Heart Code BLS with verified questions answers

Course Overview Chain of survival High Quality CPR for adults, a child, and an infant How to use an AED Effective team dynamics in multi-rescuer resuscitation How to treat Special Considerations in basic life support How to relieve Foreign-body airway obstruction for an adult, a child and an infant What is the correct order of steps in the In-Hospital Chain of Survival for adults? -High Quality CPR -Early Recognition and prevention -Post Cardiac Arrest Care -Defibrillation -Activation of Emergency Response -Recovery 1. Early Recognition and prevention 2.Activation of Emergency Response 3.High Quality CPR 4.Defibrillation 5.Post Cardiac Arrest Care 6.Recovery What are the correct actions to take for Scene Safety and Assessment -Look for no breathing and only gasping and check pulse (scan victims chest for rise and fall for no more than 10 sec) (Check carotid pulse) -Verify Scene Safety -Check for Responsiveness (Tap shoulders, Shout 'Are you OK?") - Activate the Emergency Response System and get an AED (Activate ERS via mobile device) (Get the AED or send someone to do) To minimize delay in starting CPR you may..... Assess breathing and pulse at the same time. (no more than 10 sec) What do we know about gasping? Gasping is not normal breathing and is a sign of cardiac arrest. Pulse check on an adult 1. Locate the Trachea (on the side closest to you), using 2 or 3 fingers 2. Slide those fingers into the grove between the trachea and the muscles at the side of the neck, where you can feel the carotid pulse 3. Feel for a pulse for at least 5 but no more than 10 seconds (No pulse, begin CPR starting with chest compressions) What is the correct chest compression rate for adults ? 100 to 120/min What can Feedback devices monitor? - Compression Depth - Compression Rate - Chest Recoil Feedback devices can monitor CPR and provide real-time feedback How do you open the airway for breaths if SINGLE RESCUER is present? Head tilt - Chin lift Step 1 One hand on the victims forehead, push with palm to tilt head back. Step 2 Place fingers of the other hand under the bony part of the lower jaw, near the chin. Step 3 Lift the jaw to bring the chin forward. When using a pocket mask, where should the rescuer be positioned? At the side of the victim Bag Mask Device -Provides positive-pressure ventilation -May be used with or without oxygen flow, provides about 21% oxygen from air -Bag attached to a face mask -May include a 1 way valve depending on device After positioning yourself directly above the victim's head, what is the correct order of steps for using a bag-mask device? 1. Place Mask on Victims Face using bridge of nose as a guide 2. Use the E-Clamp Technique to hold the mask in place while you lift the jaw to hold the airway open (E Clamp : thumb and index finger make a C, pressing edges of the mask to the face while remaining fingers lift the angles of the jaw opening the airway) 3. Squeeze the bag to give breaths (1 second each) while watching for chest rise If there are two rescuers, 1. positioned directly above the victim opening airway and positioning bag-mask device. 2. Positioned at the side of the victim squeezing the bag Why is an AED Needed? (Automated external defibrillator) To analyze the heart rhythm and provide a shock in order to restore normal heart rate and rhythm There are Two life threatening arrhythmias that can cause cardiac arrest pVT and VF (pulseless ventricullar tachycardia and ventricular fibrillation) What is pVT? Pulseless ventricular tachycardia What is VF? Ventricular fibrillation What are two life threatening arrhythmias? Pulseless ventricular tachycardia (pVT) and Ventricular Fibrillation (VF) After an AED delivers a shock, what should the rescuers do next? Resume CPR, Starting with chest compressions Steps to Using an AED 1. Power on the AED & follow Prompts 2. Choose adult pads for victims 8 years of age and older 3. Attach the adhesive AED Pads to the victims bare chest 4. When the AED prompts you, clear the victim during analysis, be sure that no one is touching the victim. (the AED may take a few seconds to analyze, and some AEDs will tell you to push a button to begin analysis) 5. If AED advises a shock, it will charge then tell you again to clear the victim. Clear the victim before delivering the shock button. After any shock delivery, immediately resume CPR Where should AED pads be placed in the anterolateral placement for adults and children 8 years and older? Side of the left nipple & Below the right collarbone Where should AED pads be placed in the anteroposterior placement for adults and children 8 years and older? left side of chest halfway between the tip of the breast bone and left nipple, with the upper edge of the pad below the nipple line Place the other pad on the left side of the victim's back, beneath the shoulder blade, next to the spine Normal breathing, Pulse felt Monitor until emergency responders arrive No normal breathing, pulse felt - 1 breath every 6 seconds, or 10 breaths/min - Check the pulse every 2 minutes - if no pulse, start CPR - if possible