I.F.E Bleeding Anesthesia Amniotic fluid embolism Cardiovascular/cardiomyopathy Clot/cerebrovascular Trauma Overdose (opioids, magnesium sulfate, other) Lung injury/acute respiratory distress syndrome Ions (glucose, potassium) Fever (sepsis) Eaclampsia/emergency hypertension
How do you open the airway? What do you do simultaneously?
Head-tilt, Chin/lift Technique Modified Jaw Thrust Maneuver (if head, neck or spinal injury is suspected) Check for breathing and a carotid pulse for AT LEAST 5 seconds but NO MORE THAN 10 seconds
Other conditions requiring basic life support may include
Life-threatening injury or illness Obstructed airway Opioid overdose
For adults, how do you check for a pulse?
Palpate the carotid artery by sliding two fingers into the groove of the patient's neck Provide care based on the conditions found
How do you provide care for someone that is choking?
Perform a series of 5 back blows and 5 abdominal thrusts until the person can cough forcefully, speak, cry or breathe; or they become unresponsive.
ROSC stands for
Return Of Spontaneous Circulation
After 2 minutes of delivering ventilations to an adult patient in respiratory arrest, you reassess them for breathing and a pulse. What should you do if the patient's pulse becomes absent?
Start CPR immediately and use an AED when it is available
CPR
a process involving ventilations and compressions to circulate oxygenated blood to the patient's vital organs
Assess, Recognize and Care Concept
a systematic, continuous approach for quick and accurate assessment, rapid recognition & immediate care in emergency situations
Left Uterine Displacement (LUD)
a technique used in a pregnant patient to move the gravid uterus up and toward the left to relieve pressure on the inferior vena cava and maximize the return of blood to the heart and cardiac output.
For a pregnant patient in cardiac arrest, at how many team members are needed to perform high-quality CPR?
at least three (preferably four) team members 1) compressions 2) continuous left uterine displacement (LUD) 3-4) airway and breathing
chest compression fraction (CCF)
the portion of time (%) that chest compressions are performed during a resuscitation attempt
fundus
top of uterus
After administering naloxone, what do you do?
check for responsiveness and assess for breathing and a pulse
When you use a BMV you should position yourself behind the patient's _______ in the __________ position.
1) head 2) cephalic
A patient is suspected of an opioid overdose. Which findings would most likely support this suspicion? Select all correct options that apply. a) Unconsciousness b) Respiratory depression c) Pinpoint pupils d) Rapid respirations e) Hypotension
a) Unconsciousness b) Respiratory depression c) Pinpoint pupils
Opening the Airway in Infants, Children, and Adults
INFANTs: neutral position CHILDREN: slightly past-neutral position ADULTS: past-neutral
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? a) About 1 inch b) About ½ inch c) About 2 inches d) At least 2 inches
c) About 2 inches
What are some adverse effects of Naloxone?
allergic reaction may cause acute opioid withdrawal symptoms (body aches, increased heart rate, irritability, agitation, vomiting, diarrhea or convulsions)
OHCA stands for
Out-of-Hospital Cardiac Arrests
ventilation
a process that delivers oxygen to a patient that is not breathing
CPR stands for
cardiopulmonary resuscitation
Check for breathing and a carotid pulse for AT LEAST 1)____ seconds but NO MORE THAN 2)____ seconds
1) 5 2) 10
What three actions should you take if an adult patient shows signs of ROSC?
1) Stop CPR/AED use. 2) Check for breathing and a carotid or femoral pulse. 3) Monitor the patient until the advanced cardiac life support team takes over.
What is the correct volume of air to deliver during BVM ventilations?
400-700 mL (by depressing the bag about halfway)
Pediatric Advanced Life Support
4th link of the Pediatric In-Hospital Cardiac Chain of Survival gives the patient access to emergency medical care delivered by specially trained professionals
What should the chest compression fraction (CCF) be?
60-80% (at least 60%)
Obstruction (of airway)
Blockage within the airway that can prevent inhalation or ventilation
Providing Care may include what?
Delivering ventilations to a patient in respiratory arrest or respiratory failure. Performing CPR on a patient in cardiac arrest. Positioning and providing care as needed for a patient with a life-threatening injury or illness. Clearing an obstructed airway. Administering naloxone to a patient experiencing an opioid overdose.
To effectively communicate with the family, you should
Demonstrate credibility as well as confidence and empathy. Build rapport and establish trust. Speak slowly and in terms the family can understand. Be prepared to repeat information, if necessary. Be open and honest, especially about the patient's condition. Minimize family members' fears as necessary, but avoid giving misleading information or false hope (e.g., "Everything is going to be OK."). Reassure the family that everything that can be done is being done.
The ______ ___________ position is used when placing a BVM on a patient, maintaining an open airway, or sealing the BVM.
E-C hand
Who provides advanced life support?
EMS professionals and paramedics
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
When delivering ventilations to Jalen, a 6-year-old patient, you open his airway to a neutral position. Is this the best course of action (true/false)?
False For children like Jalen, you should open the airway to a slightly past neutral position. If Jalen were an infant, you would open the airway to a neutral position.
To perform compressions on Maggie (4 years old), you use the encircling thumbs technique (i.e., two thumbs centered on the sternum just below the nipple line with fingers encircling the chest). Is this the best course of action (true/false)?
False For children, use the same technique as you do for an adult: One hand on top of the other with fingers interlaced and off the chest centered on lower half of the sternum, although on small children a one-hand technique is acceptable.
Compression to Ventilation Ration for Adults, Children, and Infants
INFANTS Single-Provider CPR = 30:2 Multiple-Provider CPR = 15:2 CHILDREN Single-Provider CPR = 30:2 Multiple-Provider CPR = 15:2 ADULTS Single-Provider CPR = 30:2 Multiple-Provider CPR = 30:2
Compression Depth for Adults, Children, and Infants
INFANTS: 1.5 inches (3.8 cm) CHILDREN: 2 inches (5 cm) ADULTS: 2-2.4 inches (5-6 cm)
Where do you check for pulse in infants, children, and adults?
INFANTS: brachial artery (arm) CHILDREN: carotid artery (neck) ADULTS: carotid artery (neck)
If Theo (6 years old) were a smaller child or toddler, Amy could use a one-hand technique to perform high-quality chest compressions. True or false?
True
Compression Technique for Infants
SINGLE-PROVIDER CPR Encircling Thumbs Technique ***Alternative = Two-finger Technique. ***If the required depth cannot be achieved with either the encircling thumbs technique or the two-finger technique in infants = one-hand technique MULTIPLE-PROVIDER CPR Encircling Thumbs Technique
Resuscitative Cesarean Delivery (RCD)
Surgical delivery of the fetus performed when a pregnant patient is in cardiac arrest with the goals of resuscitating the pregnant patient and increasing the likelihood of fetal survival.Resuscitative cesarean delivery (RCD)
Using AED Pads for Children > 8 years OR > 55lbs (25kg)
TYPE: Adult AED Pads (NEVER pediatric AED pads OR pediatric electrical setting) PLACEMENT: Anterior/Lateral - right of the sternum and below the right clavicle - left side of the chest on the midaxillary line, a few inches below the left armpit
Using AED Pads for Children ≤ 8 years OR ≤ 55lbs (25kg)
TYPE: Pediatric AED pads (if available) ; Adult AED pads & electrical settings are okay PLACEMENT: Anterior/Lateral - right of the sternum & below the right clavicle - left side of the chest on the midaxillary line, a few inches below the armpit ***If based on the size of the child's chest it would look like the AED pads would touch each other, use an anterior/posterior pad placement instead.
Continue CPR/AED use until:
The team leader tells you to stop. Other trained providers arrive to relieve you. You see signs of ROSC. You are presented with a valid DNR order. You are too exhausted to continue. The situation becomes unsafe.
Don't stop CPR unless
The team leader tells you to stop. You are presented with a valid DNR order. Other trained providers arrive to relieve you. You see signs of ROSC. You are too exhausted to continue. The situation becomes unsafe.
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
When performing single-provider CPR on Theo (6 years old), Amy was correct to use a compression-to-ventilation ratio of 30:2. True or false?
True
Sadie is a 2.5-year-old child weighing 28 pounds. To perform high-quality chest compressions, you may need to use a one-hand technique. Is this the best course of action (true/false)?
True. For a smaller child, you may need to use a one-hand technique to perform high-quality chest compressions. When using a one-hand technique, be sure you are able to compress the chest about 2 inches.
