High-Quality CPR improves the victim's chances of...
Survival
What are the critical characteristics of High-quality CPR?
a. start compressions
b. push hard, push fast
c. allow complete chest recoil
d. minimize interruptions
e. give effective breaths
f. avoid excessive ventilation
What are the 6 links in the adult Chain of Survival for an Out-of-Hospital Cardiac Arrest?
a. recognition
b. activation
c. CPR
d. defibrillation
e. advanced life support
f. post-cardiac arrest care
What are the 5 links in the pediatric Chain of Survival?
a. prevention
b. bystander CPR
c. rapid activation
d. advanced life support
e. post-cardiac arrest care
AED
Automated External Defibrillator
AHA
American Heart Association
ECC
Emergency Cardiovascular Care
CPR
cardiopulmonary resuscitation
BLS
basic life support
agonal gasps
abnormormal breathing that may be present in the first minutes after sudden cardiac arrest
OHCA
Out of hospital cardiac arrest
pVT
pulseless ventricular tachycardia is a life-threatening arrhythmias that cause cardiac arrest
VF
ventricular fibrillation is an arrest rhythm. The heart muscles quiver in a fast, unsynchronized way so the heart does not pump blood
PPE
personal protective equipment is equipment worn to help protect the rescuer from health or safety risks
Sudden Cardiac Arrest
occurs when the heart develops an abnormal rhythm and can't pump blood
Heart Attack
occurs when blood flow to part of the heart muscle is blocked
Infant
less than 1 year of age (excluding newly born infants in the delivery room)
Children
1 year of age to puberty
Brachial pulse
medial aspect of the antecubital space
abdominal thrusts (heimlich maneuver)
to relieve an obstruction
What are the three main components of BLS
a. chest compressions
b. airway
c. breathing
After checking responsiveness what steps should be performed at the same time?
pulse + chest rise + breathing
What are the five initial BLS steps for adults?
a. verify scene is safe for you and the victim
b. check for responsiveness
c. if victim is not responsive, shout for nearby help
d. activate emergency response system
e. if you are alone get AED
How long should a healthcare provider take to check pulse?
No more than 10 seconds, no less than 5
Where is the carotid pulse?
on the trachea (side closest to you)
What are the seven steps for chest compressions for an adult?
a. position yourself at the victims side
b. make sure victim is faceup on a flat surface
c. position your hands and body to perform chest compressions
d. give chest compressions at a rate of 100 to 120/min
e. press down at least 2 inches with each compres
Why is it important to have a firm surface under a victim during chest compressions?
This allows compressions of the chest and heart to create blood flow
When do you move a victim for CPR?
If victim is in a dangerous environment, or if you can't perform CPR effectively
What are the two methods for opening the airway to provide breaths?
Head tilt-chin lift
Jaw thrusts
When do you use jaw thrust method?
When there is a head or neck injury suspected
What are the three steps to perform a head tilt-chin lift?
a. place one hand on victims forehead and push with palm to tilt head back
b. place fingers of other hand under bony part of lower jaw near the chin
c. lift the jaw to bring the chin forehead
What are two things to avoid with the Head Tilt-Chin Lift?
Do not press deeply into the soft tissue under the chin because this might block the airway, also do not close the victims mouth completely.
What are the six steps for giving mouth-to-mouth with a pocket mask?
a. position yourself at the victims side
b. place mask on victims face
c. seal pocket mask against the face
d. perform a head tilt-chin lift to open the airway
e. while you lift jaw, press firmly to seal the pocket mask against face
f. deliver breath over
Describe the E-C clamp technique for Bag-Mask breathing
Perform a head lift
Place the mask on the face with the narrow portion at bridge of nose
Use thumb and index finger to make a "C"
Use remaining fingers to lift jaw, open airway, and press face to mask
How long do you squeeze the bag for bag-mask breathing? What if there's supplemental O2?
