CPR to know

Step 1: choking in infants

-first sit or kneel with the infant in your lap -hold the infant facedown and resting on your forearm, with the head slightly lower than the chest -support the head and jaw with your hand

Rescue breathing: children/infants

-give 1 breath every 2 to 3 seconds (20 to 30 breaths/min) -give each breath over 1 second, and make sure there is chest rise with each breath -during rescue breathing, check the victim's pulse every 2 minutes

Step 2: mouth-to-mouth-and-nose breathing: infants

place your mouth over the infant's mouth and nose to create an airtight seal

How does CPR differ in an unresponsive adult choking victim?

the airway is checked for the obstructing object

Step 1: abdominal thrusts: adults and children

stand or kneel behind the victim and place your arms around the victim's waist; with one hand, locate the navel.

Which team role makes treatment decisions and assigns roles?

team leader

Which team role keeps track of interruptions in compressions?

timer/recorder

Mouth-to-mouth breaths: adults, children, and infants

-3 steps -mouth-to-mouth breathing is a quick and effective way to provide oxygen to a victim when a barrier mask is not available -each breath you take contains 21% oxygen. When you provide a rescue breath, the air you breathe into a victim contains about 17% oxygen

Which of the following are resuscitation triangle roles in a high-performance team?

-AED/Monitor/Defibrillator -compressor -airway

Advanced airways

-a laryngeal mask airway, supraglottic airway device, and endotracheal tube are types of advanced airways -when an advanced airway is in place: perform continuous compressions at 100 to 120/min give 1 breath every 6 seconds for adults give 1 breath every 2 to 3 seconds for a child or infant no pauses in compressions to give breaths

Defibrillation for infants less than 1 year of age

-a manual defibrillator is preferred rather than an AED -if a manual defibrillator is not available, an AED with a pediatric does attenuator is preferred -if neither is available, you may use an AED without a pediatric dose attenuator

Transdermal medicine patch

-do not place the pad directly over a medicine patch -take the patch off and quickly wipe the chest before you put on the pad

Step 3: mouth-to-mouth breaths: adults, children, and infants

-give a second breath (blowing for about 1 second) while watching for chest rise

Signs of choking: adults and children

-with a severe airway obstruction, the victim will show signs of poor air exchange and difficulty breathing such as *silent cough *inability to speak or breathe *cyanosis (turning blue) -an adult or older child may clutch the neck with both hands, making the universal choking sign. If the victim nods that they are chocking, you must act

When providing rescue breaths to an adult victim, you should give _____ breath(s) every _____ seconds

1 & 6

What is the correct order of steps in the in-hospital chain of survival for adults?

1. Early recognition and prevention 2. Activation of emergency response 3. High-quality CPR 4. Defibrillation 5. Post-cardiac arrest care 6. Recovery

What is the correct sequence of actions for performing mouth-to-mouth-and-nose breaths for an infant?

1. Perform a head tilt-chin lift 2. Place your mouth over the infant's mouth and nose to create an airtight seal 3. Give one breath, blowing for about 1 second, watching for chest rise

Your adult friend suddenly collapse at home, and you determine she needs CPR. You begin CPR, starting with chest compressions, and are about to deliver breaths by using mouth-to-mouth breaths. You open the airway with a head tilt-chin lift. What is the sequence of your next actions?

1. Pinch the nose and seal your lips around the victim's mouth 2. Give 1 breath and blow for about 1 second 3. Watch for chest rise while giving the breath 4. Give a second breath (blowing for about 1 second, watching the chest rise)

What is the correct order of steps of the pediatric out-of-hospital chain of survival?