How do you provide care for someone that is choking and you cannot reach far enough around the patient to perform abdominal thrusts, they might be pregnant, in a bed or in a wheelchair?
Use a combination of basic and advanced airway management techniques based on your training and availability Attempt a series of 5 back blows and 5 chest thrusts to clear the airway.
automated external defibrillator (AED)
a portable electronic device that automatically analyzes the patient's heart rhythm and provides defibrillation, an electrical shock that may help the heart re-establish a perfusing rhythm
Which of the following statements about performing chest compressions for adults are true? a) Allow the chest to fully recoil after each compression. b) Provide smooth compressions at a rate of 100 to 120. c) Compress the chest to a depth of at least 2 inches (5 cm). d) Compression time should be greater than recoil times. e) Compress the chest to a depth of at least 1 inch (2.54 cm). f) Provide smooth compressions at a rate of 90 to 130.
a) Allow the chest to fully recoil after each compression. b) Provide smooth compressions at a rate of 100 to 120. c) Compress the chest to a depth of at least 2 inches (5 cm).
After completing a rapid assessment, you'll use your findings to quickly recognize the emergency condition and determine your immediate course of action. True or false? a) True b) False
a) true
You would use pediatric AED pads for which children? Select all correct options that apply. a) 10-year-old weighing 85 lbs b) 12-year-old weighing 95 lbs c) 2-year-old weighing 27 lbs d) 7-year-old weighing 75 lbs e) 5-year-old weighing 43 lbs
c) 2-year-old weighing 27 lbs e) 5-year-old weighing 43 lbs
After exposing the patient's chest, how should your hands be positioned (for compressions in adults)? a) Two-fingers technique b) Encircling thumbs technique c) Two hands, one on top of the other, fingers interlaced
c) Two hands, one on top of the other, fingers interlaced
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? a) Every 4 to 6 minutes as needed. b) Every 10 to 15 minutes as needed. c) Every 7 to 9 minutes as needed. d) Every 2 to 3 minutes as needed.
d) Every 2 to 3 minutes as needed.
When drowning is the suspected cause of cardiac arrest, what should you do?
deliver two initial ventilation before starting CPR
For adults, how do you provide care for respiratory arrest?
deliver ventilations 1 ventilation every 6 seconds, with each ventilation lasting about 1 second and making the chest rise
Adult In-Hopsital Cardiac Chain of Survival
describes six actions that, when performed in rapid succession, increase the likelihood of a patient surviving cardiac arrest. 1) Surveillance and prevention 2) Recognition of cardiac emergency and activation of the emergency response system 3) Early high-quality CPR 4) Early defibrillation 5) Integrated post-cardiac arrest care 6) Recovery
If provided in the first few minutes of cardiac arrest, high-quality CPR can _______ or _________ a patient's chance of survival.
double ; triple
Primary Assessment
first examination and evaluation of the patient that focuses only on life threats, specifically ABCs aims to stabilize the patient Airway Breathing Circulation Disability Exposure
Recovery
follow-up during the recovery process in the form of rehabilitation, therapy and support from family and healthcare providers
When opening the airway (for everyone), what position should you use if you suspect a head, neck or spinal injury
modified jaw-thrust maneuver
cardiac arrest
not breathing/ineffective ventilation has no pulse
During a rapid assessment, how do you simultaneously check for breathing, a pulse, and life-threatening bleeding?
opening of the Airway (A) checking for the presence or absence of normal Breathing (B) simultaneously assessing for Circulation (C) by a pulse check
Bag-valve-mask (BVM) Ventilations
performed during multiple-provider CPR two-person technique for bag-valve-mask (BVM) ventilations is the preferred technique one provider seals the mask (E-C hand position) and simultaneously opens the airway to a past-neutral position, while another provider delivers smooth, effortless ventilations that last about 1 second and make the chest begin to rise
adolescent
someone from the onset of puberty through adulthood
Scope of practice
the range of duties and skills you have acquired in training that you are authorized to perform by your certification to practice.
What is the compression rate and depth for delivering high-quality CPR for adults?
100-120 compressions/min 2 - 2.4 inches
If you determine that the patient is not breathing and their central pulse is absent, you should 1)____________ _______immediately.
initiate CPR
After providing initial care, which actions must you implement? a) Reassess the patient and the effectiveness of your interventions to determine the next steps. b) Apply another appropriate care measure for the initial presenting problem or a new problem. c) Document to establish a record of the events that took place, the care you provided and the facts you discovered. d) All of the above.
d) All of the above.
What is the ventilation rate and volume for delivering high-quality CPR for adults?
each ventilation should last 1 sec long 1 ventilation every 6 seconds delivers just enough volume to make the chest begin to rise (400 mL to 700 mL)
You have a duty to act when a patient experiences a 1)______________________ ___________________ in your practice setting. These protocols may vary depending on the setting and your role. In addition, your 2)_________ of 3)___________ for your individual position may further determine appropriate actions. You may also face life-threatening emergencies outside your practice setting. Although a duty to act may not always exist outside your practice setting, being prepared and willing to respond is essential. Consult your state and local rules and regulations related to 4)__________ ________________ and other 5)_________ considerations.
1) life-threatening emergency 2) scope 3) practice 4) liability protections 5) legal
Resuscitative cesarean delivery (RCD) should be performed by a trained provider within ___ minutes from the time of arrest. In a pregnant patient with out-of-hospital cardiac arrest, RCD should be performed ________________ upon the patient's arrival to the emergency department if the patient has not achieved ________.
1) 5 2) immediately 3) ROSC
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? a) Continue performing compressions to minimize interruptions. b) Clear the patient taking care not to touch the patient.
b) Clear the patient taking care not to touch the patient.
You have been providing compressions and are starting to fatigue. How do you verbalize the coordination plan to switch? a) Call for a position change by saying "switch" in place of the number one in the last compression cycle. b) Tell Ryan to provide compressions while the AED analyzes the heart rhythm.
a) Call for a position change by saying "switch" in place of the number one in the last compression cycle. When performing high-quality CPR, it is important to work as a team. This includes clearly indicating and completing position switches to avoid exhaustion. For example, you should call for a position change by saying "switch" in place of the number one in the last compression cycle. ***Note: You should stop compressions while the AED is analyzing heart rhythm.
You are performing CPR on an infant. A second provider prepares to apply the AED pads. Where should they place the pads? Select all correct options that apply. a) Left shoulder, above the clavicle b) Abdomen, 2 inches above the umbilicus c) On the back between the scapulae d) Middle of the infant's chest on the sternum e) Right side of the chest, below the nipple
c) On the back between the scapulae d) Middle of the infant's chest on the sternum
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? a) Tell the person to try coughing. b) Gently lower them to the ground and begin CPR, starting with chest compressions. c) Perform a series of 5 back blows and 5 abdominal thrusts until the person can cough forcefully, speak, or breathe; or they become unresponsive. d) Open their mouth and look for an object; if seen remove it with a finger sweep.
c) Perform a series of 5 back blows and 5 abdominal thrusts until the person can cough forcefully, speak, or breathe; or they become unresponsive.
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: a) Cardiac arrest b) Shock c) Respiratory failure d) Obstructed airway
c) Respiratory failure
You and additional providers have been caring for a child in respiratory arrest with a pulse of 65 bpm. After 2 minutes, you reassess the child for breathing and a pulse. What should you do if the central pulse decreases to 50 bpm with signs of poor perfusion despite adequate ventilations and oxygen? a) Continue delivering 1 ventilation every 2 to 3 seconds until the patient is ventilating sufficiently. b) Start CPR immediately. c) Perform a secondary assessment. d) Place the patient in the recovery position and monitor them until EMS, rapid response or resuscitation team arrive.
c) Start CPR immediately.
You are providing abdominal thrusts to an adult patient with an obstructed airway when she suddenly becomes unresponsive. Another team member has already left to get the AED and additional resources. Identify the proper steps of care for an unresponsive adult with an obstructed airway. Continue cycles of CPR, checking for an object before each set of ventilations. Deliver 2 ventilations. Perform 30 compressions. Carefully lower the patient to a firm, flat surface. Look for an object in the patient's mouth and perform a finger sweep if it is seen.
1) Carefully lower the patient to a firm, flat surface. 2) Perform 30 compressions. 3) Look for an object in the patient's mouth and perform a finger sweep if it is seen. 4) Deliver 2 ventilations. 5) Continue cycles of CPR, checking for an object before each set of ventilations.
