Within how many seconds should you start chest compression once recognizing cardiac arrest?
Within 10 seconds
At what rate should you compress in CPR?
100 to 120/min
At what depth should you compress in CPR?
Adult - at least 2 inches (5cm)
Children - at least one thirst the depth of the chest, ~2inches
Infants - at least one third the depth of the chest ~1.5 inchest (4cm)
Where should you place your hands when performing compressions on an infant?
2 fingers in center of the chest, just below the nipple line
What is the ratio of compressions to breaths?
30 compressions to 2 breaths unless two or more rescuers than 15:2 compressions to breaths.
In BLS what is the next step when using an AED if patient does not have a shockable rhythm? if the rhythm is shockable?
Not shockable? - resume CPR for ~2 mins until prompted by AED to allow rhythm check.
Shockable? - give 1 shock then resume CPR immediately.
What is the maximum compression depth in CPR?
Depth should not be more than 2/4 inches (6cm)
What rate should you provide breaths to a patient with a pulse but abnormal breathing?
1 breath every 3-5 seconda or about 12-20 breaths per minutes.
For a patient found to have abnormal breathing but with a pulse, what would be an indication for starting CPR?
Add compressions if pulse remains <60/min with signs of poor perfusion ie cool extremities, decreased responsiveness, weak pulses, pale, mottling, cyanosis.
How to relieve new born of FB airway obstruction?
give up to 5 back slaps AND up to 5 chest thrusts. repeat until effective or victim becomes unresponsive. If patient becomes unresponsive begin CPR.
What is the first step in the BLS algorithm?
Verify the scene is safe
What is the second step in the BLS algorithm?
Chesk for responsiveness ("Are you ok?") if not responsive, shout for help and activate emergency response system. Either get yourself or send someone to get AED and emergency equipment.
What is the third step in BLS algorithm?
look for no breathing or only gasping and chest pulse simultaneously (should be able to do within 10 seconds)
What do you do if the victim is NOT breathing but a pulse is present?
Rescue breathing and check for pulse about every two minutes. If no pulse is felt during check you will need to start CPR
Ratio of compressions to breaths for a single rescuer?
30 compressions to 2 breaths.
What airway opening maneuver should you use if head or neck injury is suspected?
Jaw-thrust maneuver
Steps of the head tilt-chin lift?
1. place one hand on the victims forehead and push with your palmr to tilt the head back
2. Place fingers of the other handunder the bony part of the loewr jaw near the chin
3. lift the jaw to bring the chin forward.
Over what amount of time should each breath be delivered over?
Deliver each breath over 1 second.
What should be noted on each breath given in CPR?
Note a visible chest rise
What is the EC clamp technique?
Technique for holding mask in place while lifting victims jaw to hold their airway open
If a 2 rescuer scenario, about how often should rescuers switch compressors?
Should switch about every 2 minutes or 5 cycles, usually when AED is analyzing the rhythm.
What is an AED?
An Automated External Defibrillator is a device that can identify abnormal rhythms and shock the heart to stop such a rhythm.
Victims age what in above should have adult pads used when using AED?
All victims 8 years and older should get adult pads
In Anterolateral placement - Where should the AED pads be placed on the victims chest?
One directly below the collar bone and the other to the side of the left nipple with the top edge of the pad a few inches below the armpit.
Where are AED pads placed in Anteroposterior placement?
one on the left side of the chest just below the nipple and the other left side of patient's back next to the spine.
What should you do if you have an adult victim but only child sized pads?
Do not apply pads, just continue high quality CPR - it is better to provide high quality CPR than to attempt to shock an adult with victim child pads.
What should you do if the patient has a hairy chest?
Either use razor provided to remove hair or if you have two sets of pads, use on set to remove hair.
What should you do if a patient has been immersed in water?
wipe chest before attaching AED pads
Can you use the AED if a victim is lying in the snow or a puddle?
Yes, just make sure to wipe the chest dry beforehand
What should you do if you go to apply AED pads and the victim is found to have an implanted defibrillator/pacemaker?
Avoid placing AED pad directly over implanted device and then follow normal steps of operation
What you should do before applying AED pads to a patient with a transdermal medication patch?
If it does not delay delivery, remove patch and wipe area before attaching AED pad.
Which is first, powering on AED or attaching pads to the victim?
Powering on AED
What is an optimal chest compression fraction?