1. Prevention 2. Activation of emergency response system 3. High-quality CPR 4. Advanced resuscitation 5. Post-cardiac arrest care 6. Recovery

You should deliver _____ back slaps and _____ chest thrusts to a choking infant who is responsive

5 & 5

When an advanced airway is in place, chest compressions should be provided at a rate of ______ to ______ per minute

100 to 120

When providing rescue breaths to a child or infant victim, you should give 1 breath every _____ to _____ seconds

2 to 3

When providing rescue breaths to a child or infant victim, you should give 1 breath every _______ to _______ seconds

2 to 3

Abdominal thrusts: adults and children

3 steps

Choking in infants

3 steps

Cardiac arrest in a pregnant patient

High-quality CPR can increase the mother's and the infant's chance of survival -perform compressions and use an AED as you would for any cardiac arrest victim. Shock from the AED will not harm the infant -if additional rescuers are present and rescuers are trained, perform continuous lateral uterine displacement, in addition to high-quality BLS -if the woman is revived, place her on her left side. This may help improve blood flow to her heart and therefore, to the infant

When a chocking infant becomes unresponsive, what is the one thing you need to do differently when performing CPR?

check the airway for the obstructing object

If a choking victim is too large for you to wrap your arms around the waist, you should perform ________ thrusts

chest

Assigning your team members to individual roles and outlining what each member needs to do during the resuscitation attempt is an example of what element of high-performance team dynamics?

clear roles and responsibilities

A rescuer arrives at the side of an adult victim and suspects an opioid-associated life-threatening emergency. The victim is unresponsive and not breathing normally but has a pulse. What is the next action the rescuer should take?

give 1 rescuer breath every 6 seconds

Step 3: mouth-to-mouth-and-nose breathing: infants

give one breath, blowing for about 1 second. Watch for the chest to rise as you give the breath

AED special considerations

hairy chest, water, transdermal medicine patch, implanted defibrillator or pacemaker, defibrillation for infants less than 1 year of age

When performing abdominal thrusts on adults and children, in which direction should your thrusts be directed?

upward

What is the indication for mouth-to-mouth rescue breaths?

when a barrier device is not available

Mouth-to-mouth-and-nose breathing: infants

3 steps

Rescue breathing: adults

-give 1 breath every 6 seconds (10 breaths/min) -give each breath over 1 second and make sure there is visible chest rise with each breath -during rescue breathing, check the victim's pulse every 2 minutes

Step 3: abdominal thrusts: adults and children

-grasp your fist with the other hand and press your fist into the victim's abdomen with a quick, forceful upward thrust -repeat thrusts until the object is expelled from the airway or the victim becomes unresponsive

Step 1: mouth-to-mouth breaths: adults, children, and infants

-hold the victim's airway open with a head tilt-chin lift -pinch the nose closed with your thumb and index finger

Choking: unresponsive adults or children

-if a choking victim becomes unresponsive, send someone to activate the emergency response system -lower the victim to the ground -perform CPR with 1 exception: each time you open the airway to give breaths, look for the obstructing object -if you see an object that can be easily removed, carefully remove with your fingers. Do not do a blind finger swab

What is recommended to minimize interruptions in compressions when using an AED?

-if no shock is advised and after any shock delivery, immediately resume high-quality CPR, starting with chest compressions -when 2 or more rescuers are present, one rescuer should continue chest compressions while the other prepares the AED -continue with high-quality CPR until an AED prompts to clear

Water

-if someone is lying in water, quickly move the victim to a dry area; if the victim is lying is snow or a small puddle, use the AED -if the chest is covered with water or sweat, wipe the chest before attaching the pads

Implanted defibrillator or pacemaker

-if you see a lump indicating a device, avoid placing the pad directly over it

Hairy chest

-if your AED has 1 set of pads and a razor, quickly shave the area and then apply the pads -if your AED has 2 sets of pads, use the first set to remove the hair. Apply the first set of pads, press them down so they stick as much as possible, and quickly pull them off. Then apply the new, second set of pads

While performing high-quality CPR, when do pauses in compressions typically occur?

-intubation -compressor switches -defibrillation -rhythm analysis -pulse checks

Opioid-associated life-threatening emergency

-opioid-associated life-threatening emergency is a condition that can cause a person to stop breathing but still have a pulse -naloxone is a medication that can temporarily reverse the effects of opioid overdose *common routes of administration for naloxone include intravenous, intramuscular, and intranasal -for a person who is unresponsive and not breathing normally but has a pulse: *give 1 rescue breath every 6 seconds in an adult *give 1 rescue breath every 2 to 3 seconds in a child or infant *then, if your local protocol allows, give naloxone. Don't delay breaths to give naloxone

