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Emergency Clinical Care > BLS exam > Flashcards

BLS exam Flashcards

1
Q

What are the two key components of successful cardiac arrest care?

A

Early high-quality CPR and rapid defibrillation

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2
Q

How do emergency telecommunicators increase rates of bystander CPR and improve outcomes?

A

Assisting the public by giving instructions on CPR which allow the bystander to perform high-quality CPR and early defibrillation

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3
Q

How can mobile phone apps and text messages be useful in the time of an emergency?

A

By locating members who are trained in CPR and by helping rescuers to locate the nearest AED

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4
Q

How can bystanders perform CPR without training?

A

They can perform chest compressions and seek guidance from the emergency telecommunicators.

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5
Q

What does ROSC stand for?

A

Return of Spontaneous circulation

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6
Q

Which age is considered an adult?

A

After puberty

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7
Q

What are some variables CPR skills rely on?

A

Level of training, experience, and confidence (rescuer proficiency); type of victim (child vs. adult). Available equipment and other rescuers

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8
Q

When would you use hands-only CPR?

A

When there is a person with not a lot of training and no equipment but witnesses someone that has a cardiac arrest

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9
Q

When would you use 30:2 CPR?

A

A person who is trained in BLS and witnesses somebody go under cardiac arrest

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10
Q

What are the main components of CPR?

A

Chest compressions, airway and breathing

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11
Q

What are the steps for CPR?

A

Verify scene safety
Check for responsiveness→ Shout are you okay? If there is no responsiveness, Tell someone to call 911 and get an AED
Check for pulse and respiration
Normal breathing and pulse: monitor patient until help arrives
No breathing but pulse: give rescue breaths every 6 seconds or 10 breaths/ min; check pulse every 2 minutes; start CPR if no pulse; administer naloxone if there is an opioid overdose
No breathing or only gasping, no pulse: start CPR (30:2)
AED arrives and use: check rhythm
Rhythm: give shock and resume CPR
No shock: resum CPR until AED tells you to allow rhythm check
Continue monitoring the patient until help arrives or when patient starts to move

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12
Q

What are agonal gasps?

A

They are a sign of cardiac arrest and they are irregular and slow breathing.

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13
Q

Where would you feel a pulse on an adult?

A

Cartoid pulse: locate the trachea and slide the fingers into a groove and check for pulse for no more than 10 seconds but atleast 5 seconds

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14
Q

What would happen if you keep interrupting chest compressions?

A

The lower the supply to the organs and the brain

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15
Q

Where should you place the victim when performing chest compressions?

A

On a firm hard surface

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16
Q

What is the compression to ventilation ratio for adults?

A

30:2

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17
Q

What is the universal compression rate?

A

100 to 120/min. It is the same for all cardiac arrest victims.

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18
Q

What is the compression depth for adults?

A

At least 2 inches

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19
Q

Why is chest recoil important?

A

It allows for the blood to flow back into the heart; do not lean on the chest between compressions

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20
Q

What is CCF?

A

It is the chest compression fraction and it is the proportion of time that rescuers perform chest compressions during CPR

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21
Q

Where do you position your hands on the chest during chest compressions?

A

The center of their chest; the lower half of the breastbone (sternum). Place the heel of your hand on top of the other hand. Straighten your arms and you should be directly over the victim.

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22
Q

What do you do when a pregnant women’s uterus is compressing the large blood vessels in the abdomen?

A

LUD: Lateral uterine displacement; manually moving the uterus to the patient’s left to relieve the pressure on the large blood vessels

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23
Q

What do you do when a pregnant woman is revived?

A

Place her on her left side so that improves blood flow to her heart and to the baby

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24
Q

What are two mistakes to avoid when doing a head tilt-chin lift?

A

Avoid pressing deeply into the soft tissue under the chin- it might block the airway
Do not close the victim’s mouth completely

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25
Q

How do you perform the jaw thrust?

A

Position yourself at the victim’s head and place one hand at the side of the patient’s head and place your fingers under the angle of the patient’s lower jaw and lift with both hands to push the jaw forward

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26
Q

What is the positioning when using pocket masks?

