CPR Review
Airway
- opens and maintains airway provides ventilation
Children typically have cardiac arrest after they have respiratory failure. T/F
True
Role of the Timer/Recorder
- records the time of interventions and medications (and announces when next are due) - records the frequency and duration of interruptions in compressions - communicates these to the team leader
The 5 steps in the adult chain of survival include all of the following except: A. early CPR B. rapid defibrillation C. advanced airway placement D. integrated post-cardiac arrest care
C. advanced airway placement Early CPR provides vital oxygen to the brain and vital organs increasing the likelihood of recovery. Rapid defibrillation increases the chance of effectively restoring a normal heart rhythm. Advanced airway placement is not part of the BLS adult chain of survival. Post cardiac arrest care reduces the possibility of long-term impairment and increases the chance of a victim making a full recovery.
Efforts to relieve choking should be stopped when: A. The obstruction is removed B. The victim becomes unresponsive C. The victim begins breathing normally D. Any of the occurs
D. Any of the above occurs There is no need to continue choking interventions if the object is dislodged and the patient can breathe once again. If a victim becomes unresponsive/unconscious, treat the situation as cardiopulmonary arrest and start CPR. Efforts to relieve chocking should be abandoned.
Where should you attempt to perform a pulse check in a child who is anywhere from 1 yr to puberty? A. Brachial Artery B. Ulnar Artery C. Temporal Artery D. Carotid Artery
D. Carotid Artery
When do you insure that the scene is safe?
as soon as you see the victim
What is the first step when responding to an emergency situation?
assess the scene/situation
A child is not breathing but has a pulse rate of 50 per minute. The rescuers should: A. Start CPR with compressions B. Give 1 breath every 5-6 seconds C. give 1 breath every 3-5 seconds D. do nothing, the child is not in distress
A. Start CPR with compressions A pulse rate < 60 bpm is consistent with cardiac arrest in children. Therefore, CPR is required, starting with chest compressions
Chain of Survival
Activate the emergency response system; CPR; Defibrillation; Advanced Life Support; Post-Cardiac arrest care
AHA considers a child what age?
Age 1 to puberty
if 2 rescuers are performing CPR for a 10 month old infant, the ratio of compressions to breaths is: A. 15 compressions: 1 breath B. 15 compressions: 2 breaths C. 30 compressions: 1 breath D. 30 compressions: 2 breaths
B. 15 compressions: 2 breaths
When assessing the victim, you should feel for a pulse for: A. 3 secs B. 5-10 secs C. 15-20 secs D. 20-30 secs
B. 5-10 secs
An AED should be used A. before performing CPR B. After performing CPR
B. After performing CPR
Which of the following best describes how a defibrillator works? A. it delivers an electrical shock to start the heart again B. It delivers an electrical shock to the heart to clear excessive electrical activity and allow the heart to regain its normal rhythm C. It delivers an electrical sock to the heart which burns damaged heart tissue D. It delivers an electrical shock to the chest to dislodge blood clots
B. It delivers an electrical shock to clear excessive electrical activity and allow the heart to regain its normal rhythm
The recommended compression depth for an adult is: A. 1 inch B. 1.5 inches C. At least 2 inches D. None of the above
C. At least 2 inches AHA recommends for adults to provide compressions at a depth of at least 2 (5 cm) inches, but not more than 2.4 inches (6 cm)
The correct sequence for basic life support is A. Airway, breathing, compressions B. Breathing, Airway, Compression C. Compressions, Airway, Breathing D. Breathing, Compressions, Airway
C. Compressions, Airway, Breathing Remember: CAB
The best place to try to find a pulse in an adult is A. The femoral artery in the upper leg B. The brachial artery in the upper arm C. The carotid artery on the side of the neck D. The radial artery on the thumb side of the wrist
C. The carotid artery on the side of the neck
The correct sequence in the AHA Adult Chain of survival is: A. Activate the emergency response system; CPR; Defibrillation; Advanced Life Support; Post-Cardiac arrest care B. Activate the emergency response system; CPR; Advanced Life Support; Defibrillation; Post-Cardiac arrest care C. Activate the emergency response system; Defibrillation; CPR; Advanced life support; Post- Cardiac arrest care. D. Advanced Life Support; Activate the emergency response system; CPR; Defibrillation; Post-Cardiac arrest care
A. Activate the emergency response system; CPR; Defibrillation; Advanced Life Support; Post-Cardiac arrest care
If performing rescue breathing, you should: A. Avoid excessive ventilation B. Provide a breath every 2 seconds C. Do not allow the chest to expand between breaths D. All of the above are correct
A. Avoid excessive ventilation Excessive ventilation may cause air to build up in the person's stomach, which may lead to difficulty providing good compressions.
