BLS for healthcare providers

Question 1

CPR

Answer 1

– 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

Question 2

infants

Answer 2

• younger than 1

- excludes newly born infants in the delivery room

Question 3

children

Answer 3

-1 year of age to puberty
-Signs of puberty are chest and underarm hair in
males; any breast development in females

Question 4

adults

Answer 4

-adolescents or older

Question 5

scene safety

Answer 5

-make sure scene if safe for you and victim

Question 6

check responsiveness

Answer 6

-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

Question 7

Adult BLS algorithm

Answer 7

• 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

Question 8

chest compression technique

Answer 8

• 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

Question 9

opening the airway

Answer 9

• medical patient- head tilt chin lift

- trauma patient- jaw thrust- grab under mandible and pull forward

Question 10

breaths

Answer 10

• consider barrier device
• pocket face mask
• use bag value mask if available
• breaths should be delivered over 1 second

Question 11

2 rescuers

Answer 11

• still 30:2 with adults

- change compressor every 2 minutes or sooner as needed

Question 12

situation when an advanced airway is in place

Answer 12

• such as endotracheal tube

- perform continuous compressions giving 1 breath every 6 seconds without pause in compressions

Question 13

CPR coach

Answer 13

• 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

Question 14

AED use

Answer 14

-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

Question 15

hairy chest

Answer 15

-if extra set of pads, use first set to remove hair or shave

Question 16

water or other liquid on chest

Answer 16

-dry the chest

Question 17

implanted defibrillators and pacemakers

Answer 17

• usually in left upper chest, so not in the way

- avoid placing pad directly over device

Question 18

transdermal medication patches

Answer 18

-remove patch and wipe area while wearing gloves

Question 19

modifications for infants and children

Answer 19

• 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

Question 20

chest compressions for children

Answer 20

• 1 or 2 hands
• depth 2 inches
• 1/3 AP diameter

Question 21

chest compressions for infants

Answer 21

• 2 finger technique or thumb encircling hands technique

- 1.5 inches or 1/3 AP diameter

Question 22

AED use for different ages

Answer 22

• 8 and older -> adult pads
• younger than 8 -> child pads
• if child pads are not available use adults
• pads should not touch each other

Question 23

opening the airway and providing artificial ventilation

Answer 23

• 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

Question 24

active compression-decompression CPR

Answer 24

-involves compressing the chest and then actively pulling it back up to its neutral position

Question 25

impedance threshold device (ITD)

Answer 25

• 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

Question 26

mechanical piston device

Answer 26

• depresses sternum via compressed gas
• powered or electric powered plunger
• automatic chest compressions
• good for when youre in the back of a moving ambulance

Question 27

load distributing band CPR or vest CPR

Answer 27

-a circumferential chest compression device composed of constricting band and backboard

Question 28

when not to start CPR

Answer 28

• 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

Question 29

foreign body airway obstruction in adults

Answer 29

• Instead of abdominal-thrust maneuver, use chest thrusts for the following responsive patients:
• Women in advanced stages of pregnancy
• Obese patients

Answer 30

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