After the second dose of naloxone, Liz almost immediately makes some sudden movements. Jamal should perform which action(s)? Select all that apply. a) Check responsiveness and assess for breathing and a pulse. b) Position Liz in the supine position. c) Suction the airway if Liz vomits. d) Reassess Liz for any changes in condition. e) If Liz stops responding, do not re-administer naloxone.
a) Check responsiveness and assess for breathing and a pulse. c) Suction the airway if Liz vomits. d) Reassess Liz for any changes in condition.
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? a) The AED prompts, "No shock advised." b) Theo spontaneously moves. c) The AED prompts, "Shock delivered." d) Joe detects agonal breaths (isolated, infrequent gasps).
b) Theo spontaneously moves. If the team saw signs of the return of spontaneous circulation (ROSC), such as spontaneous movement or normal breathing, they would stop performing CPR on Theo.
Defibrillation
the delivery of an electrical shock using an AED may restore an effective heart rhythm, increasing the patient's chance for survival.
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? a) Observe for any signs of illness or injury, including life-threatening bleeding. b) Check for responsiveness. c) Check for breathing and a carotid pulse. d) Determine whether any additional help is needed. e) Open the patient's airway.
a) Observe for any signs of illness or injury, including life-threatening bleeding. d) Determine whether any additional help is needed.
An adult patient in respiratory failure may have some ventilation; however, this ventilation is insufficient to sustain needed gas exchange, oxygen and carbon dioxide. True or false? a) True b) False
a) True
What is the first step of the In-Hospital Pediatric Cardiac Chain of Survival? a) Surveillance and prevention b) Recognition of cardiac emergency and activation of emergency response system c) Early high-quality CPR d) Pediatric advanced life support
a) Surveillance and prevention
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? a) True b) False
a) True
You should switch roles about every 2 minutes, which usually occurs during the time of AED analysis, or sooner if the compressor is becoming fatigued. True or false? Select the correct answer to this question. a) True b) False
a) True
An adult patient with a suspected opioid overdose is in respiratory arrest. Which of the following actions are most appropriate? Select all correct options that apply. a) Provide 1 ventilation every 6 seconds. b) Begin CPR immediately. c) Check the pulse and breathing about every 2 minutes. d) Administer naloxone, if your facility's protocol allows. e) As soon as available, use an AED.
a) Provide 1 ventilation every 6 seconds. c) Check the pulse and breathing about every 2 minutes d) Administer naloxone, if your facility's protocol allows.
A 4-year-old child is in respiratory failure. Her central pulse rate is 65 bpm. Which of the following actions are appropriate? Select all correct options that apply. a) Deliver 1 ventilation every 6 seconds b) Start CPR immediately c) Deliver 1 ventilation every 2 to 3 seconds d) Check the pulse and breathing about every 2 minutes
c) Deliver 1 ventilation every 2 to 3 seconds d) Check the pulse and breathing about every 2 minutes
Once the AED is retrieved, what is the first step? a) Turn on the AED and follow the prompts. b) Attach the AED pads. c) Push the shock button. d) Clear the patient and ensure nobody is touching him/her.
a) Turn on the AED and follow the prompts.
When is consent to give care implied for a responsive choking child? a) When a parent or guardian is not available to give consent. b) When the child is in a healthcare facility. c) When the child is over 12 years old.
a) When a parent or guardian is not available to give consent.
Mrs. Price does not comply with your request to step aside and is beginning to interfere with the team's efforts to perform high-quality CPR. You notice a family member quietly standing by and elicit her help: "Is Mrs. Price your mother?" She replies yes, and you say: "OK, can you sit over there with her? A nurse will be here shortly to update you." When you asked the daughter to assist you with Mrs. Price, you took advantage of a readily available resource to find a solution. This is an example of: a) Critical Thinking b) Problem Solving
b) Problem Solving Problem solving refers to the ability to use readily available resources to find solutions to challenging situations or issues that arise. Critical thinking, however, refers to thinking clearly and rationally to identify the connection between information and actions.
You monitor the team's performance and determine they are providing effective care. You tell them to keep up the good work. However, Lauren notes: "Sam has been providing compressions for about 2 minutes. I can take over compressions if needed." You ask Sam how he's doing and he replies: "I'm getting a little tired." You direct Lauren and Sam to switch roles after they complete the CPR cycle. The team's action best represents which practice used to prevent errors? a) crew resource management b) chain of command management
a) crew resource management This is an example of crew resource management. As depicted here, crew resource management centers around the team leader, who coordinates the actions and activities of team members so that the team functions effectively and efficiently. It also guides the team members to communicate directly and openly with the team leader about dangerous or time-critical decisions.
You are ready to apply AED pads to a patient who has a transdermal medication patch. What should you do? a) Keep the transdermal medication patch in place and adjust the AED pad placement so the pads do not touch it. b) Before applying AED pads, remove the transdermal medication patch with a gloved hand and wipe away any remaining medication from the skin.
b) Before applying AED pads, remove the transdermal medication patch with a gloved hand and wipe away any remaining medication from the skin.
Which of these actions are appropriate ways to minimize interruptions in chest compressions? Select all correct options that apply. a) Continue CPR while the shock is delivered. b) Immediately resume CPR after the shock is delivered. c) Continue CPR while the AED is analyzing the heart rhythm. d) Continue CPR while the AED pads are applied.
b) Immediately resume CPR after the shock is delivered. d) Continue CPR while the AED pads are applied.
Which is the correct technique for multiple-provider CPR when an advanced airway is in place? a) Providers deliver cycles of 30 compressions and 2 ventilations. b) One provider delivers 1 ventilation every 6 seconds, while the other provider delivers continuous chest compressions without pausing for ventilations.
b) One provider delivers 1 ventilation every 6 seconds, while the other provider delivers continuous chest compressions without pausing for ventilations.
You must perform single-provider CPR on an adult patient in cardiac arrest. What technique should you use? a) Perform 15 chest compressions at a rate of 80 to 100 per minute. Then deliver 2 ventilations, each lasting about 1 second, with a pocket mask or mouth-to-mouth. b) 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. c) Perform 30 chest compressions at a rate of 100 to 120 per minute. Then deliver 2 ventilations, each lasting about 1 second, with a BVM.
b) 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.
CHECKING FOR RESPONSIVENESS If the patient appears responsive, follow the 1)_____________________ ________________. If the patient is unresponsive, call for help, activate 2)_____________________, and get the 3)_______. If the patient is responsive, obtain 4)___________ and provide care.
1) shout-tap-shout sequence 2) emergency medical system (EMS) 3) AED 4) consent
When opening the airway to a past-neutral position and checking for a pulse and breathing, assess the patient for no more than ____ seconds.
10
closed-loop communication
a communication technique used to prevent misunderstandings the receiver confirms that the message has been received and understood.
Identify the situations in which it is safe to use an AED. Select all correct options that apply. a) If the patient is wearing jewelry or has body piercings, providing the AED pads are not placed directly over any metallic jewelry or piercings b) 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 c) If the patient is near flammable or combustible materials, such as free flowing oxygen d) If the patient is pregnant, providing the AED pads do not incorporate any breast tissue e) If the patient has a pacemaker or implantable cardioverter-defibrillators (ICDs), providing the AED pads are not placed directly over the device f) If the patient is lying in a large puddle of water
a) If the patient is wearing jewelry or has body piercings, providing the AED pads are not placed directly over any metallic jewelry or piercings b) 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 d) If the patient is pregnant, providing the AED pads do not incorporate any breast tissue e) If the patient has a pacemaker or implantable cardioverter-defibrillators (ICDs), providing the AED pads are not placed directly over the device
You are working as part of a BLS team, providing care to a patient in cardiac arrest. Which actions demonstrate critical thinking? a) Re-evaluating the situation for changes, interpreting these changes and modifying patient care accordingly b) Acting as a role model for other team members c) Determining a course of action based on assessment findings d) Anticipating roles and functions as part of a team based on the patient's presentation and condition e) Delivering a shock when the AED prompts
a) Re-evaluating the situation for changes, interpreting these changes and modifying patient care accordingly c) Determining a course of action based on assessment findings d) Anticipating roles and functions as part of a team based on the patient's presentation and condition
Mr. Henderson is unresponsive. You direct Gloria to activate EMS and get the nearby AED and resuscitation equipment. Then, you simultaneously check for breathing, a pulse, and life-threatening bleeding. "One one-thousand, two one-thousand, three one-thousand, four one-thousand, five one-thousand..." You note he is not breathing and has a central pulse. You do not see signs of life-threatening bleeding. What emergency condition is Mr. Henderson experiencing? a) Respiratory arrest b) Cardiac arrest
a) Respiratory arrest
Which statement(s) are true about your duty to act? Select all that apply. a) When a patient experiences a life-threatening emergency in your practice setting, you have a duty to act. b) Although a duty to act may not always exist outside your practice setting, being prepared and willing to respond is essential. c) Failure to fulfill your duty to act within your practice setting cannot result in legal action. d) Your facility's specific protocols and your scope of practice may determine your appropriate actions.
