BSL study guide

After checking for breathing and a pulse, you verify that the child is not breathing normally but has a pulse. His airway is not obstructed. How do you deliver rescue breaths?

1 breath every 2 to 3 seconds, or about 20 to 30 breaths per minute.

What is the correct ventilation rate?

1 breath every 6 seconds 10 breaths per minute. Check for pulse every 2 minutes and do CPR if there is no pulse.

What is the recommended compression to ventilation ratios for infants and children?

1 rescuer: 30:2 2 or more: 15:2

What is the hand placement of chest compressions in infants?

1 rescuer= 2 fingers in the center of the chest, just below the nipple line 2 rescuers=use the 2 thumb

What is the depth of chest compressions in infants?

1 ½ inches (4 cm)

What is the role of an Airway/Rescuer?

Positioned by the victim's head Maintains open airway and delivers breaths while watching for chest rise and avoiding excessive ventilation.

You check the infant's pulse every 2 minutes and detect the heart rate is less than 60/min with signs of poor perfusion. While your colleague begins CPR, what actions do you need to take?

Power on the AED, follow the prompts, and use the child pads

How do you assess for breathing?

Scan the victim's chest for rise and fall (no more than 10 sec.)

The AED detects a shockable rhythm and advises a shock. After delivering 1 shock, you and your partner immediately resume CPR by using what ratio and which compressions technique?

complete cycles of 15 compressions and 2 breaths, and use the 2 thumb-encircling hands technique

When only 2 rescuers are present, they take what roles?

compressor and airway monitor/defibrilator and team leader

If 3 rescuers are present, they take what roles?

compressor, airway and monitor/defibrilator

When compressions are paused, what happens?

compressors should hover their hands over the chest and be prepared to resume compressions

For seamless transitions, when should you switch?

every 2 minutes

What are the steps in the out of hospital chain of survival for adults?

Activation of Emergency Response High quality CPR Defibrillation Advanced resuscitation Post Cardiac Arrest Care Recovery

What is the target rate for chest compressions for children and infants?

100 to 120/min

What is the correct rate for CPR?

100-120 compressions a minute.

What is the correct hand placement for CPR?

2 hands on the lower half of the breastbone.

What is the correct hand placement for chest compressions in children?

2 hands or 1 hand on the lower half of the breastbone.

How do you check pulse on an infant?

2 or 3 fingers on inside of the upper arm, halfway between shoulder and elbow.

Defibrillation for infants less than 1 year of age

A manual defibrillator An AED with pediatric dose attenuator. If neither is available, you may use an AED without pediatric dose attenuator.

What should you do when you see an adult choking victim?

Abdominal thrust on an upward direction If chocking victim is too large, you should perform chest thrusts.

If person is not responsive, what do you do?

Activate emergency response system (AED)

When should rescuers switch compressors?

After every 5 cycles of CPR about every 2 minutes, or sooner if tired.

What do you do for an unwitnessed collapse for children and infants?

Alone= start CPR (cycles of 30:2.) After about 2 minutes, if you are still alone, activate the emergency response system and get an AED if not already done. Use the AED as soon as it is available. Not alone=send someone to get AED and begin CPR immediately. Use the AED as soon as it is available.

Why is an AED is needed?

Analyze the heart rhythm and provide a shock.

What is the AED pad placement for adults and children 8 years or older?

Anterolateral Placement. Below the right collarbone Side of the left nipple, few inches below the armpit.

What is the correct depth for chest compressions in children?

Approximately 2 inches (5 cm)

What is the correct approach of an AED pad placement for infants and children less then 8 years of age?

As indicated on the pad packages

What is the role of a compressor?

Assesses the victim. Stays next to the victim's chest to perform chest compressions

What is the correct depth for CPR?

At least 2 inches (5cm)

How do you use an AED on an adult?

Attach the adhesive AED pads to the victim's bare chest Anterior Posterior placement= Left side of the chest and left side of the back. Clear the victim during analysis. Be sure that no one is touching the victim.

If the victim is not breathing or is only gasping, what do you do?

Begin high quality CPR (Sign of cardiac arrest)

Until the AED delivers a prompt to clear the victim for analysis, what should rescuers do?

Continue high quality CPR.

How do you deliver rescue breaths?

