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Pinellas County Protocol 2023 > BLS Skills > Flashcards

BLS Skills Flashcards

(64 cards)

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1
Q

Adult CPR indications and contra indications

A

Indications = no pulse

Contra = valid DNR or exception criteria

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2
Q

For CPR, what is the BLS survey and how long to do it?

A

Responsive, Breathing, pulse

<10s

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3
Q

Where to compress on Adult CPR

A

Lower half sternum just above xiphoid

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4
Q

Minimum compression depth adult

A

At least 2 in depth

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5
Q

To allow for chest recoil, you should not…

A

Lean on the chest

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6
Q

CPR compression rate and ratio

A

100-120 bpm
30 to 2

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7
Q

During a code what should you immediately do before the compression?

A

Put a Philips QCPR on center chest

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8
Q

Interruptions in chest compressions should be less than… with a CCF goal of…

A

< 10s
CCF 80%

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9
Q

Who fits the CPR feedback sensor

A

55+ lbs

Or 8+ years old

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10
Q

Child (what age?) CPR indications and contras

A

Indications = a traumatic 1-13 arrest

Contra = valid DNR or exceptions

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11
Q

Where to put hands for child CPR

A

Lower half sternum above xiphoid

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12
Q

How deep to compress for child CPR

A

At least 1/3 chest diameter

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13
Q

Compressions rate and ratio for child cpr

A

100-120 bpm

30:2 one rescuer
15:2 two rescuer

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14
Q

Infant CPR indications and contraindication

A

Indication = atraumatic arrest < 1 year or < 60 HR with hypoperfusion evidence

Contra = DNR or exceptions

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15
Q

CPR spot for infants

A

Same as adults/child

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16
Q

How deep to compress for infant CPR

A

1/3 chest diameter

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17
Q

Compression rate and ratio for infant CPR

A

Rate 100-120

30:2 or 15:2

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18
Q

BVM indications and contra indications

A

Indication = resp insuffic/ failure / arrest or pre-oxygenation prior to ETT

Contra = none

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19
Q

Ventilation rate and duration

A

Rate = 12 to 16 bpm

1 breath over 1 second

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20
Q

How to measure OPA? NPA?

A

OPA = corner mouth to ear lobe

NPA = corner nose to ear lobe

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21
Q

How to ventilate medical patients vs trauma patients?

A

Medical = 12-16 bpm , ETCO2 35-45, good SPO2

Trauma = signs of herniation 20 BPM or ETCO2 30

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22
Q

How often to bag if signs herniation?

A

20 breaths per minute

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23
Q

Steps to adult BVM ventilations & airway adjuncts?

A
  • open airway
  • suction PRN
  • insert OPA / NPA
  • ventilate proper rate / technique
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24
Q

