QUESTIONS AND ANSWERS SURE A+
✔✔BLS for Adult 3. Provide CPR/AED Care - ✔✔Review the specific care steps for a
patient in cardiac arrest who does not have an advanced airway in place:
-Single-Provider CPR
-Multiple-Provider CPR
-AED Use
-Stopping CPR/AED Use
✔✔BLS for Adult single-Provider CPR - ✔✔1. Provide chest compressions
-The compressor exposes the chest.
-The compressor performs 30 chest compressions. The compressor centers their
hands on the lower half of the sternum and compresses the chest to a depth of at least
2 inches (5 cm) at a rate of 100 to 120 compressions per minute, allowing for full chest
recoil. It should take 15 to 18 seconds to perform 30 chest compressions.
2. Deliver ventilations
-Seal the pocket mask and simultaneously open the airway to a past-neutral position
using the head-tilt/chin-lift technique. Or, use the modified jaw-thrust maneuver if a
head, neck or spinal injury is suspected.
-Deliver 2 ventilations. Each ventilation should last about 1 second and make the chest
begin to rise.
*Interruptions of chest compressions should be less than 10 seconds. Therefore, a bag-
valve-mask (BVM) is not a practical way to deliver ventilations during CPR when
responding alone.
-Continue CPR
-Provide 30 chest compressions at the proper rate and depth, using correct hand
placement and allowing for full chest recoil.
-Seal the mask and open the airway.
-Deliver 2 ventilations.
✔✔If the patient is not breathing normally and has no pulse, you must perform single-
provider CPR. What should you do? - ✔✔Perform 30 chest compressions at a rate of
100 to 120 per minute. Then deliver 2 ventilations, each lasting about 1 second, with a
pocket mask or mouth-to-mouth.
✔✔The AED arrives, and you attach the pads appropriately and clear the area. When
the AED is analyzing or delivering a shock, what should you do? - ✔✔Hover your hands
over the patient's chest, taking care not to touch the patient.
✔✔What should you do if ROSC is achieved? - ✔✔-Monitor the patient until the
advanced cardiac life support team takes over.
-Stop CPR/AED use.
-Check for breathing and pulse.
,✔✔You and two other providers, Amanda and Ryan, witness an adult patient collapse in
the hospital hallway. You perform a visual survey and check for responsiveness. When
the patient doesn't respond to the shout-tap-shout sequence, you tell Amanda to
activate the rapid response team and Ryan to retrieve the AED and BVM. Then, you
open the airway and simultaneously check for breathing and a pulse. They both repeat
your instructions back to you to "close the loop." Did the team respond appropriately? -
✔✔YES
✔✔When you simultaneously check for breathing and a pulse, you note the patient is
not breathing normally but has a pulse. What should you do next? - ✔✔Deliver 1
ventilation every 5 to 6 seconds, each lasting about 1 second, while checking for
breathing and pulse about every 2 minutes.
✔✔Amanda returns and announces the code team is on the way and Ryan returns
stating, "I have the AED and BVM." After providing 2 minutes of ventilations, you open
the airway and simultaneously check for breathing and a pulse. The patient is not
breathing normally and does not have a pulse. What should the team do next? - ✔✔You
should immediately perform 30 chest compressions, while Amanda prepares to deliver
2 ventilations. Ryan should set up the AED, attach the pads and tell everyone to "clear"
as the AED begins to analyze.
✔✔You and the team delivered one shock to the patient, then performed about 2
minutes of CPR. You have been performing compressions and are starting to fatigue.
What should you do? - ✔✔You should anticipate a compressor change and verbalize
the coordination plan to switch. You should switch off compressions when the AED
analyzes again.
✔✔You will switch "compressor" roles with Ryan during the AED analysis. What actions
should the team do during the analysis to ensure the switch occurs in less than 10
seconds? - ✔✔Ryan should hover his hands a few inches over the patient's chest,
preparing to take over compressions. You and Amanda should clear the patient while
preparing to deliver ventilations and operate the AED. After the shock is delivered or if
no shock is advised, Ryan should immediately begin compressions—he does not need
to wait for the AED prompt shock delivered.
✔✔High-Performance Resuscitation Team - ✔✔Characteristics of a high-performance
team include well-defined roles and responsibilities; clear, closed-loop communication;
and respectful treatment of others.
✔✔Coordinated, efficient, effective teamwork is essential to provide high-quality CPR,
improve patient outcomes and deliver expert care.
Think about all of the activities performed during a resuscitation. For example: - ✔✔-
AED pads are applied.
, -AED must charge.
-Pocket mask or BVM might need to be repositioned.
-Airway might need to be reopened.
-Other trained providers arrive and relieve you.
-Providers switch positions.
-Advanced airway might need to be inserted.
-Pulse checks might be done.
*All of these activities could affect your ability to maintain contact with the patient's
chest.
✔✔Team Roles during resuscitation - ✔✔Leadership/Supportive Roles
-Recorder
This team member records and communicates key data during the resuscitation effort
(for example, data related to interruptions to chest compressions).
-Team Leader
The team leader assigns roles, sets clear expectations, prioritizes, directs, encourages
team input and interaction, monitors the delivery of CPR/AED, makes adjustments in
real time and focuses on the big picture.
CPR/AED Roles
-Airway Manager
This team member maintains an open airway and seals the mask.
-Ventilator
This team member is responsible for ventilations.
-Compressor
This team member is responsible for chest compressions.
-AED Operator
This team member manages the AED and relieves the compressor.
✔✔Team Roles during resuscitation and the integration of Other Trained Providers -
✔✔Coordination becomes even more important when other trained providers, such as
an advanced life support team or code team, arrive. This coordination of all involved is
necessary to:
-Ensure that all individuals involved work as a team to help promote the best outcome
for the patient.
-Promote effective perfusion to the vital organs.
-Minimize interruptions of chest compressions to less than 10 seconds, which have
been shown to improve survival.
*Ultimately, the team leader is responsible for this coordination. When other trained
providers arrive, the team leader communicates with them, providing them with a report
of the patient's status and events.
✔✔Continuous Quality Improvement - ✔✔Healthcare providers and their employers
have a responsibility to ensure that they provide the highest quality CPR throughout
every resuscitation event. To achieve this goal, it is necessary to gather and use data to
inform improvements in individual and team performance. Methods of evaluating CPR