Chapter 13- BLS Resuscitation

Question 1

Basic life support (bls)

Answer 1

A noninvasive emergency life-saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest

Question 2

What sequence is used if a patient is in cardiac arrest

Answer 2

CAB sequence (compressions, airway, breathing)

Question 3

Cardiopulmonary restorations (CPR)

Answer 3

used to establish a circulation and artificial ventilation in a patient who is not breathing and who has no pulse

Question 4

What are the steps to Cpr?

Answer 4

1. Restore circulation by performing chest compressions to the body
2. Perform 30 high quality compressions at a depth of 2 to 2.4 inches in an adult at the rate of 100-120 a minute. Then open the chin with a jaw thrust of head tilt chin lift maneuver
3. Then restore breathing by providing rescue breaths via mouth to mask or bag valve mask. Administer 2 breaths, each over one second while visualizing chest rise

Question 5

Advanced life support (als)

Answer 5

Involves advanced life-saving procedures, such as cardiac monitoring, administration of intravenous fluids and medications, and the use of advanced airway adjuncts

Question 6

Return of spontaneous circulation (ROSC)

Answer 6

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

Question 7

What are the five links in the chain of survival?

Answer 7

Recognition/activation of ems
Performing high quality cpr
Rapid defibrillation
Basic and advanced ems
als and postarrest care

Question 8

Recognition and activation of the emergency response system (Number one of the chain of survival)

Answer 8

This step assures that emergency responders are dispatched to the scene quickly

Question 9

Immediate high quality cpr (second link in chain of survival)

Answer 9

Immediate CPR by a bystander is essential for success for resuscitation of a person in cardiac arrest

Question 10

Rapid defibrillation (third link of chain)

Answer 10

Early defibrillation offers the best opportunity to achieve a successful patient outcome. They have become readily available in many schools, fitness clubs, sports arenas, and other gathering places

Question 11

Basic and advanced life support (fourth chain link)

Answer 11

This link in the chain describes care provided by EMTs and ALS providers before the patient arrives to the emergency department

Question 12

Advanced life support and postarrest care

Answer 12

This is the caretaking for the person once they’ve been brought to the hospital. It ensures that they get the correct therapy to fully recover

Question 13

What is considered an Infant?

Answer 13

Anyone under 1 year old

Question 14

What defines a child

Answer 14

Anyone between the age of 1 and the beginning of puberty (facial/body hair for boys and breast development for girls)

Question 15

What is ventricular fibrillation (v-fib)

Answer 15

The disorganized quivering of the ventricles, resulting in no forward bloodflow and a state of cardiac arrest

Question 16

What is ventricular tachycardia (v-tach)

Answer 16

A rapid contraction of the ventricles that does not allow for normal filling of the heart

Question 17

When do you apply the AED to infants or children?

Answer 17

After the first five cycles of CPR have been completed

Question 18

What should you do if you notice an AICD (automated implanted carioverter defibrillator) on a patient?

Answer 18

You should place the AED pad at least 1 inch away from the device

Question 19

What do you do if there is a medication patch on a patient and you need to give them AED?

Answer 19

You take off The patch with a gloved hand, wipe away any excess medicine and place the pad on

Question 20

What do you do right after you have determined that a patient is unresponsive?

Answer 20

You quickly check for breathing and a pulse, it should take no longer than 10 seconds

Question 21

What depth of compressions should you give an adult?

Answer 21

2-2.4 inches

Question 22

How many chest compressions does it take to reestablish effective blood flow to the heart?

Answer 22

5 to 10 compressions

Question 23

Head tilt chin lift maneuver

Answer 23

An affective way for opening the airway and most patients when there is NO indication of a spinal injury

Question 24

Jaw thrust maneuver

Answer 24

If a spinal injury suspected, use this maneuver. Place your fingers behind the angles of the patient’s lower jaw and then move the jaw upward

Question 25

How do you do the head tilt chin lift maneuver?

Answer 25

Place one hand on the patients four head and apply for and backward pressure with your palm to talk to head back, then place the tips of your index and middle fingers under the lower jaw and lift upwards

Question 26

Recovery position

Answer 26

If the patient is breathing adequately or on his own and has no signs of injury to the spine, hip, or pelvis, then place them in this position. This position helps to maintain a clear airway of a patient with a decreased LOC with no traumatic injuries

Question 27

Hyperventilation

Answer 27

Ventilating too fast or with too much force

Question 28

Ventilation

Answer 28

The physical active air moving in and out of the lungs. Required for adequate respirations.

Question 29

Gastric distention

Answer 29

The result of the stomach becoming filled with air, may happen with too much artificial ventilation

Question 30

Aspiration

Answer 30

Vomitus or other foreign materials in the lungs

Question 31

How often do you switch partners during CPR?

Answer 31

After five cycles of CPR (should be around 2 minutes)

Question 32

What is a pit crew approach to the management of cardiac arrest?