opioid overdose, administer naloxone if available per protocol No normal breathing or only gasping, pulse not felt - Start CPR. - Perform Cycles of 30 compressions and 2 breaths -Use AED as soon as it is available Shockable rhythm - (give 1 shock and resume CPR immediately for 2 minutes/until AED allow for rhythm check) Nonshockable rhythm - (resume CPR immediately for 2 minutes/until AED allow for rhythm check) Continue CPR until ALS providers take over or the victim starts to move Pediatric Chain of Survival 1. Early recognition and prevention 2.Activation of Emergency Response 3. High Quality CPR 4. Advanced Resuscitation 5. Post-Cardiac Arrest Care 6. Recovery Pulse check in an infant 1a. Feel for a Brachial pulse (place 2-3 fingers on the inside of the upper arm) (at least 5 sec, but no more than 10 sec) (PREFERRED) or 1b. Feel for a femoral pulse (place 2 fingers in the inner thigh)(at least 5 seconds but no more than 10 seconds) 2. If no pulse within 10 sec or the heart rate is 60/min or less , BEGIN HIGH QUALITY CPR. (starting with chest compressions) What are some differences between adult and child compressions? depth of compressions and hand placement Children compression depth and rate depth : Approx. 2 inches (5cm) Rate : 100 to 120/min Children's hand placement and chest recoil Hand Placement : 2 Hands or 1 hand on the lower half of the breastbone Chest recoil : allow complete recoil; do not lean on the chest Minimizing Interruptions : limit interruptions to less than 10 seconds Chest Compressions For Infants - Rate, Depth and hand placement Rate : 100 to 120/min Depth : Approx 1 1/2 inches (4cm) Hand Placement : 1 rescuer - 2 fingers in center of chest , just below the nipple line OR may use encircling hands technique as well or heel of one hand 2 Rescuers , then use the two thumb - encircling hands technique, center of chest - just below nipple line Infant chest recoil and minimizing of interruptions Allow complete chest recoil; do not lean on the chest limit interruptions to less than 10 seconds compression to ventilation ratios for infants and children with 1 rescuer and 2 or more 1 rescuer : 30:2 2 rescuer : 15:2 witnessed vs unwitnessed collapse: children and infants Witnessed collapse alone with no mobile phone, leave the victim and activate ERS and get the AED before beginning CPR. (use AED as soon as available) not alone , send someone to get the AED and begin CPR immediately Unwitnessed Collapse 2 min CPR immediately , leave victim to activate ERS and get AED. Return to child or infant and resume CPR (use AED as soon as available) AED pad placement for children less than 8 and infants Follow as indicated on the pad packages Pediatric BLS - normal breathing and a pulse is felt monitor until emergency responders arrive Pediatric BLS - No normal breathing an a pulse is felt 1 Rescue breath every 2-3 seconds (20-30 breaths per min) assess pulse rate for no more than 10 seconds ****** ****** heart rate 60/min with signs of poor perfusion [START CPR] (add compression) heart Rate or = 60/min [continue rescue breathing] check pulse every 2 min if no pulse , start CPR Pediatric BLS - No breathing or only Gasping and no pulse felt witnessed - activate the ERS, get AED and begin CPR unwitnessed - begin CPR immediately CPR 30 compressions and 2 breaths (1 rescuer) 15 compressions and 2 breaths (2 rescuers) Use AED as soon as its available After about two minutes if you're still alone activate te ERS and retrieve AED Pediatric BLS - Once AED arrives -Use AED as soon as it is available Shockable rhythm - (give 1 shock and resume CPR immediately for 2 minutes/until AED allow for rhythm check) Non-shockable rhythm - (resume CPR immediately for 2 minutes/until AED allow for rhythm check) Continue CPR until ALS providers take over or the victim starts to move pulse check in an child or adult check carotid pulse When should the rescuer operating the AED clear the victim? During rhythm analysis and before shock delivery What team role keeps track of interruptions in compressions Time/recorder Which team role makes treatment decisions and assigns roles? Team Leader Effective team dynamics consist of - Debriefing - knowledge sharing - Constructive intervention - Clear roles and responsibilities After an AED delivers a shock, what should the rescuer do next? Resume CPR, starting with chest compressions How can you achieve a high chest compression fraction? minimize pauses in chest compressions What does the compressor do? assesses the patient and provides compressions what does the monitor/defibrillator do? Operates the AED and alternates with compressions after every 5 cycles or 2 minutes to avoid fatigue What does the airway team member do? Provides ventilation Closed loop communication the process of verifying that the message sent was received as intended. constructive intervention correcting actions when incorrect tactfully Special considerations for defibrillation in children less than 8 years of age - A manual defibrillator is preferred for infants less than 1 year of age - use smaller sized pads if available -if child pads are not