A

Place the mask on the patient’s face (bridge of the nose as a guide)
Place your index finger and thumb on the mask and push down and place the rest of the fingers on the face not the eyes
With the other hand place your thumb on the chin and life the jaw up
Press firmly and deliver a breath over a second and note if the chest rose

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27
Q

How do you position yourself during 1 rescuer bag mask technique?

A

Use the thumb and index finger of one hand to make a c on the side of the mask and press down
Use the remaining fingers to lift the jaw and squeeze the bag while watching for the chest to rise. Deliver each breath over a second

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28
Q

How you perform two rescuer bag mask technique?

A

Resucer 1 is positioned over the victim and uses the technique from 1 rescuer bag mask technique with both hands and the other rescuer squeezes the bag

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29
Q

ow do you perform ventilation with someone with a stoma or tracheostomy tube?

A

Position the bag mask over the stoma or tube. If the chest doesn’t rise, then connect the bag mask device to teh tracheostomy tub. Another option, close the victim’s mouth while providing breaths over the stoma or tracheostomy tube.

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30
Q

During 2 rescuer CPR, when should the first rescuer switch with the second rescuer?

A

Every 5 cycles or 2 minutes and you should take less than 5 seconds to switch

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31
Q

How should a team with 2 or more rescuers operate?

A

The first rescuer checks the victim and orders someone to call 911 and get an AED. Rescuer 2 provides breaths. They should switch every 5 cycles in order for

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32
Q

What is a CPR coach?

A

A CPR coach is a person who coordinates the start of CPR< improve the quality of chest compressions by giving feedback, they set the midrange targets, give feedback about ventilation rate and volume and communicates with the team to minimize the length of pauses in compressions

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33
Q

Why having a CPR coach is beneficial for the team?

A

There is higher quality CPR, higher CCF, and shorter pause durations and they allow the team leader to focus on other aspects.

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34
Q

What does the AED do?

A

Identify abnormal heart rhythms as shockable or non shockable

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35
Q

What is defibrillation?

A

Stopping abnormal heart rhythm by using electrical shocks

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36
Q

What is a palpable pulse?

A

A pulse felt by the rescuer

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37
Q

What are signs of ROSC?

A

Breathing, coughing, or movement and a palpable pulse or measurable blood pressure

38
Q

What is an Arrhythmia?

A

Abnormal or irregular heart rhythm

39
Q

How do arrhythmias occur?

A

When the electrical impulses that cause the heart to beat occur too quickly, too slowly or erratically

40
Q

What are two life-threatening shockable arrhythmias that cause cardiac arrest?

A

Pulseless ventricular tachycardia (pVT0 and ventricular fibrillation

41
Q

What is pVT?

A

Lower chambers of the heart (ventricles) begin contracting at a very fast pace, a rapid heart known as ventricular tachycardia develops. Sometimes, the ventricles pump so quickly that no pulse can be detected. Therefore, organs no longer receive blood.

42
Q

What is ventricular fibrillation?

A

The heart’s electrical activity becomes chaotic resulting in the muscles to quiver in a fast, unsynchronized way that they are no long pumping blood.

43
Q

What does PAD stand for and what do they do?

A

Public Access Defibrillation. Increase AED availability and train laypeople on how to use them.

44
Q

Who are laypeople?

A

a person without professional or specialized knowledge in a particular subject.

45
Q

Where should you place the AED once it arrives?

A

At the victim’s side near where the rescuer who will operate it

46
Q

What are the steps for operating an AED?

A

Place the AED on the side and turn it on
Apply the pads on the chest and stomach
Say clear when AED analyzes the rhythm
When AED says to says to say clear say clear
Then before pressing the shock button say clear
After shock is advised start CPR

47
Q

What are the two placements for AED pads?

A

Anterolateral: on adults; one of the chest laterally and one by the stomach laterally
Anteroposterior (AP): usually on the child; on the center of the chest between the nipples and on the back of teh child between teh shoulder blades

48
Q

What do you do if there is hair on the chest?

A

Use a razor to shave off where you need to apply the pads, but if there is no razor but two pads use one to wax off the hair and the other for the AED

49
Q

What do you do if the patient is in water, covered with water or sweat, or lying in snow or a small puddle?

