5. In-hospital resuscitation

Question 1

T/F: suspected or confirmed covid-19 infection is a contraindication to mouth-to-mouth ventilation in clinical settings

Answer 1

True

Question 2

options for opening airway in unresponsive patient with suspected c-spine injury?

Answer 2

jaw thrust or chin lift in combination with manual in-line stabilisation (MILS) - if obstruction persists add head tilt small amount at a time until the airway is patent

Question 3

T/F: agonal breathing is a sign of life/ circulation

Answer 3

false (also doesn’t indicate ROSC during chest compressions so don’t stop)

Question 4

T/F: a very short period of seizure activity can occur at the start of a cardiac arrest

Answer 4

true

Question 5

If you’re alone and encounter a patient in cardiac arrest should you
A) commence CPR
B) leave the pt to get help and equipment

Answer 5

B) leave the pt to get help and equipment

Question 6

Correct hand position for chest compressions?

Answer 6

middle of the lower half of the sternum

Question 7

qualities required of high quality CPR?

Answer 7

depth 5-6cm, full chest recoil after each compression, rate of 100-120/ min, approx same amount of time for compression and relaxation, minimise hands off time

Question 8

T/F: a palpable carotid or femoral pulse is a good indicator of high quality chest compression

Answer 8

false - if available use a prompt or feedback device

Question 9

how often should the person delivering chest compressions swap with someone else?

Answer 9

ideally every 2 minutes or sooner if they are unable to maintain high quality compressions (ideally during planned pauses to compressions e.g. rhythm check)

Question 10

example of a supraglottic airway?

Answer 10

igel

Question 11

correct inspiratory time when giving ventilations?

Answer 11

approx 1s - given enough volume to produce a visible risk of the chest wall

Question 12

What is the purpose of monitoring waveform capnography in cardiac arrest?

Answer 12

can be used to monitor CPR quality, as an indicator of ROCS and as a prognostic indicator

Question 13

How and when can continuous ventilation be used during CPR?

Answer 13

If tracheal intubation has been achieved
May also be possible with a supraglottic airway e.g. i-gel

Ventilate at 10 breaths at minute

Question 14

Using manual defibrillation, it is possible to reduce the pause between stopping and restarting chest compressions to less than __ secs

Answer 14

5

Question 15

T/F: for manual defibrillation, once the pads are applied, pause briefly for a rapid rhythm check (<5s)

Answer 15

true

Question 16

once the rhythm has been checked on the manual defibrillator and it shows VT/ pVT, should you
A) restart chest compressions
B) continue to pause while charging the defib

Answer 16

A) restart chest compressions - but inform all other members of the team to stand clear of the patient

Once charged, stop compressions > deliver shock > restart compressions immediately

Question 17

T/F: the length of the pre-shock pause and delivering a shock is inversely proportional to the change of successful defibrillation

Answer 17

true

if any delays are caused y difficulty in rhythm analysis or individuals touching the bed, restart compressions while a decision is made of what to do

Question 18

How frequently should the cardiac rhythm be assessed?

Answer 18

about every 2 minutes

Question 19

what to do if the patient is not breathing and has a pulse

Answer 19

ventilate the patient’s lungs at 10 breaths a minute and check for a pulse every minute

if any doubt of whether they have a pulse, commence chest compressions

Question 20

Initial management of VF/ VT cardiac arrest that occurs in a monitoring and witnessed environment (cath lab, CCU, critical care unit, already attached to manual defbrillator)

Answer 20

up to 3 quick successive shocks
start check compressions and continue CPR for 2 mins if 3rd shock unsuccessful (the 3 initial shocks are considered as the 1st shock in the ALS algorithm)

Question 21

T/F: precordial thumps are effective at regaining a pulse and should be used before calling for help

Answer 21

false - rarely work, delivery of a thump must not delay calling for help or accessing a defibrillator