Pediatric BVM indications and contraindications

A

Indication = bad resp / resp failure / resp arrest

Contra = none

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25
How to position airway of pediatric
Sniffing position < 2 yr = sheet under shoulder blades > 2 yr = sheet under occiput
26
How to measure OPA and NPA for ped?
Use handtevy
27
Medical vs trauma ped ventilation rate
Medical = 12-16 bpm, ETCO2 35-45, adequate SPO2 Trauma = signs of herniation = 20px , or ETCO2 30
28
CPAP Indications contraindications
Indications = reactive airway disease (asthma / COPD). Water in lungs (CHF, acute pulm edema, drowning / near drowning, selected toxic inhalations) Contra = hypo (< 90sbp), altered (14 GCS), bad resp (arrest or <8), pneumothorax, trach / cric, vomit
29
Starting rate and adjustments for CPAP. Min and max
Start 5 cmH20 Titrate 2.5cmH20 every 3-5 min to max 10
30
During CPAP, what to monitor for and how often vitals
Monitor: BP, Resp, Alertness? Check on your BRA-hs Vitals per 5 min
31
What to do when giving CPAP and pt needs nitro?
Remove mask and administer when indicated
32
CPAP steps
- assemble / connect O2 - explain - mask - administer -monitor / document
33
Nebulizer with CPAP and ETT indications & contraindications
Indication = When CPAP or ETT pt has bronchospasms Contra = med allergy
34
Steps for nebulizer w/ CPAP
- explain - assemble ( 2 sources of O2 w/ separate regulators) - attach nebulizer ( 8 lpm) - CPAP starts at 5 cmH20 - instruct pt to breath
35
What O2 rate for a nebulizer
8 lpm from a SECOND O2 source
36
Steps for nebulizer with ETT
- identify requires 2 o2 sources (w/ separate regulators) - assembler and attach - prep and attach neb (8lpm) - BVM (15-20lpm) - ventilate 12 -16 bpm or maintain ETCO2 35-45 mmhg - reassess and monitor
37
Rate to BVM and O2 rate for BVM with ETT
15-20 Lpm with oxygen 12-16 bpm or ETCO2 35-45 mmhg
38
How to attach neb to ETT
ETT to superset tee piece, nebulizer, to BVM
39
How to attach a neb to a CPAP
T piece adapter
40
Wound packing, combat gauze, emergency trauma dressing indications contraindications
Indications = life threat bleed where cant use tourniquet & direct pressure doesnt work Contra = the abdomen
41
What 2 precautions for trauma combat gauze
1. Difficult at non-compressible sites 2. Avoid contact w/ eyes
42
Combat gauze / trauma dressing steps
EPDR Expose Pack Direct pressure wRap it up
43
Tourniquet indication contraindication
Indication = direct pressure fails Contra = cant place proximal to wound
44
What precaution with tourniquets
Incorrect placement can increase venous bleed
45
Tourniquet steps
- identify proximal placement (armpit / groin) - no joints - communicate w/ pt - tighten until bleed stops - failure = 2nd tourniquet - note time/date on pt’s skin - reassess
46
What happens if tourniquet doesnt work
Second one
47
When SHOULD tourniquets be removed?
Only by receiving facility
48
Chest Seal indications contraindications
Indications = penetrate chest / ab wounds Contra = none
49
What precautions with chest seal
Difficulty with excess blood, moisture and debris
50
Chest seal steps
- Clean & dry wound PRN - remove one seal at a time - place firmly with sticky side down - Apply light pressure occlusive seal - repeat w/ 2nd wound
51
You want to increase the pressure on a CPAP pt. What must you always do prior?
VITALS
52
What are all the main sections of the Systematic Approach?
- Dispatch info - Scene sizeup - General impression - Chief complaint - Primary assessment - 1st Impression - Secondary assessment - Redefine diagnosis - Reassess
53
In the systematic approach, what are you thinking about on the way to the call? (dispatch info)
game plan scene safety concerns additional resources what equipment
54
in the systematic approach, what's included in your scene sizeup?
- see hear smells - safety? BSI? - patient location & environment - cultural / social concerns - communication
55
In the systematic approach, what are all the components of the primary assessment?
- exsanguination - Airway - Breathing (RRQ, lung sounds) - Circulation (RRQ, Skin) - Disability (AVPU/GCS) - Exposure
56
in the systematic approach, what parts are in the "first impression"?
- Threats fixed? - sick or non sick? (load/go or stay/play) - differential diagnosis - transport decision
57
What parts are in the secondary assessment of the systematic approach?
Vitals / Diagnostics History (Sampler & OPQRST) Head to toe
58
In the systematic approach, what do you do after you complete your secondary assessment?
redefine your differential diagnosis (life threat, critical, or non-emergent) reassess (repeat primary and VS)
59
what does the R in SAMPLER mean?
risk factors
60
What do you check in a head to toe exam?
head holes (eyes, ears, nose, mouth) throat neck chest abd pelvis extremities back/butt
61
What extra thing MUST you do when bagging a kid or baby?
Open to the pop-off valve (releases extra pressure = prevents barotrauma)
62
You get ROSC on a pt after cpr. What must you press on the MRX?
“Stop CPR” button
63
Silence vs acknowledge alarm
Silence shuts off all alarms and you need to restart the monitor to reset it Acknowledge = silences alarm x2 min
64
How long to suction an airway? Do you suction going in or out?
<10s going OUT

Pinellas County Protocol 2023 (9 decks)

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