a) When a patient experiences a life-threatening emergency in your practice setting, you have a duty to act. b) Although a duty to act may not always exist outside your practice setting, being prepared and willing to respond is essential. d) Your facility's specific protocols and your scope of practice may determine your appropriate actions.
agonal breathing is a sign of what?
cardiac arrest
supine
lying on the back with the face upward
The BLS team is caring for a patient in respiratory arrest. 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? a) "My shift is almost over. Another team member will come speak with you as soon as they can so you can get the latest information on your loved one's condition." b) "We are doing all we can for him, and I'm sure that he is going to get better soon." c) "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." d) "I'm going to give you all the information I have quickly because I need to get back, but if you have any follow-up questions, you can ask the doctor when the doctor is available."
"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."
How do you provide care to an adult patient in respiratory arrest/respiratory failure?
- Activate EMS, the rapid response team or the resuscitation team, as appropriate, and call for an AED. - Deliver 1 ventilation every 6 seconds; each ventilation should last about 1 second and make the chest begin to rise. If an advanced airway is in place, the rate remains the same. - Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/ initial interventions, if not already done. - Continue to check breathing and pulse every 2 minutes; if pulse becomes absent, start CPR immediately and use an AED when it's available. - Position patient as appropriate for clinical condition. - Perform secondary assessment as patient condition allows.
What is the correct ventilation rate for a pediatric patient (child or infant) in respiratory arrest or respiratory failure?
1 ventilation every 2-3 seconds.
What is the correct rate of ventilation delivery for an adult in respiratory arrest or respiratory failure?
1 ventilation every 6 seconds
For a patient in cardiac arrest, deliver 1)____ ventilation(s) that last about 2)___ second(s) each and make the chest begin to ______; allow the air to exit before delivering the next ventilation.
1) 2 2) 1 3) rise
If a child/infant's central pulse is > 60 bpm, deliver 1 ventilation every _________ seconds. If an advanced airway is in place, the rate _____________________. If at any time the central pulse decreases to ≤ 60 bpm with poor perfusion despite adequate ventilation and oxygen, start ________. If their central pulse is ≤ 60 bpm with signs of poor perfusion, start _________. If at any time central pulse and perfusion improve, 5)___________ and deliver 1 ventilation every 6)____________ seconds until the patient is ventilating sufficiently.
1) 2-3 2) remains the same 3) CPR 4) CPR 5) stop CPR 6) 2-3
1) For adult patients, high-quality CPR includes _______ chest compressions followed by _____ ventilations (____ ratio). 2) When an advanced airway is in place, the ______ ratio does not apply. Instead, one provider delivers ____ ventilation every ____ seconds, while the other provider delivers _____________ chest compressions without _______________ for ventilations. 3) Transitions between compressions and ventilations should be smooth to minimize interruptions in compressions to less than ____ seconds.
1) 30, 2 ; 30:2 2) 30:2, 1 , 6, continuous, pausing 3) 10
If the fundus is below the umbilicus or gestational age is known to be 1)________________ follow the Basic Life Support: Adults and Adolescents code card. If the fundus at or above umbilicus or gestational age known to be 2)_______________, follow the Basic Life Support: Pregnant Patients code card.
1) < 20 weeks 2) ≥ 20 weeks
If you are alone and do not have a mobile phone or other forms of communication, you must decide to call first or care first. What should you do for a child or an infant whom you witnessed suddenly collapse OR an unresponsive child or infant with a known cardiac condition?
1) Call for additional resources 2) Provide care based on the conditions found.
Adult Out-of-Hospital Cardiac Chain of Survival
1) Early High-Quality CPR 2) Early Defibrillation 3) Advanced Life Support 4) Integrated Post-Cardiac Arrest Care 5) Recovery
Rapid Assessment involves what?
1) Performing a visual survey. 2) Checking responsiveness. 3) Opening the airway and simultaneously checking for breathing, a pulse, and life-threatening bleeding (ABC)
How do you provide high-quality CPR for adults?
1) Position the patient appropriately on a firm, flat surface. 2) Ensure proper hand placement and body position. Immediately begin chest compressions at a proper depth and rate. Allow the chest the recoil fully after each compression and minimize interruptions to less than 10 seconds. Simultaneously, deliver 1 ventilations (1 every 6 seconds) that last about 1 second and delivers just enough volume to make the chest begin to rise (400 mL to 700 mL)
If you are alone and do not have a mobile phone or other forms of communication, you must decide to call first or care first. What should you do for an unresponsive child or infant whom you did not see collapse?
1) Provide 2 minutes of care based on the conditions found 2) Call for additional resources.
How do you communicate with a family after patient's death?
1) Provide the information honestly and with compassion, in a straightforward manner, and include information about events that may follow 2) Allow the family to begin processing the information. 3) Allow time for the family to begin the grief process. Ask whether they would like to contact or have you contact anyone, such as other family members or clergy. 4) Anticipate a myriad of reactions by family members, such as crying, sobbing, shouting, anger, screaming or physically lashing out. 5) Wait and answer any questions that the family may have.
How do you use Pocket Mask Ventilations?
1) Select an appropriately sized mask and then assemble it by screwing a small nozzle into the center of the mask 2) Place the mask at the bridge of the nose, then lower it over the patient's nose and mouth, making sure it doesn't extend past the chin. 3) Seal the mask by placing the webbing b/w your index finger and thumb at the top of the mask above the valve, and then placing the remaining fingers on the side of the patient's face. 4) Place the thumb of your other hand along the base of the mask and place your bent index finger under the patient's chin. 5) Open the airway past neutral, take a normal breath, make a complete seal over the mask valve with your mouth, and give 2 ventilations. Each ventilation should last about 1 second and make the chest begin to rise. Between ventilations, quickly break the seal and take another breath.
Pediatric In-Hospital Cardiac Chain of Survival
1) Surveillance and Prevention 2) Recognition of Cardiac Emergency and Activation of Emergency Response System 3) Early High-Quality CPR 4) Pediatric Advanced Life Support 5) Integrated Post-Cardiac Arrest Care 6) Recovery
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. Early defibrillation Recovery Recognition of cardiac emergency and activation of the emergency response system Early high-quality CPR Integrated post-cardiac arrest care Surveillance and prevention
1) Surveillance and prevention 2) Recognition of cardiac emergency and activation of the emergency response system 3) Early high-quality CPR 4) Early defibrillation 5) Integrated post-cardiac arrest care 6) Recovery
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.
Before providing care to an adult patient with a life-threatening injury or illness, you have to position them for 1) ___________ ________________. If patient is lying down and does not have a suspected head, neck, spinal or pelvic injury, place them in a ______________ _________________.
1) clinical position 2) recovery position
An emergency situation can occur anywhere in a healthcare facility or on scene. The 1)______________ you provide, accessible 2)______________ and 3)________________________, and the 4)__________ ________________ available may vary depending on the location of the emergency situation. For example, responding to an emergency situation in a common area of a healthcare facility will be distinct from responding to one occurring at the patient's bedside.
1) interventions 2) resources 3) equipment 4) team members
When the fundus is at or above the umbilicus or gestational age is known to be 20 weeks or later, 1)________ _____________ ______________________ must be provided continuously throughout the resuscitation effort and until the 2)__________ is 3)_________________, even if 4)_____________ is achieved.
1) left uterine displacement (LUD) 2) infant 3) delivered 4) ROSC
An adult patient may be experiencing a life-threatening injury or illness, if they are 1)_______________, 2)_________________ or experiencing an altered level of 3)_________________ and they are 4)______________ and have a 5)___________.
1) responsive 2) unresponsive 3) consciousness 4) breathing 5) pulse
When 1)__________________ _____________ or a(n) 2)__________ airway (e.g., an oropharyngeal airway) is used, CPR is performed the same way. However, if a(n) 3)_____________ airway (e.g., an endotracheal tube) is used, one provider delivers 4)___ ventilation every 5)___ seconds while another provider delivers 6)___________ chest compression without 7)__________ for ventilations.