1 second each. Over 1 second, still
What are the four steps for Bag-mask during one rescuer CPR?
-position yourself above victims head
-place mask on face, using bridge of the nose as a guide
-use E-C clamp to hold mask
-squeeze bag to give breaths, to watch chest rise
What is the second rescuers job when they arrive on the scene?
To get the AED, activate emergency response unit
What are the duties for Rescuer 1 in a 2-rescuer CPR?
-make sure victim is faceup
-perform compressions
-at the victims side
What are the duties for Rescuer 2 in a 2-rescuer CPR?
-at victims head
-maintain an open airway
-give breaths
-encourage compressions
To be an effective team what must be done continuously?
Minimize interruptions and communicate continuously
To reduce rescuer fatigue, when switch compressor roles how often?
Every 5 cycles ( 2 minutes)
To minimize interruptions when should the switch occur? How long should it take?
When AED is analyzing the rhythm. Take less than 5 seconds.
What method to be used if a victim has a head or neck injury?
Jaw thrust
What are the three steps to perform a jaw thrust?
a. place one hand on forehead and push with palm to tilt head back
b. place finger on bony part of lower jaw
c. lift jaw to bring chin forward
What happens to the heart muscle during ventricular fibrillation?
Quiver in a fast, unsynchronized way, so heart does not pump blood
What is ROSC?
Return of spontaneous circulation
What does a defibrillator do?
analyzes heart rhythm to identify presence of a rhythm that responds to shock therapy. Stuns heart
What are the four universal steps for operating an AED?
a. power on AED
b. attach AED pads
c. clear victim to analyze rhythm
d. deliver a shock if AED advises and clear victim
Why is it important to minimize time between last compression and shock delivery?
The shock is more likely to be effective
What are four special situations that require the rescuer to take additional action?
a. has a hairy chest
b. is immersed in water or has water covering chest
c. has implanted defibrillator or pacemaker
d. has transdermal medication patch or other object on skin
What are the four steps to take if a victim has a hairy chest
-use first set to remove hair
-press them down as much as possible
-pull them off
-apply new set of pads
Can you use an AED on a victim submerged in water? Why?
No. Water is a conductor of electricity
How can you identify an implanted defibrillator or pacemaker?
they create a hard lump beneath skin of upper chest or abdomen
What happens if you place an AED pad directly over an implanted medical device?
The device may block delivery of the shock to the heart
What are four types of transdermal medication patches?
a. nitrogen
b. nicotine
c. pain medication
d. hormone replacement therapy patches
What can happen if an AED pad goes directly over a transdermal medication patch?
The patch may block transfer of energy from AED patch to heart and cause small burns
Which victim would need only rescue breathing?
An unresponsive victim who has a pulse but is not breathing
How often should rescue breaths be given in infants and children when a pulse is present?
Give 1 breath every 3 to 5 seconds (12 to 20 breaths per minute)
What action can rescuers perform to potentially reduce the risk of gastric inflation?
Deliver each breath over 1 second and deliver just enough air to make the victim's chest rise
What is the preferred technique for giving rescue breaths to an infant?
mouth-to-mouth-and-nose
Give 3 examples of an opioid
hydrocodone, morphine, and heroin
You suspect an opioid-associated-life-threatening emergency. A friends is phoning 9-1-1 and is looking for the naloxone auto injector. What action should you take?
Assess breathing and pulse. Rescue breathe 1 every 5-10 seconds
What are the signs that you would see with a mild foreign-body airway obstruction?
good air exchange
can cough forcefully
may wheeze between cough
Which victims of foreign-body airway obstruction should receive abdominal thrusts?
responsive adult or child
infant 5 back blows, 5 chest thrusts
You are performing abdominal thrusts on a 9-year-old child when he suddenly becomes unresponsive. After you should for help, what is the most appropriate action to take?
Lower victim to the ground
What is the compression: ventilation ratio for an adult?
30:2