A

Pull the victim out of the water
Quickly wipe the chest before attaching AED pads
Used AED after quickly wiping the chest

50
Q

What do you do if there is an implanted defibirillatior or pacemaker in the victim?

A

Avoid placing the pads where the pacemaker if possible and follow the normal steps for AED

51
Q

What do you do if there is a transdermal medication patch on the victim?

A

If the shock won’t deliver, wear protective gloves or another barrier to remove the patch (avoid transfer of medication) and wipe the area before attaching the pad

52
Q

What do you do if the woman is pregnant and you need to use the AED?

A

Still use the AED but once the woman is revived, put her on her left side

53
Q

What do you do if the victim is wearing clothing and jewlery?

A

Remove bulky clothing but if the clothes are difficult to remove then still provid chest compressions but you have to take the clothing off when there is an AED. If the jewlery does not come in contact with the AED pads then don’t take it off.

54
Q

What are the 3 elements of team dynamics?

A

Roles and responsibilities; communication; debriefing

55
Q

What are the roles and responsibilities?

A

Assigning roles and responsibilities; Knowing limitations; Offer constructive intervention (pointing out mistakes)

56
Q

What is the responsibility of the compressor?

A

Compressions

57
Q

What is the responsibility of the Monitor/Defibrillator/ CPR coach

A

Monitors AED; acts as a CPR coach

58
Q

What is the responsibility of the Airway (role)

A

Opens the airway; bag-mask ventilation

59
Q

What is the responsibility of the team leader?

A

Assigns roles; treatment decisions; provides feedback; assumes responsibility for roles that are not defined

60
Q

What is the responsibility of the IV/IO medications?

A

AN ALS provider; administers medications

61
Q

What is the responsibility of the timer and recorder?

A

Records the time of interventions and medications; records frequency and interreuptions; communicates this to the team leader

62
Q

What should be done during communication?

A

Sharing knowledge (observations and feedback): summarize and reevaluate; using closed-looop communication ( getting message- repeating it- and confirming if it was heard correctly); giving clear messages; showing mutual respect

63
Q

Why is coaching and debriefing important?

A

It helps understand mistakes and understand what they should do better

64
Q

What are the steps for CPR for infants and children?

A

Scene safety
Shouting are you okay
Breathing and pulse
Normal breathing & pulse: monitor patient until help arrives
Not breathing normally & pulse good: rescue breathing- 1 breath every 2-3 seconds or 20-30 breatsh a minute and asses the pulse rate every 10 seconds
Is the heart rate less than 60/min (fewer that 6 beats in 10 seconds)
If yes, start CPR,
If no, continue rescue breathing. Check for pulse every 2 minutes.
Was the sudden collapse witnesseD?
If yes, call 911 first
If no, start CPR sycle with 30 compressions and 2 breaths. Use an AED as soon as it is available.
After 2 minutes, if you are stil alone, call 911 and get an AED
Use AED and follow AED
Give shock if it is shockable and resume CPR until AED says so about every 2 minutes
Nonshockable rhythm- continue CPR and use AED every 2 minutes.,
Continue until advance life support providers arriver or when the victim starts to move, breathe or react.

65
Q

How do you feel the pulse for infant?

A

You feel for a brachial pulse

66
Q

How do you feel for a child pulse?

A

Check for femoral pulse and carotid pulse

67
Q

What is perfusion?

A

The flow oxygenated blood from the heart through the arteries to the body’s tissues.

68
Q

What are some signs of poor perfusion?

A

Cold extremities, Continued decline in consciousness/responsiveness, weak pulse, pale skin, mottling (patchy appearance), and cyanosis

69
Q

What is the ventilation ratio for an infant during single-rescuer CPR

A

30:2

70
Q

What is the ventilation ratio for an infant during 2 rescuer CPR?

A

15:2

71
Q

What is the compression depth for an infant?

A

1 ½ inches

72
Q

What are the two infant compression techniques?

A

2 finger technique: place 2 fingers on the center of the infant’s chest just below the nipple line on the lower half of the breastbone
Place both thumbs side by side in teh center of teh infant;s chest, on the lower half of the breastbone. Then, encircle the infant’s chest and support the infant’s back

73
Q

Why are breaths important for infants and children?