1) supplemental oxygen 2) basic 3) advanced 4) 1 5) 6 6) contineous 7) pausing
Leaning on the patient's chest at the top of the compression will impede 1)____________ __________ and prevents the heart from 2)___________ completely. This, in turn, decreases 3)___________ ___________.
1) venous return 2) filling 3) cardiac output
You demonstrate high-quality CPR by keeping interruptions in CPR to less than _____ seconds.
10
E-C Position
A method to hold the mask in place; position one hand around the mask, forming an "E" with the last three fingers and a "C" with your thumb and index finger.
To provide care to an adult patient with a life-threatening injury or illness, what should you do?
Activate EMS, the rapid response team or the resuscitation team, as appropriate, and call for an AED. Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/initial interventions. Position patient as appropriate for clinical condition or recovery position (if suspected head, neck, spinal or pelvic injury) Perform secondary assessment as patient condition allows. Reassess patient, recognize issues and provide care as needed.
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? a) True b) False
An acutely ill patient's condition can change rapidly, and deterioration can follow; therefore, frequent assessment, recognition and care are critical.
What questions should you ask yourself during a visual survey?
Are immediate dangers present? What guidance needs to be given to family members? Does the patient look sick or unresponsive? Does the patient's skin appear pale, mottled, or cyanotic? Do they appear to be breathing Is there severe life-threatening bleeding? Who is available to help? Do you need any additional equipment?
What is the correct area of the chest to perform chest thrusts?
Center of the chest on the lower half of the sternum
What are the signs and symptoms of myocardial Infarction (MI)?
Chest discomfort or pain that is severe, lasts longer than 3 to 5 minutes, goes away and comes back, or persists even during rest. Discomfort, pressure or pain that is persistent and ranges from discomfort to an unbearable crushing sensation in the chest, possibly spreading to the shoulder, arm, neck, jaw, stomach or back, and usually not relieved by resting, changing position or taking medication. Chest pain that comes and goes (such as angina pectoris). Difficulty breathing/ shortness of breath Pale or ashen skin (especially around the face) Sweating (especially on the face) Dizziness or light-headedness Possible altered mental status or level of consciousness Nausea or vomiting
Paloma is 9 years old and weighs 62 pounds. Single-provider CPR is in progress and you have just arrived with the AED. You set up the AED and apply pediatric AED pads while CPR continues. Is this the best course of action (true/false)?
False Since Paloma is 9 years old and weighs MORE THAN 55 pounds, you should use adult AED pads or adult electrical settings. NEVER use pediatric AED pads or a pediatric electrical setting on a child older than 8 years or weighing more than 55 pounds because the shock delivered will not be sufficient.
Ben is a 4-year-old child in cardiac arrest due to drowning. After recognizing that he is in cardiac arrest, you begin CPR immediately starting with compressions. Is this the best course of action (true/false)?
False 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 in a child or infant with a primary respiratory etiology.
If the patient stops responding after the administration of naloxone, what do you do?
Immediately check for responsiveness and assess for breathing and a pulse Begin care as appropriate. Repeat naloxone administration every 2 to 3 minutes as needed.
How do you check for breathing?
Look at the chest for rising and falling Listen for escaping air Feel for breathing on the side of your cheek
Ventilations for Children
Open airway to slightly past-neutral position (avoid hyperextension). Use modified jaw-thrust maneuver instead if you suspect head, neck or spinal injury. Each ventilation should last about 1 sec and make the chest begin to rise Allow air to exit before delivering the next ventilation.
Ventilations for Infants
Open the airway to a neutral position. Avoid hyperextension or flexion in the neck. Deliver 2 ventilations that last about 1 second and make the chest begin to rise. Minimize interruptions in chest compressions to less than 10 seconds. If an advanced airway is in place, one provider delivers 1 ventilation every 2-3 secs
What are some signs that someone is choking?
Panicked, confused or surprised facial expression Clutching the throat (the universal sign of choking) Running about & flailing the arms Trying to get attention Stridor (high-pitching squeaking noises) No noises at all Flushed, pale or cyanotic skin appearance
What are some examples of a patient for whom chest thrusts would be the alternative technique, instead of abdominal thrusts?
Patient whom you may not be able to reach far enough around to perform abdominal thrusts Patient whom might be pregnant Patient in a bed or wheelchair with features that make abdominal thrusts difficult to do Patient for whom back blows or abdominal thrusts are not effective in dislodging the object
Which is the correct 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
What are the indicators of opioid overdose?
Pinpoint pupils Unconsciousness or severe sleepines Respiratory depression Cyanosis Track marks from intravenous drug use Prescription pill bottles, pipes, needles, syringes, pill powder or other drug-related items History of opioid drug abuse.
What is the proper form for delivering chest compressions for adults?
Place the heel of one hand in the center of the patient's chest on the lower half of the sternum. Place your other hand on top of the first one and interlace your fingers or hold them up so they don't rest on the patient's chest. Position yourself so your shoulders are directly over your hands to compress the chest using a straight up-and-down motion. (more effective & less tiring) Keep your arms straight, lock your elbows.
How should you position and seal a BVM?
Place the mask at the bridge of the nose and lower it over the nose, mouth, and chin. The mask should not extend past the patient's chin. Hold the mask in place with the E-C hand position. Seal the mask completely around the patient's mouth and nose by lifting the jaw into the mask.
If the patient is responsive after the administration of naloxone, what do you do?
Place them in a recovery position providing you do not suspect a head, neck, spinal, hip or pelvic injury. Reassess the patient for any changes in condition until EMS, the rapid response team or the resuscitation team arrives. ***If they vomit, suction their airway or call for help to provide suctioning
What are the different methods for providing ventilations?
Pocket mask ventilations Bag-valve-mask resuscitator ventilations Mouth-to-mouth ventilations Mouth-to-nose ventilations
Compression Technique for Adults
Position one hand on top of the other with fingers interlaced and off the chest centered on the lower half of the sternum.
Compression Technique for Children
Position one hand on top of the other with fingers interlaced and off the chest centered on the lower half of the sternum. Smaller children = one-hand technique
Closed-loop communication involves what four essential components?
SENDER: The person initiating the communication MESSAGE: The content of the communication; must be expressed clearly so that everyone involved knows exactly what the message is RECEIVER: The person for whom the message is intended FEEDBACK: The confirmation by the receiver that the message has been received AND understood; an essential element of closed-loop communication
Using AED Pads for Infants
TYPE: Pediatric AED pads (if available) ; Adult AED pads & electrical settings are okay PLACEMENT: Anterior/Posterior - Middle of Chest (Sternum) - Back (b/w Scapulae)
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
You recognize that Maggie (4 years old)is in cardiac arrest. You are alone and do not have a mobile phone or other forms of communication. Although you called out for someone to help and get an AED, nobody responded. You did not witness Maggie collapse, so you provide 2 minutes of CPR before leaving Maggie to get help. Is this the best course of action (true/false)?
True
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 A two-person technique for bag-valve-mask (BVM) ventilations (also referred to as bag-mask ventilations) is the preferred methodology because it provides a better seal and ventilation volume. To perform this technique, one provider seals the mask and maintains an open airway while the other provider delivers ventilations.
Maggie is 4 years old and weighs 42 pounds. You simultaneously check for breathing and a pulse (carotid) for no more than 10 seconds. At the same time, you scan the body for bleeding. Is this the best course of action (true/false)?
True For children like Maggie, you should simultaneously check for breathing and a pulse (carotid) for no more than 10 seconds. At the same time, you should scan the body for life-threatening bleeding.
When you attempt to apply the adult AED pads, you realize they will touch one another on Paloma's chest (9 years old). Instead of the anterior/lateral position, you use the anterior/posterior position for AED pad placement. Is this the best course of action (true/false)?
True If the pads risk touching on a child's chest, you should use the anterior/posterior AED pad placement (one pad to the center of the patient's chest—sternum—and one pad to the patient's back between the scapulae).
If the patient with an obstructed airway is a child or shorter than you, it may be better to kneel behind them rather than stand to perform back blows and abdominal thrusts. True or False?
True If the patient with an obstructed airway is a child or shorter than you, it may be better to kneel behind them rather than stand to perform back blows and abdominal thrusts.
Aaliyah is 11 years old and weighs 97 lbs. She shows signs of puberty including breast development. You provide chest compressions at a depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm). Is this the best course of action (true/false)?
