Lesson 3:Basic Life Support for Adults
You demonstrate high-quality CPR by keeping interruptions in CPR to less than _____ seconds.
10
high-quality CPR includes:
30 chest compressions followed by 2 ventilations.
You are working as part of a high-performance BLS team. Which roles would you and the other providers most likely fill?
-Airway manager/ventilator -AED operator -Team leader -Compressor
You are working with a BLS team performing CPR on a 62-year-old female patient. Which actions demonstrate high-quality CPR?
-Deliver smooth ventilations that last about 1 second each and make the chest begin to rise. -Allow for full chest recoil after each compression. -Compress the chest at a rate of 100 to 120 per minute.
You are delivering ventilations with a bag-valve-mask (BVM) resuscitator to an adult patient in cardiac arrest. Which actions are correct?
-Ensure that the chest begins to rise. -Hold the mask in place with the E-C hand position. -Seal the mask and open the airway by lifting the jaw into the mask.
Identify the situations in which it is safe to use an AED.
-If the patient is experiencing cardiac arrest as a result of a traumatic injury -If the patient is pregnant-If the patient is wearing jewelry or has body piercings, providing the AED pads are not placed directly over any metallic jewelry or piercings -If the patient has a pacemaker or implantable cardioverter -defibrillators (ICDs), providing the AED pads are not placed directly over the device -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
An adult patient suffers cardiac arrest in bed and requires CPR. When compressing the patient's chest, which technique promotes high-quality CPR?
-Position yourself so your shoulders are directly over your hands. -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. -Keep your arms straight and lock your elbows. Compress the chest using a straight down-and-up motion.
Valerie has established that Mr. Goodman does not have a pulse and is not breathing, 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?
-Provide smooth compressions at a rate of 100 to 120 compressions per minute and a depth of at least 2 inches. -Avoid excessive ventilations. -Allow the chest to fully recoil after each compression.
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?
-The compressor should continue providing compressions until the AED pads are applied and the AED prompts that it is analyzing. -Team members should rotate roles every 2 minutes, which is generally during the AED analysis, to prevent compressor fatigue. -After the shock is delivered, the team should immediately resume CPR. They do not need to wait for the AED prompt.
You are evaluating the quality of CPR provided by the BLS team. Which methods would you use for this evaluation?
-Visual observation -Chest compression fraction -Feedback device -Capnography
You and another provider are performing CPR on an adult patient in cardiac arrest. An advanced airway is not yet in place. Which actions demonstrate appropriate care?
-You use the same hand position and compression rate and depth as you would for single-provider CPR. -One provider focuses on rapid assessment and starting CPR; the other calls for additional resources and gets the AED. -You use a compression-to-ventilation ratio of 30:2.
You have been performing multiple-provider CPR on a patient in cardiac arrest. The patient is now showing signs of return of spontaneous circulation (ROSC). Which action(s) would the team perform?
-stop CPR -Check for breathing and pulse -Monitor the patient until the advanced cardiac life support team takes over.
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?
-the provider delivers 1 ventilation every 6 seconds -The provider performs continuous compressions without pausing for ventilations.
Provide smooth compressions at a rate of at least _____ and a depth of at least 2 inches, allowing the chest to fully recoil after each compression. Minimize interruptions in chest compressions to less than 10 seconds. Provide smooth, effortless ventilations that last about _____each and make the chest begin to rise, avoiding excessive ventilations.
100 to 120 per minute 1 second
Providers should switch off giving compressions every _______—or sooner if the provider giving compressions is fatigued.
2 minutes
When checking for a pulse and breathing, assess the patient for at least _______
5 seconds but no more than 10.
what actions are required after confirming the patient needs BLS?
Basic life support (BLS) for a patient in cardiac arrest includes high-quality CPR and the use of an AED. BLS also includes the delivery of ventilations to patients in respiratory arrest.
why we perform CPR?
CPR is needed to circulate blood containing oxygen to the patient's vital organs.
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.
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
ROSC
Return of Spontaneous Circulation- when pulses return to a patient who has been in cardiac arrest
After the resuscitation event, the BLS team conducted a debriefing session to ensure continuous CPR quality improvement. Which observation or data point suggests a need for improvement?
The chest compression fraction (CCF) was 58%. According to expert consensus, a CCF of at least 60% is needed to promote optimal outcomes, and the goal should be 80%.
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?
True
If capnography were in use, an ETCO2 level of ___ would indicate to the team that there could be a problem with the quality of chest compressions.
When capnography is in use, an ETCO2 below 10 mmHg indicates that there could be a problem with the quality of chest compressions.
when to perform Basic Life Support for Adults?
When the heart and normal breathing have stopped
Joanne and Valerie switched to operating the BVM. While Joanne sealed the mask, Valerie depressed the bag. What is the correct volume of air to deliver during ventilations?
When using the bag-valve-mask resuscitator, depress the bag about halfway to deliver a volume of 400 to 700 mL.
CPR
cardiopulmonary resuscitation
To minimize interruptions in compressions, ___so you are ready to _____ immediately as soon as the analysis is complete, a shock is delivered or both. Remember never to touch the patient while the AED is analyzing the rhythm or when a shock is being delivered.
hover in position resume CPR
That's correct. When a patient has a ______ adjust pad placement as necessary to avoid placing the AED pads directly over the device.
pacemaker or ICD Note: A pacemaker or ICD may be placed in the right upper chest near the clavicle or in the abdomen.
capnography
procedure to record carbon dioxide levels
what is the purpose of chest compressions and ventilations?
provides only a fraction of the normal blood flow to the brain and heart.
To optimize patient outcomes and increase the likelihood of _____________________________ providers must strive to provide the highest quality CPR at all times.
return of spontaneous circulation (ROSC),