At least 60% with a goal of 80%
What should a single rescuer do if they come across a down victim with no idea how long they have been down?
begin CPR and THEN after about two minutes if still alone you should activate the emergency response systemt and retrieve AED if not already donw.
What pulse should be palpated for a pulse check in an infant?
Brachial pulse
What pulse should be palpated for pulse check in a child?
carotid or femoral
What is the indication to add compressions to a resucitation in a victim who has a pulse?
If the victim's pulse remains 60/min or less with signs of poor perfusion.
Is it ok to lead a victim to activate the emergency response system and retrieve AED?
Yes if the victim is not breathing well and has no pulse and the collapse was sudden and witnessed then it is ok to leave to get AED and active response system if you are the sole rescuer
What are four signs of poor perfusion you should assess for?
1. Temperature => cool extremities
2. AMS
3. pulses => weak
4. skin => paleness, mottling, cyanosis (late sign)
What is the compression to ventilation ratio if 2 rescuers are present?
15:2
What technique is used for performing compressions on an infant?
2 finger technique
What is the preferred compression technique for an infant when two rescuers are present?
2 thumb encircling hands technique
Why is the 2 thumb encircling hands techinique preferred for infant cpr when two rescuers are present?
1. produces better blood supply to heart muscle
2. helps ensure consisten depth and force of compression.
3. May generate higher blood pressures.
To maximize airway patency in an infant how should they be posistioned?
ensure the nect is in a neutral posistion so that the external ear canal is level with the tops of the infants shoulder.
Why are breaths so important in CPR for infants and children?
Unlike adults, infants and children who develop cardiac arrest often have respiratory failure or shock that reduces oxygen content in the blood even before the onset of arrest and thus compressions alone are not as effective for delivering oxygenated bloo
What should you do if you have a child victim but only adult AED pads?
Use adult pads - they will deliver a high shock but this is preferred to no shock
What AED pad positioning is used for children and infants?
Anteroposterior position middle of chest and back
Which is preferred for infants, an AED or a manual defibrillator?
A manual defibrillaor since it has more capabilities and can provide low energy doses
If there is an advanced airway in place ie laryngeal mask airway or supreglottic airway device, that is the rates of breaths provided?
Should provide 1 breath every 6 seconds ie 10 breaths per minutes across ALL ages
How does the rate of rescue breathing differ between an adult victim and a child victim?
For an adult victim you should devlier 1 breath about every 5 to 6 second (10-12 breaths per minute).
For a child or infant you should delvier 1 breath every 3 to 5 second ie 12-20 breaths per minute
What is the preferred technique for giving breaths to infants?
The mouth-to-mouth-and-nose technique
What is the danger of giving breaths too quickly or with too much forse?
Air is likely to enter the stomach rather than the lungs.
What should you do as a rescuer if a victim has a mild airway obstruction ie good airway excahnge, able to cough forcefully, and perhaps wheezing between coughs?
Do NOT interfere with their own attempts to relieve the obstruction but rathe stay with them and encourage coughing.
How should a rescuer perform the heimleich manuever in a pregnant or obese adult?
Should perform chest thrust as opposed to abdominal thrust.
What maneuver is used to relieve choking in an infant?
back slaps or chest thrust - do NOT use abdominal thrust.
What is the optimal position to have infant victim in when performing maneuvers to relieve choking?
Hold infant facedown with the head slightly lower than the chest, resting on your forearm while supporting the infant's head and jaw with your hand.
How do you perform a back slap to relieve infant choking?
With infant on forearm and arm resting on thigh, use the heel of your hand to deliver up to 5 back slaps forcefully between the infants should blades.
What is the next step for a choking infant after you have delivered 5 back slaps?
Place your free hand on the infants back and then supporting the back of the infants head with the pal of your hand, turn the infant as a unit and provide 5 quick downward chest thrust in the middle of the chest over the lower half of the breast bone at r
Whn attempting to rescue a choking infant, how long should rescuer perform back slaps and chest thrust?
rescuer should alternate between 5 back slaps and 5 chest thrust until infant becomes unresponsive at which time should begin CPR
What is an extra step when performing CPR on an infant that has become unresponsive due to choking on an object?
Extra step if to check for object in back of their throat each time you open the airway.
What should NOT be done to find object in choking infants throat?
No BLIND finger sweeps.