AED placement
Place one pad on the right center of the person's chest above the nipple. Place the other pad slightly below the other nipple and to the left of the rib cage.
When doing mouth-to-mouth breathing for a small child or infant, it is acceptable to cover the victims mouth and nose with your mouth to form an airtight seal. T/F
True
How long do you take for a pulse check?
min 5 secs and max 10 secs
When is CPR required?
no pulse or breathing & unconscious
Compression-Ventilation ratio without advanced airway on a child or infant with 1 rescuer.
30:2
How is choking best relieved in a responsive infant?
5 back slaps and 5 chest thrusts
Hand placement during adult CPR
2 hands on the lower half of the breastbone (sternum)
Hand placement during child CPR
2 hands or 1 hand (optional for very small child) on the lower half of the breast bone (sternum)
Hand placement on infant during CPR w two rescuers
2 thumb- encircling hands in the center of the chest, just below the nipple line
Completing a jaw thrust maneuver
- grasp the angles of the lower jaw and lift with both hands, one on each side, moving the jaw forward
Compression depth for an infant
- At least 1/3 AP diameter of chest - About 1 1/2 inches (4 cm)
Compression depth for a child
- At least 1/3 AP diameter of chest - About 2 inches (5 cm)
Recognition of Cardiac Arrest for adult, child, and infant
- Check for responsiveness - Assess for abnormal breathing; no breathing or only gasping - No definite pulse felt within 10 seconds - Breathing and pulse check can be performed simultaneously in less than 10 secs
Compression-Ventilation ratio with advanced airway for adults, children, and infants.
- Continuous compressions at a rate of 100-120/min - Give 1 breath every 6 secs (10 breaths/min)
Role of Compressor
- assess the pt. - does 5 cycles of chest compressions - alternates with AED/Monitor/Defibrillator every 5 cycles or 2 minutes (or earlier if signs of fatigue set in)
AED Monitor
- brings and operates the AED/monitor/defibrillator - Alternates with compressor every 5 cycles or 2 minutes (or earlier if signs of fatigue set in), ideally during rhythm analysis) - if a monitor is present, places it in position where it can be seen by team leader and most of the team
Role of the Team Leader
- every resuscitation team must have a defined leader - assigns roles to team members - provides feedback to the rest of the team as needed - assumes responsibility for roles not assigned
Activation of Emergency response system if an unwitnessed collapse of a child or infant.
1. Give 2 minutes of CPR 2. Leave the victim to activate the emergency response system and get the AEd 3. Return to the child or infant and resume CPR; use the AED as soon as it is available
Compression-Ventilation ratio without advanced airway on a child or infant with 2 rescuers.
15:2
Hand placement on infant during CPR w one rescuer
2 fingers in the center of the chest, just below the nipple line
Compression depths should be no more than _________.
2.4 inches or 6 cms
Compression-Ventilation ratio without advanced airway on an adult with 1 or 2 rescuers.