True Since Aaliyah has reached the onset of puberty, you should follow adult CPR guidelines. For adults the proper chest compression depth is at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
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 For a patient in cardiac arrest due to opioid overdose, high-quality CPR remains the priority over naloxone administration and should not be delayed or interrupted.
After the shock is delivered (or if no shock is advised) you will switch from single-provider to multiple-provider CPR. Since two providers are now performing CPR and Paloma (9 years old) does not have an advanced airway in place, you switch to a compression/ventilation ratio of 15:2. Is this the best course of action (true/false)?
True. Since two providers are now performing CPR and Paloma does not have an advanced airway in place, you switch to a compression/ventilation ratio of 15:2.
What is the correct way to perform back blows?
Using the heel of your hand, firmly strike between the scapulae.
When performing abdominal thrusts, what is the correct placement of your fist on the patient's abdomen?
When performing abdominal thrusts, place the thumb side of your fist on the middle of the abdomen, just above the navel.
crew source management
a concept that helps to promote effective and efficient teamwork and reduce the likelihood of errors by - using all available resources (including people, equipment, and procedures) - encouraging problem solving -communication among team members.
The team arrived and prepared the BVM and AED. After the shock was delivered, Ana-Lisa will immediately resume chest compressions on Theo (6 years old). Which compression-to-ventilation ratio should the team use? a) 15:2 b) 30:2
a) 15:2
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? a) 2 ventilations b) Finger sweep c) 30 compressions d) 1 ventilation every 6 seconds.
a) 2 ventilations
You are working as part of a high-performance BLS team. Which roles would you and the other providers most likely fill? Select all correct options that apply. a) AED operator b) Communications specialist c) Team leader d) Airway manager/ventilator e) Compressor f) Environmental technologist
a) AED operator c) Team leader d) Airway manager/ventilator e) Compressor
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? Select all correct options that apply. a) Activate maternal and neonatal resuscitation teams. b) Provide continuous high-quality CPR and left uterine displacement. c) Make sure AED pads do not incorporate any breast tissue. d) Apply fetal monitors to properly assess fetal status. e) Place the patient in the left lateral decubitus position and perform high-quality CPR. f) Perform resuscitative cesarean delivery (RCD), if trained, within 5 minutes from the time of arrest.
a) Activate maternal and neonatal resuscitation teams. b) Provide continuous high-quality CPR and left uterine displacement. c) Make sure AED pads do not incorporate any breast tissue. f) Perform resuscitative cesarean delivery (RCD), if trained, within 5 minutes from the time of arrest.
You initiate CPR on an 11-year-old patient who shows signs of puberty, including breast development. Which CPR/AED guideline should you follow? a) Adult b) Child c) Infant
a) Adult
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: a) Cardiac arrest b) Respiratory arrest c) Myocardial infarction (MI) d) Shock
a) Cardiac arrest
You are evaluating the quality of CPR provided by the BLS team. Which methods could you use for this evaluation? Select all correct options that apply. a) Feedback device b) Chest compression fraction c) Visual observation d) Capnography e) Arterial blood gas levels
a) Feedback device b) Chest compression fraction c) Visual observation d) Capnography
An infant has an obstructed airway but is responsive. Which technique should you use when administering back blows to the infant? a) Heel of the hand between the scapulae b) Two thumbs between the scapulae c) Palm of the hand just above the scapulae d) Fisted hand just below the scapulae
a) Heel of the hand between the scapulae
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? Select all correct options that apply. a) Hold the mask in place with the E-C hand position. b) Maintain an open airway in a neutral position. c) Ensure that the chest begins to rise. d) Bag-valve-mask (BVM) ventilations should be performed as a two-person technique to provide a better seal and ventilation volume. e) Seal the mask and open the airway by lifting the jaw into the mask.
a) Hold the mask in place with the E-C hand position. c) Ensure that the chest begins to rise. d) Bag-valve-mask (BVM) ventilations should be performed as a two-person technique to provide a better seal and ventilation volume. e) Seal the mask and open the airway by lifting the jaw into the mask.
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? Select all correct options that apply. a) Provide smooth compressions at a rate of 100 to 120 compressions per minute and a depth of at least 2 inches. b) Allow the chest to fully recoil after each compression. c) Provide slow, effortless ventilations that last about 2 seconds each and make the chest fully rise. d) Avoid excessive ventilations. e) Minimize interruptions in compressions to less than 15 seconds.
a) Provide smooth compressions at a rate of 100 to 120 compressions per minute and a depth of at least 2 inches. b) Allow the chest to fully recoil after each compression. d) Avoid excessive ventilations.
You have determined that your patient is unresponsive. What steps of the rapid assessment should you do next? Select all that apply. a) Simultaneously check breathing and a pulse for no more than 10 seconds. b) Deliver 1 ventilation every 6 seconds. c) Begin CPR immediately. d) Quickly scan down the body looking for blood or other signs and symptoms that might not have been seen during the initial impression. e) Place the patient in a recovery position and monitor them until EMS arrives.
a) Simultaneously check breathing and a pulse for no more than 10 seconds. d) Quickly scan down the body looking for blood or other signs and symptoms that might not have been seen during the initial impression.
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? a The person who is acting as the team leader b) The first team member to volunteer this information c) No one. The code team needs to do their initial assessment d) The team member who is asked questions by the code team
a) The person who is acting as the team leader
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? a) True b) False
a) True
You should perform early assessment for life-threatening bleeding during the initial impression and the breathing and pulse check. True or false? a) True b) False
a) True
Providers are preparing to deliver ventilations with a BVM to a patient in cardiac arrest. One provider seals the mask with both hands using the E-C hand position and simultaneously opens the airway to a past-neutral position. The other provider delivers smooth, effortless ventilations that last about 1 second and make the chest begin to rise. This is the preferred technique for delivering BVM ventilations when an advanced airway is not in place. True or false? a) True. The two-person technique for BVM ventilations is the preferred technique. b) False. The one-person technique for BVM ventilations is the preferred technique.
a) True. The two-person technique for BVM ventilations is the preferred technique.
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? Select all correct options that apply. a) Use a compression-to-ventilation ratio of 30:2. b) Switch positions every 5 minutes to minimize provider fatigue. c) Provide continuous compressions without pausing for ventilations. d) Begin CPR immediately after identifying cardiac arrest. e) Use a compression-to-ventilation ratio of 15:2.
a) Use a compression-to-ventilation ratio of 30:2. d) Begin CPR immediately after identifying cardiac arrest.
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? a) Yes b) No
a) Yes
You and two other providers, Amanda and Ryan, witness an adult patient collapse in the hallway. You perform a visual survey, looking for life-threatening bleeding, and check for responsiveness. When the patient doesn't respond, you tell Amanda to activate the rapid response team and you tell Ryan to retrieve the AED and resuscitation equipment. Then, you open the airway and simultaneously check for breathing, a pulse and life-threatening bleeding. They both repeat your instructions back to you to "close the loop." Did the team respond appropriately? a) Yes b) No
a) Yes First, always perform a visual survey, looking for life-threatening bleeding, and check for responsiveness. At least one provider must remain with the patient to initiate care or to monitor the patient, while others retrieve equipment and call for help. It is important to use closed-loop communication to ensure all instructions have been clearly understood.
You determine your patient is in cardiac arrest and start CPR immediately. Amanda returns and announces the code team is on the way and Ryan returns stating, "I have the AED and resuscitation equipment." What should the team do next? a) 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. b) You should continuously perform chest compressions, while Amanda delivers 1 ventilation every 6 seconds. Ryan should set up the AED, attach the pads and tell everyone to "clear" as the AED begins to analyze.
a) 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.
You determine that Mr. Price is in cardiac arrest. You direct the team to begin CPR. Mrs. Price rushes to her husband's side and cries: "What's happening? Harry, are you with us?" You explain: "Mrs. Price, your husband's heart stopped. We need to perform CPR so we can keep blood and oxygen flowing to his brain." Mrs. Price pleads: "Is he going to be OK?" You answer: "I know you're worried, but we are doing everything we can. Please step over here so we can care for him. We will update you as soon as possible." This is an example of effective family communication. a) true b) false
a) true This was effective communication with Mrs. Price because you demonstrated credibility, confidence and empathy; built rapport and established trust; were open and honest; minimized her fears but avoided giving misleading information or false hope; and reassured her that everything that can be done is being done.
