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Emergency Medical Technician > BLS Resuscitation > Flashcards

BLS Resuscitation Flashcards

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USMLE® Step 1 flashcards Royal College: Emergency Medicine flashcards
1
Q

Noninvasive emergency life-saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest

A

Basic Life Support

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2
Q

BLS sequence of events

A

ABCs

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3
Q

BLS sequence of events for cardiac arrest

A

CABs

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4
Q

Check for a pulse for no more than ___

A

10 seconds

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5
Q

Permanent brain damage is possible after only ___ without oxygen

A

4 - 6 minutes

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6
Q

If breathing stops before the heart stops, then they patient may have ___

A

Enough oxygen in the lungs to stay alive for several minutes

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7
Q

When cardiac arrest occurs before breathing stops, ___

A

The heart and brain stop receiving oxygen immediately

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8
Q

Used to re-establish circulation and artificial ventilation in a patient who is not breathing and has no pulse

A

CPR

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9
Q

CPR depth

A

2 - 2.4”

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10
Q

CPR rate

A

100 to 120 /min

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11
Q

Goal of CPR

A

Help restore spontaneous breathing and circulation

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12
Q

Timeline for oxygen deprivation in the brain

A

0-1 min: Cardiac irritability
0-4 min: Brain damage not likely
4-6 min: Brain damage possible
6-10 min: Brain damage very likely
10 min+: Irreversible brain damage

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13
Q

ALS differs from BLS by ___

A

Cardiac monitoring, administration of IV fluids and medications, and the use of advanced airway adjuncts

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14
Q

Some cases where BLS may be all that is needed to restore pulse and breathing

A

Choking, near-drowning, or lightning injuries

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15
Q

Chain of survival links

A
  1. Recognition/activation of EMS
  2. Immediate high-quality CPR
  3. Rapid defibrillation
  4. Basic and advanced EMS
  5. ALS and post-arrest care
  6. Recovery
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16
Q

Interruptions between compressions should be minimized and no longer than ___

A

10 seconds

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17
Q

Purpose of allowing the chest to fully recoil

A

Allow blood return to the heart

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18
Q

The first step when approaching a patient in need of CPR after determining if the scene is safe

A

Determine responsiveness

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19
Q

If a pulse cannot be felt definitively after 10 seconds, ___

A

Begin chest compressions

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20
Q

For BLS purposes, who is an infant, child, or adult?

A

Infant: younger than 1 year
Child: 1 year to about 12 to 14 (onset of puberty)
Adult: Onset of puberty and older

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21
Q

Determining puberty for BLS

A

Breast development in girls and underarm, chest, or facial hair in boys

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22
Q

Two basic differences in providing CPR for infants, children, and adults

A
  1. Emergencies in which infants and children require CPR usually have different underlying causes
  2. Anatomic differences in adults, children, and infants, such as smaller airways
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23
Q

Cardiac arrest in adults usually occurs ___ respiratory arrest

A

Before

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24
Q

Cardiac arrest in infants and children usually occurs ___ respiratory arrest

A

After

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25
Q

Most prehospital cardiac arrests occur as the result of a ___

A

Sudden cardiac rhythm disturbance

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26
Q

Sudden cardiac rhythm disturbance

A

Dysrhythmia

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27
Q

VF

A

Ventricular fibrillation

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28
Q

VT

A

Ventricular tachycardia

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29
Q

The normal heart rhythm is known as ___

A

Normal sinus rhythm

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30
Q

Disorganized quivering of the ventricles, resulting in no blood flow and a state of cardiac arrest

A

VF

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31
Q

Rapid contraction of the ventricles that does not allow for normal filling of the heart

A

VT

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32
Q

If you witness a patient’s cardiac arrest and an AED is available, then ___

A

Deploy the AED immediately and then begin CPR

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33
Q

Apply the AED to infants or children after ___

A

The first 5 cycles of CPR have been completed

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34
Q

Cardiac arrest in children is usually the result of ___

A

Respiratory failure

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35
Q

AICD

A

Automated Implanted Cardioverter-Defibrillator

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36
Q

Deliver shock directly to the heart if necessary

A

AICD or pacemaker

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37
Q

How to recognize AICD or pacemaker

A

They create a hard lump beneath the skin, usually on the upper left side of the chest (just below the clavicle)

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38
Q

How to place AED pads with a pacemaker

A

At least 1” away from the device

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39
Q

If you observe a patient with a pacemaker’s muscles twitching as if they were just shocked, then ___