30:2
When performing rescue breathing, each breath should last: A. 1 second B. 5 seconds C. 10 seconds
A. 1 second
You are alone and find an unconscious victim on the ground who may need CPR. The scene is safe. You assess the victim and determine he is not breathing and will not awaken. You should: A. Call for help B. Start chest compressions C. Check for a pulse D. Begin rescue breathing
A. Call for help If you are alone with the victim, first call for help. If no one responds immediately call 911.
On an infant, if you are the lone rescuer, you should perform compressions: A. Using 2 fingers just below the nipple line B. Using the heel of one hand just below the nipple line C. Using the heel of 2 hands just below the nipple line D. none of the above
A. Using 2 fingers just below the nipple line
When performing an abdominal thrust, where should you place your hands first? A. just above the belly button B. just below the belly button C. anywhere in the lower region of the abdomen D. anywhere in the upper region of the abdomen
A. just above the belly button
If an infant victim has a pulse but is not breathing, you may decide to do rescue breathing only. For this infant victim, you should provide a breath: A. every 1-2 secs B. Every 3-5 secs C. Every 5-6 secs D. Every 10 secs
B. Every 3-5 secs
A victim probably has a neck injury. What is the correct way to open the aiway? A. head-tilt-chin lift B. Jaw thrust
B. Jaw thrust A head-tilt-chin lift is effective in opening the patient's airway, but may put stress on an unstable cervical spine. In a suspected neck injury, a jaw thrust without bending the victims neck is preferable.
Assessing the victim includes all of the following EXCEPT: A. shake his/her shoulder B. Look, listen, and feel for breathing C. Yell at him/her or call his name D. Observe his breathing
B. Look, listen, and feel for breathing Instead, shake the victims shoulder, yell at him or call his name, and observe to see if he/she is breathing or breathing abnormally. Look, listen, and feel is no longer in the AHA guidelines.
The proper steps for operating an AED are: A. Power on the AED, attach electrode pads, shock the individual, and analyze the rhythm B. Power on the AED, attach electode pads, analyze the rhythm, clear the individual, and deliver shock C. Attach electrode pads, check pulse, shock individual, and analyze rhythm D. Check pulse, attach electrode pads, analyze rhythm, shock patient
B. Power on the AED, attach electode pads, analyze the rhythm, clear the individual, and deliver shock The patient must be analyzed before the AED will advise a shock This represents the correct steps for operating an AED. The rhythm must be analyzed before the AED will advise a shock. A pulse check should have been done prior to attaching the AED and is not part of AED operation. This sequence does not begin with powering on the AED.
The best place to check an infant's pulse is: A. The femoral artery in the upper leg B. The brachial artery in the upper arm C. The carotid artery on the side of the neck D. the radial artery on the thumb side of the wrist
B. The brachial artery in the upper arm
You and a friend are walking when you see an elderly man collapse in front of you. There are no hazards around. You assess the man and determine that he is unconscious and is not breathing. You should direct your friend to: A. check the pulse B. begin CPR C. Activate the emergency response team D. Open the airway
C. Activate the emergency response team
In an adult with an advanced airway in place during 2 rescuer CPR, how often should the breaths be administered? A. every 2-3 secs (20-30 breaths/min) B. Every 4-5 secs (12-15 breaths/ min) C. Every 6-8 secs (8-10 breaths per min) D. Every 10-12 secs (5-6 breaths/min)
C. Every 6-8 secs (8-10 breaths/min)
A child is gasping for breath but has a pulse rate of 100 bpm. The rescuers should: A. start CPR beginning with compressions B. Give 1 breath every 5-6 seconds C. Give 1 breath 3-5 seconds D. Do nothing, the child is not in distress
C. Give 1 breath every 3-5 seconds This child needs rescue breathing, not chest compressions. The correct rate for pediatric rescue breathing is 1 ventilation every 3-5 seconds. This equates 12-20 breathes per minute.
How often should rescuers switch roles when performing two-rescuer CPR? A. after every cycle of CPR B. after every two cycles of CPR C. after every 5 cycles of CPR D. after every 10 cycles of CPR
C. after every 5 cycles of CPR Changing roles after every cycle of CPR will create too many interruptions and impair successful resuscitation. Changing roles after every 2 cycles of CPR will create frequent interruptions in perfusion and is not consistent with AHA recommendations. Changing roles after every 5 cycles of CPR is the currently recommended frequency to promote high quality CPR. CPR is physically demanding and waiting to switch roles every 10 cycles will likely fatigue the rescuer performing chest compressions resulting in lower quality CPR.