Once the airway is open, you simultaneously check for breathing, a pulse and life-threatening bleeding. Is this the correct course of action? a) Yes b) No
a) yes A.B.C. = Airway, Breathing, Circulation
When a patient has a pacemaker or ICD, how should you adjust pad placement
adjust pad placement as necessary to avoid placing the AED pads directly over the device. **Note: A pacemaker or ICD may be placed in the right upper chest near the clavicle or in the abdomen.
When does integrated Post-Cardiac Arrest Care occur?
after the return of spontaneous circulation (ROSC)
An adult patient suffers cardiac arrest in bed and requires CPR. When compressing the patient's chest, which techniques promotes high-quality CPR? Select all correct options that apply. a) Place your hands on the center of the patient's chest above the nipple line. b) Adjust the bed or use a secure step or stool so you are at an appropriate working height. c) Position yourself so your shoulders are directly over your hands. d) Overlap your hands, slightly bend your elbows and use your arm muscles to compress the chest. e) 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. f) Place down a CPR board or activate the system in the bed to ensure a firm CPR surface.
b) Adjust the bed or use a secure step or stool so you are at an appropriate working height. c) Position yourself so your shoulders are directly over your hands. e) 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. f) Place down a CPR board or activate the system in the bed to ensure a firm CPR surface.
Gloria returns with the AED and resuscitation equipment. She states, "I'm on the phone with emergency dispatch." After 2 minutes of delivering ventilations, you stop to check breathing and pulse. You clearly state, "His central pulse is now absent." You recognize that Mr. Henderson is now experiencing which emergency condition? a) Myocardial infarction b) Cardiac arrest
b) Cardiac arrest
As you approach Mrs. Bailey you note that she appears unresponsive and you do not see signs of life-threatening bleeding. Which action should you perform next? a) Open the airway to a past-neutral position b) Check for responsiveness. c) Activate EMS, rapid response or resuscitation team. d) Simultaneously check for breathing, pulse and life-threatening bleeding.
b) Check for responsiveness. If the patient appears unresponsive, you need to check for responsiveness. If they are unresponsive, you should activate EMS, rapid response or resuscitation team. Then open the airway to a past-neutral position and check breathing and a pulse for no more than 10 seconds; and at the same time, scan the body for life-threatening bleeding (ABC). Finally, you should implement care based on your findings.
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? Select all correct options that apply. a) Reviewing the patient chart b) Checking for life-threatening bleeding c) Determining the need for additional resources d) Obtaining an initial impression of the patient e) Observing the time of the emergency event
b) Checking for life-threatening bleeding d) Obtaining an initial impression of the patient
To minimize interruptions in chest compressions, what should be done during the AED analysis and shock? a) Continue giving compressions during the AED analysis but pause compressions if shock is advised. b) Clear the patient and prepare to resume CPR immediately after the shock is delivered or if no shock is advised.
b) Clear the patient and prepare to resume CPR immediately after the shock is delivered or if no shock is advised.
You are working with a BLS team performing CPR on a 62-year-old female patient. Which actions demonstrate high-quality CPR? Select all correct options that apply. a) Compress the chest to a depth of about 1½ inches. b) Compress the chest at a rate of 100 to 120 per minute. c) Deliver smooth ventilations that last about 1 second each and make the chest begin to rise. d) Allow for full chest recoil after each compression. e) Interrupt chest compressions as needed to frequently assess the patient.
b) Compress the chest at a rate of 100 to 120 per minute. c) Deliver smooth ventilations that last about 1 second each and make the chest begin to rise. d) Allow for full chest recoil after each compression.
You are providing care for an adult patient in respiratory arrest. Which actions demonstrate appropriate care? Select all correct options that apply. a) Start CPR immediately. b) Deliver 1 ventilation every 6 seconds. c) Deliver 2 ventilations each lasting about 1 second. d) Continue to check breathing and pulse every 2 minutes. If pulse becomes absent, start CPR. e) Use an AED as soon as it is available.
b) Deliver 1 ventilation every 6 seconds. d) Continue to check breathing and pulse every 2 minutes. If pulse becomes absent, start CPR.
Which statement about delivering ventilations to an infant in cardiac arrest is true? a) Minimize interruptions in chest compressions to less than 5 seconds. b) Deliver 2 ventilations that last about 1 second each and make the chest begin to rise. c) Tilt the head to a slightly past neutral position. d) Provide 1 ventilation every 2 to 3 seconds.
b) Deliver 2 ventilations that last about 1 second each and make the chest begin to rise.
While simultaneously checking for breathing and a pulse, you correctly adhere to which amount of time? a) No more than 5 seconds b) No more than 10 seconds c) No more than 15 seconds
b) No more than 10 seconds
You arrive with an AED and prepare to apply the pads while the BLS team continues to provide CPR. You apply the pads using the anterior/lateral pad placement. a) Center of the patient's chest on the sternum & center of the patient's abdomen just below the navel b) Patient's upper right chest, below the right clavicle to the right of the sternum & the patient's lower left chest along the midaxillary line, a few inches below the left armpit c) Patient's lower right chest along the midaxillary line, a few inches below the right armpit & the patient's upper left chest, below the left clavicle to the left of the sternum
b) Patient's UPPER RIGHT chest, below the right clavicle to the right of the sternum & the 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? Select all correct options that apply. a) Wait to activate EMS, the rapid response team or the resuscitation team until you have concluded your secondary assessment. b) Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/initial interventions. c) Place them in left lateral decubitus position. d) Perform secondary assessment as patient condition allows. e) Reassess patient, recognize issues and provide care as needed.
b) Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/initial interventions. d) Perform secondary assessment as patient condition allows. e) Reassess patient, recognize issues and provide care as needed.
A patient showing symptoms of opioid overdose is not breathing and has a central pulse of 68 bpm. What action is priority? a) Provide care for cardiac arrest, starting with compressions. b) Provide care for respiratory arrest, starting with ventilations. c) Administer naloxone.
b) Provide care for respiratory arrest, starting with 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? a) Call a parent/legal guardian to obtain consent. b) Retrieve AED and resuscitation equipment. c) Activate EMS, rapid response or resuscitation team. d) Stay with the provider and continue assessing the child. e) Assist with CPR for 2 minutes before leaving to get additional resources.
b) Retrieve AED and resuscitation equipment. c) Activate EMS, rapid response or resuscitation team.
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? a) Provide 1 ventilation every 2 to 3 seconds. b) Start CPR immediately.
b) 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? a) Deliver 1 ventilation every 2 to 3 seconds until the child is ventilating sufficiently. b) Start CPR immediately. c) Perform a secondary assessment. d) Place the child in the recovery position and monitor them until the rapid response team arrives.
b) Start CPR immediately.
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? Select all correct options that apply. a) Continue compressions for another minute. b) Stop CPR/AED. c) Check for breathing and a carotid or femoral pulse. d) Give 2 ventilations. e) Remove the AED pads. f) Monitor the patient until the advanced cardiac life support team takes over.
b) Stop CPR/AED. c) Check for breathing and a carotid or femoral pulse. f) Monitor the patient until the advanced cardiac life support team takes over.
The rapid response team arrives and takes over resuscitation efforts. Who is the best person to communicate patient status and care completed to the rapid response team? a) The most senior-level team member b) Team leader
b) Team leader The team leader should communicate patient status and care to the rapid response team. The team leader may have been the first to respond to the emergency and is not always the most senior-level provider present.
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? Select all correct options that apply. a) The providers remove the ET tube before delivering ventilations. b) The providers deliver 1 ventilation every 6 seconds. c) The providers deliver 20 ventilations per minute. d) The providers perform compressions at one-half the usual rate. e) The providers perform continuous compressions without pausing for ventilations.
b) The providers deliver 1 ventilation every 6 seconds. e) The providers perform continuous compressions without pausing for ventilations.
Mr. Price suddenly collapses. He appears unresponsive. You do not see any life-threatening bleeding. You shout his name, tap him on the shoulder and shout again: "Mr. Price, are you OK? Can you hear me?" Mr. Price is unresponsive. As the team leader, you instruct Lauren: "Activate the rapid response team and retrieve the resuscitation equipment and AED." She repeats back to you: "I'll call the rapid response team and grab the resuscitation equipment and AED." When she returns, she states: "The rapid response team is on the way. I have the AED and will set it up." Lauren's response is an example of what type of communication? a) open-ended communication b) closed-loop communication
b) closed-loop communication Lauren's response demonstrated effective closed-loop communication, which involves four essential components: Sender Message Receiver Feedback (confirmation)
What are some of the causes of cardiac arrest in a pregnant patient? Select all correct options that apply. a) Prolonged labor b) Preterm labor c) Anesthesia d) Eclampsia e) Fever
c) Anesthesia d) Eclampsia e) Fever
A child with an obstructed airway becomes unresponsive. Which action would be most appropriate to do first? a) Gently lower the child to the ground, open their mouth and look for the object; if seen remove it with a finger sweep. b) Gently lower the child to the ground and immediately begin CPR, starting with chest compressions. c) Attempt a series of 5 back blows and 5 abdominal thrusts. d) Place the child in the side-lying recovery position.
c) Attempt a series of 5 back blows and 5 abdominal thrusts.
