BLS for healthcare providers Flashcards
CPR
– 5 Cycles of 30 Compressions and 2 Breaths
– Utilize AED as soon as available
– High Quality Compressions:
• Victim on Firm Surface
• Compression Rate 100-120 compressions per minute
• Depth: At least 2 inches (5 cm), Not more than 2.4 inches (6 cm).
• Full Chest Recoil – Allow chest to return to original position after each compression
• Consider feedback device
infants
- younger than 1
- excludes newly born infants in the delivery room
children
-1 year of age to puberty
-Signs of puberty are chest and underarm hair in
males; any breast development in females
adults
-adolescents or older
scene safety
-make sure scene if safe for you and victim
check responsiveness
-Tap the Shoulders, Shout “Are you OK?”
If not responsive, Activate Emergency Response (call 911, call a code in hospital, etc.)
-Get/send someone for AED
Adult BLS algorithm
- Assess for Breathing and a Pulse
- Carotid Pulse at neck, no more than 10 seconds
- If no pulse and no breathing – begin CPR with chest compressions
- If has a pulse but no breathing, begin rescue breathing – 1 breath every 6 seconds, recheck pulse in 2 minutes
- If has a pulse and is breathing, monitor victim
chest compression technique
- Position yourself at victim’s side
- Place heel of one hand on center of victim’s chest, other hand on top
- Lower Half of Sternum
- At nipple line
- Keep arms straight
- Shoulders over center of victim’s chest
opening the airway
- medical patient- head tilt chin lift
- trauma patient- jaw thrust- grab under mandible and pull forward
breaths
- consider barrier device
- pocket face mask
- use bag value mask if available
- breaths should be delivered over 1 second
2 rescuers
- still 30:2 with adults
- change compressor every 2 minutes or sooner as needed
situation when an advanced airway is in place
- such as endotracheal tube
- perform continuous compressions giving 1 breath every 6 seconds without pause in compressions
CPR coach
- could be the ventilator if there is only two of you
- could be an outside person if there is enough people
- making sure everything is running smoothly
AED use
-Power On AED -> most important step***
-Attach Pads to Patient’s Bare Chest
-Plug in Pads to Device
-Clear the Victim and Allow Machine to Analyze
-If Shock Advised, Make Sure Again that Victim is
Clear
-Push Shock Button while saying “Clear”
-Resume Compressions after shock
hairy chest
-if extra set of pads, use first set to remove hair or shave
water or other liquid on chest
-dry the chest
implanted defibrillators and pacemakers
- usually in left upper chest, so not in the way
- avoid placing pad directly over device
transdermal medication patches
-remove patch and wipe area while wearing gloves
modifications for infants and children
- rescue breathing rate is faster -> 1 breathe every 2-3 seconds (instead of every 6)
- if collapse not witnessed, 2 minutes of CPR before AED utilized
- if collapse is witnessed- regular adult CPR
- infant pulse check - brachial artery inside upper arm
- CPR if pulse is less than 60 beats per minute and signs of poor perfusion
- less than 60 beat per minute -> treat same as if there is no pulse
chest compressions for children
- 1 or 2 hands
- depth 2 inches
- 1/3 AP diameter
chest compressions for infants
- 2 finger technique or thumb encircling hands technique
- 1.5 inches or 1/3 AP diameter
AED use for different ages
- 8 and older -> adult pads
- younger than 8 -> child pads
- if child pads are not available use adults
- pads should not touch each other
opening the airway and providing artificial ventilation
- for a patient with a stoma, place a BVM or pocket mask device directly over the stoma
- artificial ventilation may result in gastric distention
- stomach becomes filled with air
- have a suction unit available in case patient vomits
- for patients in respiratory arrest- perform rescue breathing
active compression-decompression CPR
-involves compressing the chest and then actively pulling it back up to its neutral position
impedance threshold device (ITD)
- valve device placed between endotracheal tube (advanced airway) and BVM
- limits air entering lungs during recoil phase between chest compressions
- enhances blood flow to the brain
- doubles blood flow to the heart
mechanical piston device
- depresses sternum via compressed gas
- powered or electric powered plunger
- automatic chest compressions
- good for when youre in the back of a moving ambulance
load distributing band CPR or vest CPR
-a circumferential chest compression device composed of constricting band and backboard
when not to start CPR
- if the scene if not safe
- if the patient has obvious signs of death
- rigor mortis (stiffening of the body)
- dependent lividity- pooling of blood -> purple color skin (livor mortis)
- putrefication or decomposition of body
- evidence of nonsurvivable injury
foreign body airway obstruction in adults
- Instead of abdominal-thrust maneuver, use chest thrusts for the following responsive patients:
- Women in advanced stages of pregnancy
- Obese patients
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