A

Continue CPR and wait 30 to 60 seconds before delivering a shock with the AED

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40
Q

If the patient is wet, ___ prior to attaching the AED pads

A

Dry the chest

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41
Q

If the patient has transdermal medication patches, ___ prior to attaching the AED pads

A

Remove the patch and wipe the skin to remove the residue

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42
Q

Positioning of a patient for CPR to be effective

A

Supine on a firm, flat surface, with enough space for two rescuer to perform CPR and use the AED

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43
Q

How to find carotid pulse

A

Locate the larynx and then slide two fingers toward the side closest to you. The pulse is felt in the groove between the larynx and the sternocleidomastoid muscle, with the pads of the index and middle fingers held side by side

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44
Q

CPR ratio of time devoted to compression vs relaxation

A

1:1

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45
Q

Complications of chest compressions

A

Fractured ribs, lacerated liver, and a fractured sternum

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46
Q

It takes ___ compressions to reestablish effective blood flow to the heart after chest compressions are resumed

A

5 to 10

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47
Q

Compression to ventilation ratio

A

30:2

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48
Q

Compression area

A

In the center of the chest, at the nipple line

49
Q

Ventilation length

A

1 second

50
Q

Hyperventilation may cause ___

A

Increased intrathoracic pressure by putting pressure on the vena cava, this reducing the amount of blood that returns to the heart

51
Q

Use a ___ to ventilate through the stoma

A

Pediatric or infant mask

52
Q

Stomach becomes filled with air

A

Gastric distention

53
Q

Gastric distention occurs most commonly in ___

A

Children

54
Q

How does gastric distention occur?

A

Ventilate too forcefully or if the patient’s airway is not opened adequately, the excess gas under pressure opens up the collapsible tube (esophagus) and allow air to enter the stomach

55
Q

How does gastric distention become dangerous?

A
  1. Could vomit and block the airway
  2. Reduces lung volume by elevating the diaphragm
56
Q

How can an ALS provide remedy gastric distention?

A

Insert an orogastric or nasogastric tube to decompress the stomach

57
Q

Each set of 30 compressions should take about ___

A

17 seconds

58
Q

Before assisting with CPR, a second rescuer should ___

A

Apply airway adjuncts, including a bag-mask device and suction, and insert an oropharyngeal airway

59
Q

If CPR is in progress, then the second rescuer should ___

A

Enter the procedure after the AED and then cycle of 30 compressions and two ventilations

60
Q

How often should the compressor and ventilator switch positions?

A

Every two minutes (5 cycles of 30:2)

61
Q

Switch time between providers should take no longer than ___

A

5 seconds

62
Q

The AED should analyze the cardiac rhythm every ___

A

2 minutes

63
Q

A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression)

A

Active compression-decompression CPR

64
Q

Benefit of active compression-decompression CPR

A

May increase the amount of blood that returns to the heart, and thus, the amount of blood ejected from the heart during the compression phase

65
Q

LVAD

A

Left Ventricle Assist Device

66
Q

A mechanical pump that is implanted in the chest and help pump blood from the left ventricle to the aorta

A

LVAD

67
Q

If the LVAD is working, you will hear ___

A

A humming sound when listening to the chest with a stethoscope

68
Q

The more assistance the LVAD is providing to the heart, the ___ the patient’s pulse will be

A

Weaker

69
Q

A valve device placed between the ET tube and a bag-mask device

A

Impedance threshold device

70
Q

ITD

A

Impedance Threshold Device

71
Q

The ITD may be placed ___ if an ET tube is not in place

A

Between the bag and mask

72
Q

Designed to limit the air entering the lungs during the recoil phase between chest compressions

A

ITD

73
Q

The result of using an ITD

A

Negative intrathoracic pressure that may draw more blood toward the heart, ultimately resulting in improved cardiac filling and circulation during each chest compression

74
Q

ROSC

A

Return of spontaneous circulation

75
Q

Use of an ITD is not recommended for use with ___

A

Conventional CPR

76
Q

If ROSC occurs, the ITD should be ___

A

Removed

77
Q

A device that depresses the sternum via a compressed gas-powered or electric-powered plunger mounted on a backboard

A

Mechanical piston device

78
Q

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

A

Load-distributing band

79
Q

LDB

A

Load-distributing band

80
Q

Decreased oxygen supply

A

Ischemia

81
Q

Children consume oxygen ___ than adults

A

2 to 3 times more rapidly

82
Q

The focus of pediatric BLS

A

Airway and breathing

83
Q

Respiratory issues leading to cardiopulmonary arrest in children causes

A
  1. Injury
  2. Infections of the respiratory tract or another organ system
  3. Foreign body in the airway
  4. Submersion
  5. Electrocution
  6. Poisoning or drug overdose
  7. SIDS
84
Q