Answer 32

Following this model, each resuscitation team member is assigned a specific role before beginning care of the cardiac arrest patient For example EMT 1 will be team leader, EMT 2 and EMT 3 will perform CPR, EMT 4 will operate the AED

Question 33

What is a left ventricular assist device? (LVAD)

Answer 33

A mechanical pump that is implanted in the chest and helps pump the blood from the left ventricle to the aorta. If it is working, you will hear a hum when listening to the Chest through a stethoscope

Question 34

What do you do if there is a pulse present, but breathing is absent or in adequate?

Answer 34

You start rescue breathing, administer one breath every 5 to 6 seconds

Question 35

Active compression – decompression CPR

Answer 35

A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond it. This can allow even more blood to fill in the heart which creates a stronger contraction when the rescuer pushes back down

Question 36

Impedance threshold device (ITD)

Answer 36

A valve device placed between the ET tube and a BMV. It is designed to limit the air entering the lungs during the recoil phase between chest compressions. This can result in negative intrathoracic pressure and may draw more blood to the heart, resulting in improved cardiac filling.

Question 37

Mechanical piston device

Answer 37

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

Question 38

Load distributing band (LDB)

Answer 38

A circumferential chest compression device composed of a constricting band and backboard

Question 39

Ischemia

Answer 39

Decreased oxygen supply

Question 40

What is the primary focus with cardiac arrest in infants and children?

Answer 40

You want to focus on opening the airway and providing artificial ventilation, because most cardiac arrest events follow respiratory arrest with children and infants

Question 41

What are the causes for children or infants to have respiratory issues, leading to cardiopulmonary arrest?

Answer 41

*Injury, both blunt and penetrating * infections of the respiratory tract or another organ system * submersion (drowning) * electrocution * poisoning or drug overdose * sudden infant death syndrome (SIDS)

Question 42

What can you do to avoid a child hyperexing his/her neck on a backboard, therefore blocking the airway?

Answer 42

You can place a pad underneath the upper chest and shoulders (torso)

Question 43

What should you do if a child isn't breathing adequately, but they have a pulse?

Answer 43

You should do rescue breathing. One breath every 3-5 seconds

Question 44

Chest compression fraction

Answer 44

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

Question 45

What are the obvious signs of death?

Answer 45

*rigor Mortis *dependent lividity *putrefaction * evidence of not survivable injury, such as decapitation, dismemberment, or being burnt beyond recognition

Question 46

Rigor mortis

Answer 46

Stiffening of the body after death

Question 47

Dependent lividity

Answer 47

A discoloration of the skin caused by pooling of blood

Question 48

Putrefaction

Answer 48

Decomposition of Body tissues

Question 49

When do you not perform cpr?

Answer 49

1. If the scene is unsafe 2. If they are obviously dead 3. If they have a DNR

Question 50

What is the pneumonic for knowing when to STOP cpr?

Answer 50

STOP

Question 51

What does the pneumonic STOP stand for?

Answer 51

S-the patient STARTS breathing T-patient care is TRANSFERRED to another provider or equal or higher training O-you are OUT of strength or too tired to continue P-a PHYSICIAN who is present or providing online medical direction assumes responsibility for the patient and directs you to stop cpr.

Question 52

What should you do with a mild airway obstruction?

Answer 52

Leave them alone! Do NOT do abdominal thrusts. Encourage them to cough or to keep coughing. Give supplemental oxygen if needed and provide prompt transport to ed

Question 53

Stridor

Answer 53

A high pitched sound created by minimal air movement. Occurs when an object is not fully blocking the airway, but the small amount of air entering the lungs is not enough to sustain life

Question 54

When should you suspect in airway obstruction in an unconscious patient?

Answer 54

If the standard maneuvers to open the airway and ventilate the lungs are ineffective

Question 55

How do you remove a foreign airway obstruction from a CONSCIOUS adult or child?

Answer 55

Abdominal thrusts

Question 56

How do you remove foreign airway obstructions from a unconscious adult or child?

Answer 56

Chest compressions

Question 57

Do you remove an airway obstruction in a responsive infant?

Answer 57

Perform backslaps and chest thrusts to try to clear a severe airway obstruction

Question 58

What do you do with a patient overdoses on opioids?

Answer 58

Always start with cpr, administer naloxine if necessary, but don't wait for it to kick in. Begin resuscitation

Question 59

What are your priorities for a pregnant patient in cardiac arrest?

Answer 59

To begin high quality cpr, and to relieve pressure off the aorta and vena cava. Remove aortacaval pressure by performing manual displacement of the uterus to the patients left

Question 60

What can be done after resuscitation has stopped that can be helpful?

Answer 60

* take the family to a quiet, private place * introduce yourself and anyone with you *speak in a clear, warm and sensitive tone *try to exhibit calm reassuring authority *use the patient name *use eye contact and appropriate touch *while still on scene, be supportive but don't hover *expect a variety of emotions from the family *and if a friend or family member can be there to support them *when you need to leave. Turn the family over to someone else;