Emergency Medicine - BLS

Question 1

Steps in Emergency Response?

Answer 1

FIRST SURVEY SCENE

RAP CAB

R - RESPONSIVENESS - Tap shoulder ask if okay

A - ACTIVATE EMS if unresponsive with no breathing or no normal breathing and if access to phone

(Get defibrillator!)

P - POSITION on back - roll all body parts over at same time, be aware of head and spine injuries, support neck and spinal column

C - CIRCULATION (check pulse only
A - AIRWAY
B - BREATHING

Question 2

Is look, listen and feel for breathing part of BLS algorithm?

Answer 2

No - it has been removed in BLS 2011-2012 refinements

Question 3

What is emphasized for high quality CPR?

Answer 3

The most important thing is GETTING BLOOD MOVING (Have 2nd rescuer check carotid pulse as you do compressions)

• Compressions of adequate rate and depth
• Complete chest recoil between compressions
• Minimize interruptions between compressions
• Avoid excessive ventilation

Question 4

Chest compressions or rescue breathing first?

Answer 4

Chest compressions first before 2 rescue breaths

Question 5

What is the compression rate?

Answer 5

At least 100 compressions per minute

Question 6

What is the compression depth for adults?

Answer 6

2 inches (about 5 cm)

Question 7

What is hand placement for compressions?

Answer 7

Place heel of hand on center of victim’s chest

Put other hand on top of first with fingers interlaced

Press down 2 inches in adults, 1.5 inches in kids

Question 8

How to do 30-2 compressions and breathing?

Answer 8

• 30 compressions
• Open airway w/ head tild chin lift
• Pinch victim’s nose closed
• Take normal breath and cover victim’s mouth with yours to create airtight seal
• Give 2 one second breaths and watch for chest to rise
• If first 2 do not go in, re-tilt and give 2 more - if still do not go in, suspect choking

1 rescuer: Continue 30/2 until help arrives for ALL AGES

2 rescuer: 30/2 for adults, 15/2 for children and infants

Question 9

How long till brain damage?

Answer 9

Starts in 4-6 minutes

Certain after 10 minutes

Question 10

Do you move the victim?

Answer 10

Don’t move victim until CPR is given and EMS arrives

Exceptions

• Threat of fire or explosion
• If on a soft surface, move to a hard surface (can’t compress chest on soft surface)
• Victim should be level or head a bit below

Question 11

What is ACLS?

Answer 11

Advanced cardiac life support - - includes defibrillation, O2, drug therapy

Question 12

When to use mouth to nose breathing?

Answer 12

• If stomach is being distended you are blowing into stomach, not lungs
• Can’t open mouth
• Can’t make good seal
• Severely injured mouth
• Mouth to soma (tracheotomy)

Question 13

When to stop CPR?

Answer 13

Victim revives
EMS arrives
Too exhausted to continue
Unsafe scene

Question 14

If someone vomits when you do CPR?

Answer 14

Risk of aspiration
Rescue position (roll on to left side down, knee over side)

If STROKE - then Paralyzed Side down!

Wipe vomit with fingers wrapped in cloth

Reposition and resume

Question 15

What device has the best oxygen flow?

Answer 15

Bag Valve Mask

Still 30 / 2 - compressions are still king

Question 16

CPR for infants?

Answer 16

• Same RAP CAB EXCEPT IF ALONE, START CPR FOR 2 MINS BEFORE ACTIVATE EMS (if not alone, one can start CPR, one can call EMS)
• Seal nose and mouth or nose only
• Give shallow puffs
• Compressions - 2 fingers (middle+ring) press between nipples 1/2 to 1/3rd depth of chest
• 30/2 if 1 rescuer, 15/2 if 2 rescuer