Step 3: choking in infants

-place your free hand on the infant's back, supporting the head with the palm of your hand. This will cradle the infant as you turn the infant over faceup -keep the infant's head lower than the chest, and deliver up to 5 quick downward chest thrusts *do this at a rate of about 1 per second, each with the intention of creating enough force to dislodge the foreign body -repeat the sequence until the object is removed or the infant becomes unresponsive

Step 2: choking in infants

-rest your forearm on your thigh to provide support -deliver up to 5 back slaps forcefully between the infant's shoulder blades, using the heel of your hand *deliver each slap with sufficient force to attempt to remove the foreign body

Step 2: mouth-to-mouth breaths: adults, children, and infants

-take a regular breath and seal your lips around the victim's mouth, creating an airtight seal -give 1 breath and blow for 1 second -watch for the chest to rise as you give each breath

What are the special considerations for defibrillation in children less than 8 years of age?

-use smaller-sized pads, if available -if child pads are not included, use adult pads -a manual defibrillator is preferred for infants less than 1 year of age

With an advanced airway in place, rescue breaths should be given at a rate of ______ breath(s) every ______ second(s) for adults

1 & 6

provides ventilation

airway

What is a correct approach for AED pad placement for infants and children less than 8 years of age?

as indicated on the pad packages

You respond to a collapsed pregnant female as the only rescuer You follow the BLS sequence and find that she is unresponsive, is not breathing, and has no pulse She is visibly pregnant You activate the emergency response system What is your next action?

begin chest compressions

What are examples of effective team dynamics?

clear roles and responsibilities debriefing constructive intervention knowledge sharing always take the lead

You and your team have initiated compressions and ventilation. The AED was attached, and "no shock" was advised. Your team has continued CPR for 1 minute. You tell your team in a respectful, clear, and calm voice, "Leslie, during the next analysis by the AED, I want you and Justin to switch positions, and I want you to perform compressions for the next cycle." Leslie replies, "Got it. Next time the AED analyzes, I will switch with Justin and assume the role of Compressor." This is an example of which element of high-performance team dynamics?

closed-loop communication

What does a chest compression feedback device monitor?

compression rate compression depth chest recoil

Assesses the patient and provides compressions

compressor

As Team Leader, you notice that your Compressor is pushing too fast. It is important to correct actions that are incorrect, but it is also important to be tactful when delivering this correction to a colleague. This is an example of what element of team dynamics?

constructive intervention

What action can you take as a team during and after a resuscitation attempt that helps individual team members perform better and brings awareness to system strengths and deficiencies?

debriefing

To avoid fatigue, when should team roles alternate providing compressions?

every 5 cycles or 2 minutes

What are some of the special considerations when using an AED?

excessive chest hair implanted defibrillators/pacemakers water transdermal medicine patches

Relief of choking: unresponsive infant

if the infant becomes unresponsive: -shout for help and send someone to activate the emergency response system -place the infant on a hard, flat surface -begin CPR with 1 exception: each time you open the airway to give breaths, look for the obstructing object -if you see an object that can be easily removed, carefully remove it with your fingers. Do not do a blind finger sweep -if you are alone, after 2 minutes of 5 cycles of CPR, activate the emergency response system

Choking in obese and pregnant victims

if the victim is too large for you to wrap your arms around the waist: -wrap your arms around his or her chest -perform chest thrusts instead of abdominal thrusts

What is a sign of severe airway obstruction?

inability to speak

What are common administration routes for naloxone?

intramuscular intranasal intravenous

You witnessed the collapse of a child You are the only rescuer and do not have a mobile phone After confirming no breathing and no pulse, what is your next step?

leave the victim to activate the emergency response system and get the AED

Step 2: abdominal thrusts: adults and children

make a fist with the other hand and place the thumb side of your fist against the victim's abdomen, just above the navel and well below the breastbone

How can you achieve a high chest compression fraction?

minimize pauses in chest compressions

Operates the AED and alternates with the Compressor after every 5 cycles or 2 minutes to avoid fatigue

monitor/defibrillator

How is CPR performed differently when an advanced airway is in place?

no pauses for ventilations

Step 1: mouth-to-mouth-and-nose breathing: infants

open the infant's airway with a head tilt-chin lift