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? a) Check for breathing, a pulse and life-threatening bleeding. b) Start CPR immediately. c) Check for responsiveness. d) Open the airway.
c) Check for responsiveness
After participating in a resuscitation event in which a pediatric patient did not survive, you are feeling very stressed and having difficulty with daily activities. What is the recommended action to help you cope with the stress? a) Speak to your supervisor about your feelings b) Take some time off to alleviate your stress c) Consider a referral to a qualified mental health professional d) Debrief with your co-workers to identify changes that could be made to improve future outcomes
c) Consider a referral to a qualified mental health professional
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? a) Adaptability b) Conflict resolution c) Crew resource management d) Role modeling
c) Crew resource management
When applying the AED pads, Ana-Lisa used an anterior/posterior placement. When should providers use this placement method for a child? Select all correct options that apply. a) If the patient is 8 years old or younger or weighs less than 55 pounds, always use anterior/posterior placement. b) If the patient is older than 8 years or weighs more than 55 pounds, always use anterior/posterior placement. c) If the manufacturer recommends the use of an anterior/posterior pad placement. d) If the AED pads risk touching each other.
c) If the manufacturer recommends the use of an anterior/posterior pad placement. d) If the AED pads risk touching each other.
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? a) Feel for breathing against your hand on their chest. b) Open the patient's mouth and look for an object. c) Listen for escaping air. d) Look to see whether the chest rises and falls. e) Feel for breathing against the side of your cheek.
c) Listen for escaping air. d) Look to see whether the chest rises and falls. e) Feel for breathing against the side of your cheek.
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? a) Carry the child out to an area where there is a phone or additional providers to assist. b) Deliver 2 initial ventilations followed by 30 chest compressions. c) Perform about 2 minutes of CPR, starting with chest compressions. d) Place the child in a recovery position and leave them to activate the resuscitation team.
c) Perform about 2 minutes of CPR, starting with chest compressions.
A 32-year-old patient (30 weeks' gestation) goes into cardiac arrest. The fundus is above the umbilicus. How can team members maximize the effectiveness of chest compressions for this patient? a) Position the patient in the supine position and elevate the feet b) Position the patient in the dorsal recumbent position c) Position the patient in the supine position and provide manual left uterine displacement d) Position the patient in the left lateral decubitus position
c) Position the patient in the supine position and provide manual left uterine displacement
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? a) The AED operator and airway manager/ventilator should clear the patient while the AED analyzes, however the compressor should continue giving compressions until the AED prompts shock/no shock advised. b) When the AED arrives, the team should stop CPR to set up the AED and apply the pads. c) Team members should rotate roles every 2 minutes, which is generally during the AED analysis, to prevent compressor fatigue. d) After the shock is delivered and the AED prompts shock delivered, the team should immediately resume CPR. e) The compressor should continue providing compressions until the AED pads are applied and the AED prompts that it is analyzing.
c) Team members should rotate roles every 2 minutes, which is generally during the AED analysis, to prevent compressor fatigue. d) After the shock is delivered and the AED prompts shock delivered, the team should immediately resume CPR. e) The compressor should continue providing compressions until the AED pads are applied and the AED prompts that it is analyzing.
After determining an 8-year-old child is unresponsive, what is the best site to check for a pulse?
carotid
When an adult patient shows signs of ROSC and multiple providers are present, where should you perform pulse check?
carotid or femoral pulse
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? a) "Got it. I will also retrieve an AED." b) "Got it. I will do that as soon as possible." c) "Got it. Do you need me to do anything else?" d) "Got it. I'll call the code team."
d) "Got it. I'll call the code team."
You are caring for a 6-month-old infant who is unresponsive, breathing and has a pulse. What should you do? a) Perform primary assessment (Airway, Breathing, Circulation, Disability, Exposure) and emergent/initial interventions. b) Perform secondary assessment as patient condition allows. c) Reassess patient, recognize issues, and provide care as needed. d) All of the above.
d) All of the above.
After determining an adult patient is unresponsive, what is the best site to check for a pulse? a) Brachial artery b) Radial artery c) Posterior tibial artery d) Carotid artery
d) Carotid artery
A 28-year-old patient (27 weeks' gestation) was admitted to the intensive care unit for treatment of pneumonia-related sepsis. The patient goes into cardiac arrest. When should a trained provider perform resuscitative cesarean delivery (RCD)? a) After 5 cycles of CPR, if return of spontaneous circulation (ROSC) has not been achieved b) Within 1 hour of return of spontaneous circulation (ROSC) c) As soon as possible after return of spontaneous circulation (ROSC) d) Within 5 minutes from the time of arrest
d) Within 5 minutes from the time of arrest
You enter your patient's room and find them lying supine in bed seemingly unresponsive. After assessing breathing and pulse for no more than 10 seconds and determining the patient is in cardiac arrest, when should you start CPR? a) Within 20 seconds b) When the AED is available c) Within 10 seconds d) Immediately
d) immediately
myocardial infarction (MI)
heart attack; refers to the necrosis (death) of heart tissue as a result of insufficient delivery of oxygenated blood to the heart (ischema)
When should high-quality CPR, starting with compressions, be initiated?
immediately once cardiac arrest is recognized.
respiratory failure
ineffective ventilation have a central pulse
For both adults and pediatric patients, through what routes can you administer Naloxone?
intravenous (IV), intraosseous (IO), intramuscular (IM), subcutaneous (SC) or intranasal (IN)
When providing high-quality CPR for adults, what should you avoid doing?
leaning on the patient's chest at the top of the compression stopping/pausing compressions for more than 10 seconds delivering too many ventilations
respiratory arrest
not breathing has a central pulse
When delivering ventilation during CPR, if the second ventilation is not successful, what can you assume that the patient has?
obstruction
When it comes to deciding between providing care for respiratory/cardiac arrest and administering naloxone, which is the first priority?
providing care for respiratory/cardiac arrest
Pocket Mask Ventilations
recommended during single-provider CPR or when only one person is available to deliver ventilations to limit interruptions in chest compressions one-person technqiue
When delivering ventilations during CPR, what should you do = if the chest does not rise after the first breath?
reopen the airway, make a seal, and try a second ventilation.
After _____________________, survival outcomes are improved when providers work to stabilize the patient, minimize complications, and diagnose and treat the underlying cause.
return of spontaneous circulation (ROSC)
Amy and Joe are in the hospital playroom helping several kids cope with the challenges of hospitalization, illness and disability. Amy is playing with 6-year-old Theo James, who suddenly collapses. 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
child
someone from the age of 1 to the onset of puberty (usually around the age of 12). girls - breast development in girls boys - underarm hair development in boys
infant
someone under the age of 1
Adjuncts to ventilations include what?
supplemental oxygen basic airways advanced airways
what is rapid assessment?
the initial hands-on evaluation of a patient in an emergency situation
what is critical thinking?
the process of thinking clearly and rationally to identify the connection between information and actions.
You have been caring for a young child in respiratory failure with a central pulse of 56 bpm and signs of poor perfusion. When you reassess them, you find their central pulse is now 68 bpm and their perfusion has improved. You stop CPR and deliver 1 ventilation every 2 to 3 seconds until the patient is ventilating sufficiently. This is the correct action. True or false?
true
when an advanced airway is not in place, a _______________ technique for __________________ ventilations is the preferred technique.
two-person bag-valve-mask (BVM)
Mouth-to-Mouth Ventilations
usually done when there is no pocket mask or BVM available Open the airway to a past-neutral position (for an adult). Pinch the patient's nose shut. Take a normal breath, make a complete seal over the patient's mouth with your mouth and blow into the patient's mouth to deliver 1 ventilation over 1 second until you see the chest begin to rise. After each ventilation, break the seal and take a breath before resealing your mouth over the patient's mouth. Then deliver the next ventilation.
