BLS

Question 1

CABD

Answer 1

Circulation-airway-breathing-defibrillate

Question 2

Rescue breathing

Answer 2

6-10 rescue breaths per minute (1 breath every 6 seconds). Recheck pulse every 2 minutes

Question 3

Adult CPR

Answer 3

Chest compressions 100-120/min
Palms midline, 1 over the other, at lower 1/3 of sternum between the nipples.
Lock arms.
Press to a depth of 2-2.5 inches.
Allow for full chest recoil with each compression.
1 man or 2 men, 30 chest compressions to 2 rescue breaths.
If 2 men present, switch every 5 cycles.

Question 4

AED

Answer 4

If heart rhythm is not shockable, resume CPR.

Recheck heart rhythm at the end of 5 cycles of CPR

Question 5

Infant CPR: on arrival

Answer 5

If unwitnessed, perform 2 minutes of (5 cycles) CPR, then call for help and get an AED.
If witnessed, call for help and getting AED first, then start CPR.
Feel for either the brachial or femoral pulse (do not check for more than 10 seconds).

Question 6

Infant rescue breathing

Answer 6

Give 12-20 breaths/min.

Recheck pulse every 2 minutes.

Question 7

Infant CPR

Answer 7

Give 100-120 compressions per minute.
If 1 provider, 30 chest compressions to 2 rescue breaths. If one provider, 2 fingers on the lower sternum.
If 2 providers, 15 chest compressions to 2 rescue breaths. Switch every 2 minutes or 5 cycles.
If 2 providers, encircle the infant’s torso with thumbs 1 cm below the nipples.
Depth at least 1.5 inches or 1/3 the depth of infant’s chest.
Allow full chest recoil.

Question 8

Infant defibrillation

Answer 8

Manual defibrillation preferred.

Next next best option is an AED with a pediatric attenuator.

Question 9

Child CPR: on arrival

Answer 9

If unwitnessed, perform 2 minutes of (5 cycles) CPR, then call for help and get an AED.
If witnessed, call for help and getting AED first, then start CPR.
Feel for the carotid pulse (do not check for more than 10 seconds).

Question 10

Child rescue breathing

Answer 10

Give 12-20 breaths/min.

Recheck pulse every 2 minutes.

Question 11

Child CPR

Answer 11

Give 100-120 compressions per minute.
If 1 provider, 30 chest compressions to 2 rescue breaths.
If 2 providers, 15 chest compressions to 2 rescue breaths. Switch every 2 minutes or 5 cycles.
Palms midline, 1 over the other, at lower sternum between the nipples.
Depth at least 2 inches or 1/3 the depth of chest.
Allow full chest recoil.

Question 12

Heimlich maneuver

Answer 12

Only if patient is conscious.
Stand behind the child/adult.
Plays arms around the patient’s waist.
Make a fist with one hand and grabbed a fist with opposite hand, positioning thumb and immediately above the bellybutton.
Push fast up and in until obstruction was removed.

Question 13

Choking: Foreign body obstruction

Answer 13

Call for help.
Do not attempt a blind finger sweep.
If conscious, begin Heimlich maneuver.
If unconscious, begin CPR.

Question 14

Choking: infant

Answer 14

Call for help.
Put infant on your forearm facedown, chest being supported by palm and head and neck by your fingers.
Tilt the infant at 30 degrees with head down (Trendelenburg).
Using a flat palm, between the 2 shoulder blades, provide 5 rapid forceful blows.
Then turn infant face up, head down, using 2 fingers in the middle of the infant sternum below nipples, provide 5 rapid compressions with thrusts equaling 1/3-1/2 depth of the chest..
Continue until obstruction is removed or if infant becomes unconscious.

Question 15

Assess quality of CPR

Answer 15

Poor if quantitative waveform capnography shows PETCO2 <10 mm per Hg or diastolic pressure is <20 mm per Hg.

Question 16

ACLS: drugs

Answer 16

Epinephrine IV/IO 1 mg every 3-5 minutes

Amiodarone IV/IO 300 mg bolus, then 150 mg

Question 17

ACLS: advanced airway

Answer 17

Supraglottic advanced airway or endotracheal intubation
Waveform capnography to confirm and monitor ET tube placement
10 breaths/min with continuous chest compressions

Question 18

Return of spontaneous circulation (ROSC)

Answer 18

Confirmed by pulse and blood pressure
Abrupt increase in PETCO2 (typically greater than or equal to 40 mm per mercury)
Spontaneous arterial pressure waves

Question 19

Defibrillator: Shock energy

Answer 19

Biphasic: Manufacturer recommendation (initial dose of 100-200 J); if unknown, use maximum available. Second and subsequent doses should be equivalent, and higher doses may be considered
Monophasic: 360 J.

Question 20

Rescue breathing

Answer 20

Adult: 1 breath every 5-6 seconds
Child:1 breath every 3-5 seconds
Infant:1 breath every 3-5 seconds.

Question 21

Reversible causes of cardiac arrest

Answer 21

Hypovolemia
Hypoxia
Hydrogen ion (acidosis) 
hypo-/hyperkalemia
Hypothermia

Tension pneumothorax
Cardiac tamponade
Toxins
Pulmonary thrombosis
Coronary thrombosis

Question 22

Cardiac arrest algorithm

Answer 22

1. Activate emergency response
2. Start CPR.
3. Give oxygen.
4. Attach AED/defibrillator.
   4a. Shock if rhythm VT or VF, then resume CPR for 2 minutes and obtain IV/IO access.
   4B. Cannot shock if PEA or asystole, resume CPR for 2 minutes, obtain IV/IO access, give epinephrine every 3-5 minutes, consider advanced airway, capnography.