A

Cardiac arrest is not that sudden and is caused by respiratory complications, therefore the oxygen content in the blood is low by the time of CPR. Therefore, chest compressions alone is not adequate to deliver oxygenated blood to the heart and brain.

74
Q

How far back are you supposed to pull back the infant’s head?

A

Until the infant’s nose points to the ceiling

75
Q

When using an advanced airway in place when should you give ventilation for adults, infant and children?

A

Adult: 1 breath every 6 seconds
Infant and child: 1 breath every 2-3 seconds

76
Q

What is rescue breathing?

A

Giving breaths to an unresponsive victim who has a pulse but is not breathing

77
Q

How is respiratory arrest different from cardiac arrest?

A

A respiratory arrest is when normal breathing stops while in cardiac arrest, there is a sudden stop of the heart. In addition, in respiratory arrest there is still a pulse. In respiratory arrests, the resucer performs rescue breathing however in cardiac arrest, they perform breathing and chest compressions.

78
Q

How do you perform mouth-to-mouth on an adult and child?

A

Use head-tilt-chin lift
Pinch the nose with your thumb and index finger
Take a regular breath and seal your lips around the victim’s mouth
Deliver 1 breath over 1 second and watch for chest rise and repeat if it does not rise
Give a second breath (blow for about 1 second) and watch for the chest to rise
If you are unable to ventilate the victim, return to chest compressions

79
Q

What are the two breathing techniques for infants?

A

Mouth-to-Mouth-and-Nose technique: Place your mouth over the infant’s mouth and nose. You may need to adjust the infant’s head in order to provide ventilation
Mouth-to- Mouth Technique: The same as adult mouth to mouth

80
Q

What is gastric inflation?

A

When the rescuer gives breath too quickly or with too much force, air is likely to enter the stomach rather than the lungs

81
Q

What should rescuers do to reduce the risk of gastric inflation?

A

Avoid giving breaths too quickly, too forcefully, or with too much volume. Deliver each breath over 1 second and deliver just enough air to make the victim’s chest rise

82
Q

What is the difference between mild airway obstruction and severe airway obstruction?

A

In a mild airway obstruction, the victim is coughing, wheezing and there is good air exchange., In a severe airway obstruction, there is clutching at the throat, unable to speak or cry, no air exchange, and respiratory difficulty.

83
Q

What is the universal choking sign?

A

Clutching the throat with the thumb and fingers

84
Q

What should the rescuer do if there is a severe airway obstruction?

A

Ask if they are choking and if they nod yes and they cannot speak, that means there is a severe airway obstruction. Then, immediately start the steps to relieve the obstruction. If the victim becomes unresponsive, then start CPR. Send someone to activate EMS and if you are alone try

85
Q

What should the rescuer do if there is a mild obstructive airway?

A

If there is a good air exchange, do not interfere and encourage the victim to keep coughing. You should monitor the victim and only take action if there are signs of severe airway obstruction.

86
Q

How do you perform choking relief in a responsive adult or chil?

A

You perform abdominal thrusts. If the victim is standing or sitting, kneel or stand by the victim and wrap your arms around the victim’s waist. Make a fist with one hand. Place the thumb side of your fist against the victim’s abdomen, in the midline, slightly above the navel and below the breastbone. Grasp your fist with your other hand and press your fist into the victim’s abdomen with a quick, forceful, upward thrust. Continue until the object is dislodged.

87
Q

How do you provide choking relief to someone who is pregnant or obese?

A

chest thrusts

88
Q

What do you do if a choking victim has become unresponsive?

A

Start perfomring CPR and do not check for a pulse. When giving breaths, look for the object. If you see the object is easy to remove, remove it with your fingers.

89
Q

How do you give breaths when there is an airway obstruction?

A

Give 30 chest compressions and then remove any visible object. As long as you see the chest rise when you give breaths, the airway is no longer obstructed.

90
Q

What do you do if an infant is choking?

A

Use back slaps and chest thrusts

91
Q

WHat is the chian of survial?

A

Activation of Emergency Response
High Quality CPR
Defibrillation
Advanced Resucitation
Post-cardiac arrest care
Recovery

Emergency Clinical Care (16 decks)

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