CHAPTER 13

Question 1

The preferred method to dislodge a severe airway obstruction in adults and children; also called the Heimlich maneuver

Answer 1

abdominal-thrust maneuver

Question 2

A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression); may increase the amount of blood that returns to the heart and, thus, the amount of blood ejected from the heart during the compression phase

Answer 2

active compression-decompression CPR

Question 3

Advanced lifesaving procedures used to treat medical conditions such as cardiac monitoring, administration of IV fluids and medications, and the used of advanced airway adjunct. EMT’s may be trained in some of these areas

Answer 3

ALS -advanced life support

Question 4

Noninvasive emergency lifesaving care that is used to treat medical conditions, including airway obstruction, respiratory arrest and cardiac arrest

Answer 4

BLS - basic life support

Question 5

The combination of chest compressions and rescue breathing used to establish adequeate ventilation and circulation in a patient who is not breathing and has no pulse

Answer 5

CPR - cardiopulmonary resuscitation

Question 6

The total percentage of time during a resuscitation attempt in which active chest compressions are being performed

Answer 6

Chest compression fraction

Question 7

Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death

Answer 7

dependent lividity

Question 8

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation

Answer 8

gastric distention

Question 9

A combination of two movements to open the airway by tliting the forehead back and lifting the chin; NOT used for trauma patients

Answer 9

head-tilt-chin lift maneuver

Question 10

rapid or deep breathing that lowers blood carbon dioxide level below normal; may lead to increased intrathoracic pressure, decreased neous return, and hypotension when associated with BVM use

Answer 10

hyperventilation

Question 11

A valve device placed between the endotracheal tube and a bag-valve mask that limits the amount of air entering the lungs during the recoil phase between chest compressions

Answer 11

impedance threshold device (ITD)

Question 12

A lack of oxygen that deprives tissues of neccessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occured

Answer 12

ischemia

Question 13

Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have cervical spine injury

Answer 13

jaw-thrust maneuver

Question 14

A circumferential chest compression device composed of a constricting band and backboard that is either electrically or pneumatically driven to compress the heart by putting inward pressure on the thorax

Answer 14

laod-distributing band (LDB)

Question 15

A device that depresses the sternum via a compressed gas-powered or electric-powered plunger mounted on a backboard

Answer 15

mechanical piston device

Question 16

A side-lying position used to maintain a clear airway in unresponsive patients who are breathing adequately and do not have suspsected injuries to the spine, hips, or pelvis

Answer 16

recovery position

Question 17

The return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest

Answer 17

return of spontaneous circulation (ROSC)

Question 18

Stiffening of the body muscles; a definitive sign of death

Answer 18

rigor mortis

Question 19

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope

Answer 19

stridor

Question 20

Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT

Answer 20

ventilation

Question 21

ABCs

CABs

Answer 21

Airway, breathing, circulation

Circulation/compressions, airway, breathing

Question 22

How much time should pass between the time you recognize a patient needs BLS and the start of treatment

Answer 22

1 second

Question 23

How long can the brain be without oxygen before permanent brain damage is possible

Answer 23

4-6 minutes

Question 24

Time is crticial, fill in the blanks for the time clock
0-1 min:\_\_\_\_\_\_
0-4 min:\_\_\_\_\_\_
4-6min:\_\_\_\_\_\_
6-10min:\_\_\_\_\_\_\_
More than 10 min:\_\_\_\_\_\_\_

Answer 24

0-1: cardiac irritability 
0-4: brain damage not likely
4-6: brain damage possible
6-10: brain damage is very likely
10+: permanent brain damage

Question 25

CPR steps:

Answer 25

1. Restore circulation (chest compressions) 2. Open the airway 3. Restore breathing (provide rescue breathing)

Question 26

System Components of CPR

Answer 26

``` Recognition/Activation of EMS Immediate high quality CPR Rapid defibrilation Basic and advanced EMS ALS and postarrest care ```

Question 27

AHA’s chain of survival

Answer 27

Recognition and activation of the emergency response system Immediate, high-quality CPR Rapid defibrillation Basic and advanced emergency medical services Advanced life support and post-arrest care If any are missing, the patient is likely to die

Question 28

Although cardiac arrest in adults usually occurs before respiratory arrest, the reverse is true for __________

Answer 28

infants and children.

Question 29

CPR protocol for Children

Answer 29

Apply after first five cycles of CPR. Manual defibrillator preferred for infants 1 month to 1 year If unavailable, use pediatric-sized pads and dose-attenuating system. If neither is available, then use an AED with adult-sized pads with anterior-posterior placement.

Question 30

Special situations (contraindications of AED)

Answer 30

Pacemakers and implanted defibrillators Wet patients Transdermal medication patches

Question 31

For CPR to be effective, patient must be _____ on firm, flat surface. _____ patient onto __________

Answer 31

supine Log roll long backboard.

Question 32

If you determine that the patient is adequately breathing, and there are no signs injury to the head, spine, hip, or pelvis, what should you do?

Answer 32

Place the patient in the recovery position. This maintains clear airway, allows vomitus to drain from mouth, roll the patient as a unit.

Question 33

What is the rate of compressions and ventilation for a single rescue CPR with 1 EMT?

Answer 33

30:2

Question 34

With two EMS CPR, how often should you switch duties?

Answer 34

Every 2 min

Question 35

Cardiac arrest in infants and children ______ respiratory arrest.

Answer 35

follows Airway and breathing are the focus of pediatric BLS.

Question 36

Causes of child respiratory problems:

Answer 36

``` Injury Infections Foreign body Submersion Electrocution Poisoning/overdose SIDS ```

Question 37

Infant and Child CPR Not breathing and has a pulse: _______________ Not breathing and no pulse:_____________

Answer 37

1 breath every 3 to 5 seconds 2 breaths after every 30 compressions

Question 38

Chest compression fraction: The total percentage of time during a resuscitation attempt in which chest compressions are being performed should be

Answer 38

at least 60%

Question 39

Contraindications of CPR

Answer 39

``` If the scene is not safe If the patient has obvious signs of death Rigor mortis (stiffening of body) Dependent lividity (livor mortis) Putrefaction or decomposition of body Evidence of nonsurvivable injury DNR orders ```

Question 40

Once you begin CPR, continue until (STOP acronym):

Answer 40

S Patient Starts breathing and has a pulse T Patient is Transferred to another provider of equal or higher-level training O You are Out of strength P Physician directs to discontinue

Question 41

Airway obstruction in adults may be caused by:

Answer 41

``` Relaxation of throat muscles Vomited or regurgitated stomach contents Blood Damaged tissue Dentures Foreign bodies ```

Question 42

Abdominal-thrust maneuver (Heimlich) is recommended in ______________________

Answer 42

responsive adults and children older than 1 year.

Question 43

Instead of abdominal-thrust maneuver, use chest thrusts for the following responsive patients

Answer 43

Women in advanced stages of pregnancy | Obese patients

Question 44

When do you aply an EAD on a child?

Answer 44

After 5 cycles of CPR

Question 45

Devices and techniques to assist circulation

Answer 45

``` Active compression-decompression CPR Impedance threshold device (ITD) Mechanical piston device Load-distributing band CPR or vest CPR Manual chest compressions remain the standard of care. ```

Question 46

Foreign Body Airway in Infants

Answer 46

Instead, perform back slaps and chest thrusts (compressions).