Scene Size-Up
1) checking scene safety,
2) taking Standard Precautions,
3) noting the mechanism of injury or nature of the patient's illness,
4) determining the number of patients,
5) deciding what, if any, additional resources to call for.
Adult Head-tilt/chin-lift position
Past-neutral position
Child Head-tilt/chin-lift position
Slightly past neutral position
Infant Head-tilt/chin-lift position
Neutral position
Adult ventilations
1 ventilation every 5-6 seconds
Child ventilations
1 ventilation every 3 seconds
Infant ventilations
1 ventilation every 3 seconds
Hand position for CPR on adult
Hands centered on lower half of sternum
Hand position for CPR on child
Hands centered on lower half of sternum
Hand position for CPR on infant
1 resp: two fingers centered on sternum just below the nipple line
2 resp: two thumbs centered on sternum just below nipple line with fingers encircling chest
Compression rate: everyone
AT LEAST 100 but no more than 120 per minute
Compression depth adult
AT LEAST 2 inches (but no more than 2.4)
Compression depth child
ABOUT 2 inches (1/3 diameter of chest)
Compression depth infant
ABOUT 1.5 inches (1/3 diameter of chest)
Compression/ventilation ratio adult
1 resp: 30:2
2 resp 30:2
Compression/ventilation ratio child & infant
1 resp: 30:2
2 resp: 15:2
Rescue breathing ratio adult
1:5-6 sec
Rescue breathing ratio child & infant
1:3 sec
AED pads adult
Adult pads: older than 8 years, weight over 55 pounds
AED pads child
- Pediatric pads: age 1-8 years, weight less than 55 pounds
- adult pads if pediatric not available
AED pads infant
Pediatric pads; Adult pads if pediatric pads not available
AED pad placement adult
upper right chest, lower left chest
AED pad placement child
- upper right chest, lower left chest
- if pads risk touching, anterior/posterior placement
AED pad placement infant
anterior/posterior placement:
- middle of chest
- back between scapulae
Agonal breaths
- isolated or infrequent gasping in the absence of normal breathing
- NOT normal breathing
- care for patients as they are not breathing
Patient is not breathing but has pulse, they are experiencing _______ and you must give _________
respiratory arrest; ventilations
Opioid Overdose
Naloxone
Myocardial Infarction
- heart attack
- cardiac chain of survival
Advanced Airways
- 2 responders present
- 1 resp gives ventilations every 6 seconds, 10 ventilations per min
- 1 resp gives compressions at 100-120 per minute
Goal of Respiratory Assistance
- Continue circulating oxygen to the brain and heart
- Brain cells start to die in 4-6 min w/o oxygen
Call first if:
- alone and believe it is an adult, a cardiac condition, or a witness collapse of child or infant
Care first if:
- alone and believe it is a respiratory condition, a child or infant you did not witness collapse, or ANY drowning victim
Breathing but unresponsive
recovery position
Not breathing but have a pulse
rescue breathing
Partial obstruction
encourage coughing to dislodge object
Complete obstruction
- inability to speak, breathe, cry, or cough
- care for 2 minutes before call 911 if alone
Obstructed airway emergencies: Treatment for a conscious adult & child
- get consent
-5 back blows
-5 abdominal thrusts (heimlich maneuver)
Obstructed airway emergencies: Treatment for a conscious infant
-get consent
-5 back slaps/blows
-5 chest thrusts
- kneel, stand, or sit
-use thigh for support
-sandwich to flip
Obstructed airway emergencies: Treatment for a unconscious (adult, child, infant)
-recuse breathing
-30 chest compressions
-look/sweep if you see an object
-2 rescue breaths
Treatment for victim who was conscious and choking but has become unconscious
-lower to the ground & call 911 if haven't already
- 30 chest compressions
- check for an object and remove if seen (finger sweep)
- open airway and give 2 breaths (if don't go in proceed)
Cardiac chain of survival
1) recognize an emergency and call 911
2) early CPR
3) early defibrillation (AED)
4) advanced life support
5) integrated post-cardiac arrest care
Basic Life Support
-critical thinking
-problem solving
-communication
-team dynamic
Early CPR to:
Keep oxygen-rich blood flowing and help delay brain damage and death
Chest must be allowed to fully recoil between each compression to.....
Allow blood to flow back into the heart following the compression
Ventilations supply.....
oxygen to a patient who is not breathing
BVM resuscitator
administer higher concentrations of oxygen than a pocket mask
Best method for controlling bleeding
Applying pressure directly to the wound
Closed Injuries
Beneath the skin damaged, but the skin is not broken
ex) bruise, hematomas, and crash injuries
Open Injuries
The skin is broken, and victim is susceptible to external bleeding and wound contamination
ex) incision, avulsion, puncture, abrasion, laceration
Which of the following would be best to use to immobilize an ankle or foot injury?
Soft Splint
Which of the following identifies the progression that heat-related illnesses can follow from least to most severe?
cramps, exhaustion, stroke
Which of the following would be most appropriate to do when removing a bee stinger from a person's skin?
Scrape the stinger away from the skin with the edge of a plastic card.
You are giving care to a person in shock. Which of the following would be most appropriate?
Placing the person in a supine position
A friend collapses. As they regain consciousness, you notice that they are having difficulty speaking. One side of the person's face is drooping and they are unable to move their left arm or leg. You suspect which of the following?
Stroke
You believe that a person has a head, neck or spinal injury. What should you do?
Have the person remain in the position they are in until emergency medical services (EMS) personnel arrive and take over.
Which type of injury involves an open wound in which the bone has torn through the skin?
Open fracture
When possible, two-responder ventilation with a BVM resuscitator is preferred because:
It allows one responder to create and maintain a mask seal.
An adult choking patient becomes unresponsive after providing 5 abdominal thrusts. You lay the patient on the floor. The next step you should take is to:
Give chest compressions
How should you place your hands when giving chest compressions to an infant during CPR with two trained responders?
Encircling thumbs technique with thumbs just below the nipple line.
Your initial impression reveals severe life-threatening bleeding in an adult patient who appears to be unresponsive. Your next step should be:
Control the bleeding with any available resources.