If you find an unresponsive, apneic, and pulseless child while alone and off duty, and you did not see the collapse, ___

A

Perform CPR for 2 minutes and then call for help and get an AED

85
Q

The sudden collapse of an otherwise healthy child suggests a ___

A

Primary cardiac event that may respond to defibrillation

86
Q

Pulse check for infant

A

Brachial artery

87
Q

Pulse check for child

A

Carotid or femoral artery

88
Q

Compression area for infant

A

Just below the nipple line

89
Q

Compression area for child

A

In the center of the chest, in between the nipples

90
Q

Compression width for infant

A

Two-finger technique (alone) or two-thumb-encircling-hands technique (two-rescuer)

91
Q

Compression width for child

A

Heel of one or both hands

92
Q

Compression depth for infant

A

At least 1/3 anterior-posterior diameter (about 1.5”)

93
Q

Compression depth for child

A

At least 1/3 anterior-posterior diameter (about 2”)

94
Q

Compression/ventilation ratio for infants or children

A

30:2 w/ one rescuer
15:2 w/ two rescuer

95
Q

Foreign body obstruction response for responsive infants

A

Back slaps and chest thrusts

96
Q

Foreign body obstruction response for responsive children

A

Abdominal thrusts

97
Q

Ventilation rate for infants and children

A

1 breath every 2 to 3 seconds (20 to 30 breaths/min)

98
Q

The total percentage of time during a high-quality resuscitation attempt in which chest compressions are being performed

A

Chest compression fraction

99
Q

Chest compression fraction should be maintained greater than ___

A

80%

100
Q

When to not start CPR

A
  1. Scene is unsafe
  2. Obvious signs of death
  3. If the patient and the patient’s physician have agreed on a DNR order or no-CPR order
101
Q

Obvious signs of death

A

Absence of pulse and breathing with:
1. Rigor mortis
2. Dependent lividity
3. Putrefaction
4. Evidence of non-survivable injury (decapitation, dismemberment, or being burned beyond recognition)

102
Q

If you are presented with a POLST or MOLST form, then ___

A

Contact medical control for guidance

103
Q

When to stop providing CPR

A

S: the patient Starts breathing and has a pulse
T: the patient’s care is Transferred to another provider of equal or higher-level of training
O: you are Out of strength or too tired to continue CPR
P: a Physician who is present or providing online medical direction assumes responsibility for the patient and directs you to discontinue CPR

104
Q

ALS providers under ___ may cease resuscitation efforts without online medical direction under specific situations

A

Termination of Resuscitation (TOR) protocols

105
Q

TOR

A

Termination of Resuscitation

106
Q

BLS criteria for TOR

A
  1. Unwitnessed by EMS
  2. No AED or shock delivered
  3. No ROSC
107
Q

ALS criteria for TOR

A
  1. Same three rules from BLS
  2. Unwitnessed by bystander
  3. No bystander CPR
108
Q

Creates an artificial cough by causing a sudden increase in intrathoracic pressure when thrusts are applied to the subdiaphragmatic region

A

Abdominal thrust maneuver

109
Q

Hand placement for abdominal thrust

A

Fist, thumb side to abdomen just above the umbilicus and well below the diploid process

110
Q

What technique should be used for a patient who is obese or in an advanced stage of pregnancy who have a severe airway obstruction?

A

Chest thrusts

111
Q

Hand placement for chest thrusts

A

Fist, thumb side against the sternum, avoiding the xiphoid process and the edges of the rib cage

112
Q

In infants who have signs and symptoms of ___, do not waste time trying to dislodge a foreign body

A

An airway infection

113
Q

A previously health child who is eating or playing with small toys or an infant who is crawling around the house and who suddenly has difficulty breathing has probably ___

A

Aspirated a foreign body

114
Q

If a child or infant has gone unconscious from choking, do not ___ before providing chest compressions

A

Check for a pulse

115
Q

Priorities for a pregnant patient who is in cardiac arrest

A

Provide high-quality CPR and relieve pressure form the aorta and vena cava

116
Q

When a pregnant patient lies supine, the uterus can ___

A

Compress the aorta and vena cava (aortocaval compression)

117
Q

If a pregnant patient is not in cardiac arrest, then position them on their ___

A

Left side to relieve pressure on the great vessels

118
Q

If a pregnant patients top of their uterus (fundus) can be felt at or above the level of the umbilicus, perform ___ while CPR is being performed

A

Manual displacement of the uterus to the patient’s left to relieve aortocaval compression

Emergency Medical Technician (100 decks)

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