Block 1 Flashcards
BLS for HCP
CPR with addition of AED to offer supportive care
Adult HCP algorithm
- Recognition & activation
- Pulse check
- Compressions
- Open Airway
- Breathing
- Defibrillation
- Continue until support arrives
Recognition & activation
- Victim unresponsive
- No breathing or no normal breathing
Pulse check- absent
- Check carotid pulse
- Activate CPR if absent >10 sec
Pulse check- present
- Open airway & provide 1 breath every 5-6 seconds
- Recheck pulse every 2 minutes
Compressions
- Initial step in CPR
- x 30
Open Airway
- Head tilt- chin lift or jaw thrust
Breathing
- 2 breaths that make chest rise
- Allow exhalation between breaths
Defibrillation
- Attach ASAP
- Minimize time between CPR & shocks
High quality CPR
- Rate 100/min
- Depth of 2 inches
- Allow chest recoil
- Minimize interruptions
- Avoid excessive ventilation
Simplified algorithm
- Unresponsive -> activate emergency response -> get defib, start CPR -> check rhythm/ shock every 2 min
Relief of foreign body
- Are you choking?
- Abd thrusts (chest if obese/ pregnant)
- Repeat until effective or unresponsive
Relief of foreign body- unresponsive
Activate emergency response
- Lower to floor
- Unresponsive with no breathing = no pulse check, immediate CPR
- Look into mouth, remove if visible
- Continue CPR for 2 min, if alone, then activate response system
Shockable rhythms
- V. fib
- V. tach
Non-shockable rhythms
- Asystole
- Pulseless electrical activity
Cardioversion therapy- indications
- Unstable tachy >150/min
- AMS, ischemia, acute HF, hypotension & shock
Cardioversion therapy- definition
- Defibrillation via electrode or handheld pads
- Place in synchronize mode
- Delivers energy concurrent with QRS
Cardioversion therapy- Contraindications
- Critical conditions-> go to unsync
- HR <150
- Direct O2 across chest
- Prep to defib immediately incase of VF
Cardioversion therapy- Technique
- Premedicate with sedatives
- Sync, look for R waves
- Clear personnel
- Administer energy based on state
Cardioversion algorithm
Tachy -> > 150/ min = immediate cardioversion - > have O2, suction, IV & intubation available -> Premeditate w/ sedative if possible -> synchronized cardioversion
Cardioversion- a-fb
120-200 j
Cardioversion- stable, monomorphic VT
100J
Cardioversion- Other SVT, a-flutter
50-100J
Transcutaneous pacing- Def
External pacemakers allow adjustment of HR and current outputs
Transcutaneous pacing- Indications
- Unstable bradycardia <50/min
- Hypotension, AMS, shco, ischemia, acute HF unresponsive to meds
- Acute MI with
- Sinus dysfunction,
- Type II second degree heart block
- Third degree heart block
- New left, right or alternating BBB block
Transcutaneous pacing- Precautions
- Analgesia for conscious pts
- Avoid carotid pulse for mechanical capture
Transcutaneous pacing- Technique
- Position electrodes
- Turn pacer on
- Set demand rate to 80/min
- Set mA output until widened QRS and broad T wave after each spike
BLS survey
- Check responsiveness
- Activate emergency response/ AED
- Check circulation
- Defib
