Chain of survival
Recognition/activation of EMS Immediate high-quality CPR Rapid defibrillation Basic and advanced EMS ALS and postarrest care
What are reversible causes of cardiac arrest which may be treated on an AEMT level? (5 Hs & Ts)
Hypovolemia Hypoxia Hydrogen ion (acidosis) Hypo/hyperkalemia Hypothermia Tension pneumothorax Tamponade, cardiac Toxins Thrombosis, pulmonary Thrombosis, coronary
Anyone younger than ___ year is considered an infant.
A child is between ___ year of age and _____.
1; onset of puberty
Most cardiac arrests occur as the result of which sudden cardiac dyrhythmias?
Pulseless ventricular tachycardia
What is ventricular fibrillation?
Disorganized quivering of the ventricles generated by ectopic foci causing no forward blood flow.
What is ectopic foci?
Electrical activity originating from site other than the SA node.
What is pulseless ventricular tachycardia?
Rapid contraction of the ventricles that does not allow for normal filling of the heart.
How many cycles of CPR should be performed before applying the AED pads in an infant or child?
What is the preferred AED use for infants and children?
Pediatric-sized pads and a close attenuator.
Where should an AED pad be placed if the patient has a pacemaker?
Left pad should be placed 1” away from device.
Even when external chest compression are performed properly, they circulate only _____ of the blood that is normally pumped by the heart.
How many compresses does it take to reestablish effective blood flow to the heart?
5 to 10
Postresuscitative support for ROSC
Monitor glucose levels
Optimize ventilation and saturation above 94%
Treat hypotension - IV/IO bolus, consider treatable causes (H & T), medic backup
Advanced critical care in the ED: 12-lead EKG, coronary reperfusion, temperature management
Benefits of impedance threshold device (ITD).
Limits air entering the lungs during recoil which may increase cardiac filling and circulation during each compression.
Benefits of a mechanical piston device and load-distributing band.
Frees rescuers to complete other tasks and eliminates fatigue.
Possible respiratory issues in pediatrics leading to cardiopulmonary arrest.
Injury, blunt and/or penetrating Infections FB Submersion Electrocution Poisoning or OD SIDS
Where do you check a pulse on an infant?
Where do you check a pulse on a child?
Carotid or femoral artery
How can you check responsiveness of an infant?
Gently tap soles of feet
CPR is require in infants or children when they are ___.
Pulseless or less than 60 beats/min
Chest compression fraction.
Total percentage of time during a resuscitation attempt in which chest compressions are being performed.
What is the minimal percentage of chest compression fraction?
What are the three exceptions to not starting CPR?
- Scene is unsafe.
- Obvious signs of death, including an absence of pulse and breathing, along with: rigor mortis, dependent lividity, putrefaction, or nonsurvivable injury.
- DNR or no-CPR order
When should you STOP CPR?
S : starts breathing and has a pulse.
T : transferred to equal or higher-level of care.
O : out of strength
P : physician directs you to d/c
What is the difference between single rescuer and two rescuer CPR on a pediatric pt?
Compression/vent ratio in single rescuer is 30:2, but two rescuer is 15:2.