For any victim the compression rate is: A. At least 120 per minute B. At least 80 per minute C. At least 90 per minute D. 100 to 120 per minute
D. 100 to 120 per minute
If you have 2 rescuers for an adult victim and one or both are comfortable giving rescue breaths, the correct ratio of compressions to breaths is: A. 15 compressions: 1 breath B. 15 compressions: 2 breaths C. 30 compressions: 1 breath D. 30 compressions: 2 breaths
D. 30 compressions: 2 breaths
An infant who had been choking becomes unresponsive. The rescuer should: A. Alternate back slaps and chest thrusts B. Perform a blind finger sweep to attempt to remove obstruction C. Attempt to dislodge the obstruction using abdominal thrusts D. Begin CPR
D. Begin CPR Back blows, chest thrusts, or abdominal thrusts are not to be used if the choking victim becomes unconscious.
For a child needing CPR who has been down an unknown amount of time, the first thing you should do is: A. go for an AED B. Call 911 to activate emergency response system C. Provide rescue breaths D. Do CPR for 2 minutes before you call for help
D. Do CPR for 2 minutes before you call for help
When delivering "back blows", where should you aim for on the patient's back? A. over the shoulder blade B. Anywhere C. The lower region D. In-between the shoulder blades
D. In-between the shoulder blades
If you are alone and come upon a person who may need CPR, the first thing you should do is: A. Activate the emergency response system B. Begin CPR C. Go for an AED D. Make sure the scene is safe
D. Make sure the scene is safe
During CPR, if the victims chest does not arise after 2 attempts to give breaths, you should: A. attempt to give breaths until you see the chest rise B. Readjust the head using a jaw thrust maneuver C. Blow harder into the victims mouth D. Start chest compressions again
D. Start chest compressions again
If you are performing rescue breathing for an adult victim with a pulse, you should do all of the following except: A. Check for a pulse every 2 minutes B. Open the airway by using a head tilt/chin lift C. Use a barrier or mask if you have one D. With your index finger, sweep the victim's mouth to ensure there are no foreign bodies
D. With your index finder, sweep the victims mouth to ensure there are no foreign bodies
Which of the following are signs of airway obstruction? A. poor air exchange B. high-pitched noise while inhaling C. inability to speak D. all of the above
D. all of the above
The critical characteristics of high-quality CPR include which of the following? A. starting chest compressions within 10 seconds of recognition of cardiac arrest B. pushing hard and fast C. minimizixng interruptions D. all of the above
D. all of the above Minimizing interruption of circulation by quickly recognizing cardiac arrest and beginning CPR is an important characteristic of high-quality CPR and is emphasized by the AHA guidelines. Pushing hard enough to compress the heart and squeeze blood out, and fast enough to raise blood pressure is a vital characteristic of high-quality CPR and is emphasized in the 2015 AHA guidelines. Minimizing interruptions in CPR keeps blood pressure high enough to perfuse vital organs including the heart and brain and is critical to improving outcomes in cardiac arrest.
If you have 2 rescuers for an infant victim, you should: A. Two hands on the sternum to deliver compressions B. Two fingers on the sternum to deliver compressions C. One hand on the sternum to deliver compressions D. Two thumbs on the sternum to deliver compressions
D. two thumbs on the sternum to deliver compressions
The general public should never attempt to do rescue breathing. T/F
False
You cannot use an adult AED on an infant. T/F
False
When Assessing the victim, you should remember to "look, listen, and feel" for breathing. T/F
False Observe for abnormal breathing. If the person does not appear to be breathing, is breathing abnormally, or is only gasping, begin CPR immediately if the pulse is absent as well.
Chest recoil
allow full recoil of chest after each compression; do not lean on the chest after each compression
AED stands for ______ ______ ________
automated external defibrillator
What is the meaning of the initials CPR
cardiopulmonary resuscitation
Minimizing interruptions
limit interruptions in chest compressions to less than 10 seconds
Why is it important to compress the appropriate depth in CPR?
to promote circulation
The visible rise of the stomach which rescue breathing could be a clue of what?
you are incorrectly doing rescue breath
The visible rise of the chest with each rescue breath tells you what?
you are performing it correctly
