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Pinellas County Protocol 2023 > BLS Skills > Flashcards

BLS Skills Flashcards

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
Q

How to position airway of pediatric

A

Sniffing position
< 2 yr = sheet under shoulder blades
> 2 yr = sheet under occiput

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26
Q

How to measure OPA and NPA for ped?

A

Use handtevy

27
Q

Medical vs trauma ped ventilation rate

A

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

Trauma = signs of herniation = 20px , or ETCO2 30

28
Q

CPAP Indications contraindications

A

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
Q

Starting rate and adjustments for CPAP. Min and max

A

Start 5 cmH20

Titrate 2.5cmH20 every 3-5 min to max 10

30
Q

During CPAP, what to monitor for and how often vitals

A

Monitor: BP, Resp, Alertness?
Check on your BRA-hs

Vitals per 5 min

31
Q

What to do when giving CPAP and pt needs nitro?

A

Remove mask and administer when indicated

32
Q

CPAP steps

A
  • assemble / connect O2
  • explain
  • mask
  • administer
    -monitor / document
33
Q

Nebulizer with CPAP and ETT indications & contraindications

A

Indication = When CPAP or ETT pt has bronchospasms

Contra = med allergy

34
Q

Steps for nebulizer w/ CPAP

A
  • explain
  • assemble ( 2 sources of O2 w/ separate regulators)
  • attach nebulizer ( 8 lpm)
  • CPAP starts at 5 cmH20
  • instruct pt to breath
35
Q

What O2 rate for a nebulizer

A

8 lpm from a SECOND O2 source

36
Q

Steps for nebulizer with ETT

A
  • 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
Q

Rate to BVM and O2 rate for BVM with ETT

A

15-20 Lpm with oxygen

12-16 bpm or ETCO2 35-45 mmhg

38
Q

How to attach neb to ETT

A

ETT to superset tee piece, nebulizer, to BVM

39
Q

How to attach a neb to a CPAP

A

T piece adapter

40
Q

Wound packing, combat gauze, emergency trauma dressing indications contraindications

A

Indications = life threat bleed where cant use tourniquet & direct pressure doesnt work

Contra = the abdomen

41
Q

What 2 precautions for trauma combat gauze

A
  1. Difficult at non-compressible sites
  2. Avoid contact w/ eyes
42
Q

Combat gauze / trauma dressing steps

A

EPDR

Expose
Pack
Direct pressure
wRap it up

43
Q

Tourniquet indication contraindication

A

Indication = direct pressure fails

Contra = cant place proximal to wound

44
Q

What precaution with tourniquets

A

Incorrect placement can increase venous bleed

45
Q

Tourniquet steps

A
  • 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
Q

What happens if tourniquet doesnt work

A

Second one

47
Q

When SHOULD tourniquets be removed?

A

Only by receiving facility

48
Q

Chest Seal indications contraindications

A

Indications = penetrate chest / ab wounds

Contra = none

49
Q

What precautions with chest seal

A

Difficulty with excess blood, moisture and debris

50
Q

Chest seal steps

A
  • 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
Q

You want to increase the pressure on a CPAP pt. What must you always do prior?

A

VITALS

52
Q

What are all the main sections of the Systematic Approach?

A
  • Dispatch info
  • Scene sizeup
  • General impression
  • Chief complaint
  • Primary assessment
  • 1st Impression
  • Secondary assessment
  • Redefine diagnosis
  • Reassess
53
Q

In the systematic approach, what are you thinking about on the way to the call? (dispatch info)

A

game plan

scene safety concerns

additional resources

what equipment

54
Q

in the systematic approach, what’s included in your scene sizeup?

A
  • see hear smells
  • safety? BSI?
  • patient location & environment
  • cultural / social concerns
  • communication
55
Q

In the systematic approach, what are all the components of the primary assessment?

A
  • exsanguination
  • Airway
  • Breathing (RRQ, lung sounds)
  • Circulation (RRQ, Skin)
  • Disability (AVPU/GCS)
  • Exposure
56
Q

in the systematic approach, what parts are in the “first impression”?

A
  • Threats fixed?
  • sick or non sick? (load/go or stay/play)
  • differential diagnosis
  • transport decision
57
Q

What parts are in the secondary assessment of the systematic approach?

A

Vitals / Diagnostics
History (Sampler & OPQRST)
Head to toe

58
Q

In the systematic approach, what do you do after you complete your secondary assessment?

A

redefine your differential diagnosis (life threat, critical, or non-emergent)

reassess (repeat primary and VS)

59
Q

what does the R in SAMPLER mean?

A

risk factors

60
Q

What do you check in a head to toe exam?

A

head
holes (eyes, ears, nose, mouth)
throat
neck
chest
abd
pelvis
extremities
back/butt

61
Q

What extra thing MUST you do when bagging a kid or baby?

A

Open to the pop-off valve (releases extra pressure = prevents barotrauma)

62
Q

You get ROSC on a pt after cpr. What must you press on the MRX?

A

“Stop CPR” button

63
Q

Silence vs acknowledge alarm

A

Silence shuts off all alarms and you need to restart the monitor to reset it

Acknowledge = silences alarm x2 min

64
Q

How long to suction an airway? Do you suction going in or out?

A

<10s going OUT

Pinellas County Protocol 2023 (9 decks)

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