Basic Life Support - Cardiac Arrest Flashcards
What is the purpose of Cardio-pulmonary resuscitation (CPR)?
CPR alone is unlikely to restart the heart. The main purpose of it is to restore partial flow of oxygenated blood to the brain and heart and to delay tissue death, which extends the window of opportunity for a successful resuscitation without permanent brain damage.
How can you ‘check response’ , the step after ‘approach safely’ using AVPU be used in CPR?
Check if the patient is Alert, responding to voice stimulus, responding to pain stimulus (trapezium squeeze) or unconscious.
A= alert
V=voice stimulus?
P=Pain stimulus?
u= Unconscious; if no response to previous steps.
After ‘checking response’ what do you do next?
Open airway:
- Head tilt and chin lift
- Jaw thrust - alternative maneuver for bringing the mandible forward and relieving obstruction by the soft palate and epiglottis. Index and other fingers placed behind angle of mandible (posterior jaw bone) and pressure is applied upwards and forwards. Using the thumbs, the mouth is opened slightly by downward displacement of the chin.
What is the next step to CPR after ‘Opening Airway’?
these steps must be performed at the same time:
- Check breathing = listen, watch for chest movements
-Check pulse = using carotid artery
Do not confuse Normal breathing for agonal breathing. Agonal breathing is noisy, barley, heavy or gasping. It occurs shortly after the heart stops in up to 40% of cardiac arrests - NEEDS TO BE RECOGNIZED AS A SIGN OF CARDIAC ARREST!
After Checking breathing and pulse, what is the next stage?
30 chest compressions
After 30 chest compressions, what is the next stage?
2 rescue ventilations
How do you do effective chest compressions?
1) expose chest - use scissors
2) find centre of victim’s chest
3)locate lower half of sternum
How to do chest compressions:
- at a rate of 100-120/minute
- at a depth of 5-6cm
- equal compression and relaxation
- when possible change CPR operator every 2 minutes.
-squeeze the heart between the sternum and the spine.
How do you do 2 rescue ventilation’s?
use 100% oxygen if patient is not breathing, or breathing inadequately.
1) insert oropharyngeal Airway (OPA)
2) BVM + Oxygen
3) keep head tilted
4)use CE grip to hold the BVM.
5) observe for chest rises
6) inflate over 1 second and release
7) do 2 inflations
8) continue doing 30 compressions and 2 ventillations; 30:2 ratio
What conditions can you use a defibrillator for?
- ventricular fibrillation
-pulseless ventricular tachycardia
What can’t you use a defibrillator for?
-asystole
-pulseless electrical activity
-agonal rhythm
How many cases of cardiac arrests seen contain the first monitored rhythm as ventricular tachycardia (VT) or ventricular fibrillation (VF)?
Approximately 25%.
what is an AED?
it is an automated external defibrillator.
uses an electrical current that flows in two directions to shock the patients heart into a normal rhythm, adjusts energy according to resistance between chest pads.
It automatically checks the victims heart rhythm to detect fibrillation and then advice’s on whether or not the patient needs a shock.
How do you use a defibrillator?
1) if VF or VT is confirmed, one paramedic will charge the defibrillator whilst another continues chest compressions.
2) once the defibrillator is charged, pause chest compressions, ensure all rescuers are clear of the patient and them give one shock.
3) immediately resume CPR after the shock, starting with chest compressions. Do this for 2 minutes
If shock is advised then remove oxygen from the vicinity and “advise clear”
If necessary, remove excessive hair from the patients chest using a razor. Also remove any medication patches that may be in the way prior to pad placement (AED pads)
When can resuscitation be discontinued?
- unwitnessed collapse - likely over 10 minutes
-absence of bystander CPR for a period of greater than 10 minutes - presence of significant commodities
- finish resuscitation attempts if ALS (advanced life support) has commenced and the patient remains in a continuous asystole or agonal rhythm for at least 20 minutes. Providing at least 30 minutes of treatment time has occured including BLS (basic Life support) .
