Chapter 14 Flashcards
BLS Resuscitation (30 cards)
Elements of BLS
Airway obstruction, Respiratory arrest, and cardiac arrest
ABC’s
Airway (obstruction), Breathing (respiratory arrest), Circulation (cardiac arrest or severe bleeding)
Timeline without oxygen
0-1 min: cardiac irritability, 0-4 min: brain damage not likely, 4-6 min: brain damage possible, 6-10 min: brain damage very likely, more than 10 min: irreversible brain damage
CPR
CPR means Cardiopulmonary resuscitation. It reestablishes circulation and artificial ventilation in a patient who is not breathing and has no pulse
CPR steps
- Restore circulation (perform chest compressions)
- Open the Airway
- Restore breathing (provide rescue breathing)
ALS involves:
Cardiac monitoring, intravenous fluids and medications, and advanced airway adjuncts
AHA chain of survival
- Recognition/activation of EMS
- Immediate high-quality CPR
- Rapid defibrillation
- Basic and advanced EMS
- ALS and post-arrest care
- Recovery
Cardiac arrest in adults vs infants and children
Cardiac arrest in adults usually occurs before respiratory arrest, the reverse is true for infants and children
AED and children
Apply AED after first five cycles of CPR, use pediatric sized pads and dose-attenuating system. If neither is available, then use an AED with adult-sized pads with anterior-posterior placement
Special situations with AED
Pacemakers and implanted defibrillators
Wet patients
Transdermal medication patches
Positioning patient for CPR/AED
For CPR to be effective, patient must be supine on firm, flat surface
Must be enough space for two rescuers to perform CPR
Log roll patient onto long backboard
Things to remember during opening of the airway
-For a patient with a stoma, place a bag-mask device or pocket mask device directly over the stoma
-Artificial ventilation may result in gastric distention
-Have a suction unit available in case patient vomits
One-rescuer Adult CPR
-Single rescuer gives both chest compressions and artificial ventilations
-Ratio of compressions to ventilations is 30:2
Two-Rescuer Adult CPR
Recommended to switch positions every 2 minutes
Devices to assist circulation
-Active compression-decompression CPR= Involves compressing the chest and then actively pulling it back up to its neutral position
-Impedance threshold device (ITD)= Limits air entering lungs during recoil phase between chest compressions
-Mechanical piston device= Allows rescuer to configure the depth and rate of compression
-Load-distributing band CPR or vest CPR= A circumferential chest compression device composed of constricting band and backboard
Infant and child CPR
-Cardiac arrest in infants and children follows respiratory arrest
-Airway and breathing are the focus of pediatric BLS
-Determine unresponsiveness by gently tapping on the shoulder and speak loudly
-Provide rescue breathing
-Not breathing and has a pulse: 1 breath every 2 to 3 seconds
-Not breathing and no pulse: 2 breaths after every 30 compressions
Causes of child respiratory problems
-Injury
-Infections
-Foreign body
-Submersion
-Electrocution
-Poisoning/overdose
-SIDS
Foreign body obstruction with infant and child CPR
-Place an unresponsive, breathing child in the recovery position
-Place a wedge under the upper chest and shoulders when supine
Obvious signs of death
-Rigor mortis (stiffening of body)
-Dependent lividity (livor mortis)
-Putrefaction or decomposition of body
-Evidence of nonsurvivable injury
When to stop CPR: STOP
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
Airway obstruction may be caused by
-Relaxation of throat muscles
-Vomited or regurgitated stomach contents
-Blood
-Damaged tissue
-Dentures
-Foreign bodies
Use of chest thrusts during foreign body airway obstruction in adults
-women in advanced stages of pregnancy
-obese patients
CPR and foreign body airway obstruction
-determine unresponsiveness
-check for breathing and a pulse
-If pulse is present and breathing is absent, attempt ventilations
-if two attempts do not produce visible chest rise, perform 30 compressions. open airway, and look in mouth
-Attempt to carefully remove any visible object
Foreign body obstruction with infant and child
-If there are signs and symptoms of airway obstruction, do not waste trying to dislodge a foreign body
-On responsive, standing or sitting child, perform Heimlich maneuver
-on unresponsive child older than 1 year, manage in the same manner as an adult