Cycle of 30 compressions and 2 breaths.

What should you do when you see an infant choking victim?

Deliver up to 5 back slaps forcefully between the infant's shoulder blades using heel of your hand. Deliver up to 5 quick downward chest thrusts (1 per sec.)

What is the role of a Team leader?

Foot of victim but may move around to observe and evaluate the skills of the team and provide feedback when needed.

The child is unresponsive after you tap his shoulders and shout, Are you okay?'' He could be in cardiac arrest. What is your next step?

For 5 to 10 seconds, look for no breathing or only gasping, while simultaneously checking the carotid pulse.

The infant is unresponsive when you tap her foot and shout "Are you OK?" She could be in cardiac arrest. What is your next step?

For 5-10 seconds, look for no breathing or only gasping while simultaneously checking the brachial pulse

You check the child's pulse after 2 minutes of providing rescue breaths and cannot feel a pulse. You immediately begin CPR. After performing CPR for 2 more minutes, the child still does not have a pulse and you are still alone.What is your next step?

Get and use an AED.

What is the sequence for mouth to mouth breaths for adults?

Head tilt- chin lift Pinch the nose and seal your lips around the victim's mouth Give 1 breath and blow for about 1 second Watch for chest rise while giving the breath Give a second breath (blowing for about 1 second, watching for chest rise)

What is the sequence for mouth to mouth breaths on an Infant?

Head tilt- chin lift Place mouth over infant's mouth and nose to create an airtight seal Give one breath, blowing for about 1 seconds, watching for chest rise

How do you open the airway for breaths if a single rescuer is present?

Head tilt- chin lift.

What are the steps for using a bag mask device?

Place mask on victim's face. E-C clamp to hold mask, while lifting the jaw to hold the airway open. Squeeze the bag to give breaths (1 second each) while watching chest rise.

After 4 minutes of rescue breathing, there appears to be no pulse. what do you do next?

Immediately begin CPR and continue the AED.

After any shock delivery, what do you do?

Immediately resume CPR.

What is the common administration routes for naloxone?

Intranasal Intramuscular Intravenous

What is the role of a Timer/ Recorder?

Keeps record of the events that occur, including frequency and duration of interruptions in chest compressions, time of shock delivery and medication administration.

What are the steps for Carotid Pulse?

Locate trachea (2 or 3 fingers) Feel for pulse (5 no more than 10 sec.) No pulse= CPR starting with chest compressions

What are the steps?

Make sure scene is safe. Check for responsiveness. Assess for breathing and pulse. Activate the emergency response system and get an AED.

What do you do for a witnessed collapse for children and infants?

No mobile phone= leave the victim to activate the emergency response system and get the AED before beginning CPR. Use the AED as soon as it is available.

How do you open the airway for breaths?

One hand on victim's forehead, palm to tilt head back. Place fingers under bony part of the lower jaw. Lift the jaw to bring the chin forward.

When 2 or more rescuers are present, what happens?

One rescuer should continue chest compressions while the other operates the AED.

What is the role of a Monitor/ Defibrillation?

Operates AED CPR coach Focus on team member's performance of high quality CPR and provide feedback as needed during resuscitation attempt

If infant becomes unresponsive what should you do?

Shout for help and send someone to activate emergency response system. Place infant on hard flat surface. Begin CPR with 1 exception (each time you open the airway to give breaths, look for obstructing object) If you seen an object that can easily be removed, carefully remove with fingers (not a blind finger sweep) If you are not alone, after 2 minutes or 5 cycles of CPR, activate emergency response system.

When using a pocket mask, where should the rescuer should be positioned?

Side of the victim.

How do you check for responsiveness?

Tap and shout "Are you ok?"

If pediatric pads are unavailable. What should you do?

Use the adult pads.

If no shock is needed do you immediately resume CPR, starting with compression?

Yes

For chest recoil should you allow complete recoil?

Yes, but do not lean on the chest.

Can you assess breathing and pulse at the same time?

Yes, but take no more than 10 sec.

When do pauses occur?

intubation rhythm analysis, pulse checks, compressor switches and defibrillation

If an infant isn't breathing normally but has a pulse, what do you need to do?

provide rescue breaths, with 1 breath every 2-3 seconds