included, use adult pads mouth to mouth breathing (adults, children and infants) - provides O2 to victim when a barrier mask is not available - the air you breathe into a victim contains about 17% O2 (we take breaths that contain 21% O2) - head tilt chin lift to open airway (pinch nose closed with thumb and index finger) - take breath and seal lips around victims mouth (airtight seal) - give 1 breath and blow for 1 second (watch for chest rise as you give each breath) - Finally give second breath for 1 second (seek chest rise) Which of the following are Resuscitation Triangle Roles in a high performance team? - Airway - AED/Monitor/Defibrillator - Compressor When using a pocket mask, where should the rescuer be? At the side of the victim You do mouth to mouth rescue breaths when.... a barrier device is not available Ratio for providing rescue breaths to an adult victim 1 breath : 6 seconds Ratio for providing rescue breaths to a child or infant victim? 1 breath : 2-3 Seconds how is CPR performed differently when an advanced airway is in place? No pauses for ventilations Instead of performing a compression to breath ratio of 30:2 what are the new ratios when an advanced airway is in use? 100-120 compressions per minute 1 breath every 6 seconds (adult) 1 breath every 2-3 seconds (pediatric patient) No pauses for ventilations!! What devices are considered advanced airway devices? laryngeal mask supraglottic airway devices endotracheal tubes What are common administration routes for naloxone ? - Intravenous - Intramuscular - Intranasal Naloxone A medication that can temporarily reverse the effects of opioid overdose. (intravenous, intramuscular and intranasal) Opioid associated life threatening emergency is a condition that alters breathing and pulse in what way? Causes a person to stop breathing but still have a pulse unresponsive and not breathing normally but has a pulse 1 rescue breath : 6 seconds (adult) 1 rescue breath : 2-3 seconds (child or infant) if protocol allows , give naloxone. (don't delay breaths to give naloxone) Hairy chest and AED 1 set of Pads and razor - shave area quickly 2 sets of pads only - use first set to remove hair , then apply second set Water/Sweat and AED quickly move victim to dry area , wipe chest down before attaching pads (if victim is lying in snow or a small puddle continue and use the AED) Transdermal Medicine Patch and AED Take the patch off and quickly wipe the chest before you put the pad on Implanted Defibrillator/ pacemaker and AED avoid placing pad directly over it Defibrillation for infants less than 1 years of age A Manual Defibrillator is preferred rather than an AED If not available, An AED with a pediatric does attenuator is preferred if neither is available, you may Use an AED without a pediatric attenuator Cardiac arrest in a pregnant patient Do not delay providing chest compressions Perform compressions and use AED (Shock from the AED will not harm the infant) If additional rescuers are present , perform "continuous lateral uterine displacement" if woman is revived place her on her left side (helps improve blood flow to the heart of her and infant) Signs of choking : adults and Children silent cough, inability to speak or breathe, cyanosis or turning blue Adult or older child may clutch the neck with both hands making the universal chocking sign if the victim nods that they cannot talk, you must act In a kneeling position or standing position you will perform an abdominal thrust Direction of abdominal thrust Upward If chocking victim is too large to wrap arms around waist perform chest thrust How does CPR differ in an unresponsive adult chocking victim? the airway is checked for obstructing objects Choking in infants 1. sit or kneel with the infant in your lap 2. hold the infant facedown and resting on your forearm (head slightly lower than the chest) 3. support the head and jaw with your hand 4. Rest forearm on your thigh to provide support 5. Deliver up to 5 Back Slaps forcefully (between shoulder blades with heel of hand attempting to remove foreign body) 6. Place free hand on infants back(cradle's infant as you turn into face up position) - keep head lower than chest and deliver up to 5 quick downward chest thrust! When a choking infant becomes unresponsive, what is the one thing you need to do differently when performing CPR? check the airway for obstructing object How does CPR differ in an unresponsive adult chocking victim? The airway is checked for obstructing object Relief of choking: Unresponsive infant (Do not do blind finger sweep!) If unresponsive, shout for help and send someone to activate the ERS Perform CPR {look for obstructing object each time you open the airway to give breaths} only remove the object carefully with fingers if you can see it if you are alone after 2 minutes or 5 cycles of CPR activate the ERS While performing high quality CPR, when do pauses in compressions typically occur? Defibrillation Rhythm analysis Intubation pulse checks Compressor Switches True or false : You should deliver 5 back slaps and 5 chest thrust to a choking infant who is responsive. true