BLS Skills Flashcards
Adult CPR indications and contra indications
Indications = no pulse
Contra = valid DNR or exception criteria
For CPR, what is the BLS survey and how long to do it?
Responsive, Breathing, pulse
<10s
Where to compress on Adult CPR
Lower half sternum just above xiphoid
Minimum compression depth adult
At least 2 in depth
To allow for chest recoil, you should not…
Lean on the chest
CPR compression rate and ratio
100-120 bpm
30 to 2
During a code what should you immediately do before the compression?
Put a Philips QCPR on center chest
Interruptions in chest compressions should be less than… with a CCF goal of…
< 10s
CCF 80%
Who fits the CPR feedback sensor
55+ lbs
Or 8+ years old
Child (what age?) CPR indications and contras
Indications = a traumatic 1-13 arrest
Contra = valid DNR or exceptions
Where to put hands for child CPR
Lower half sternum above xiphoid
How deep to compress for child CPR
At least 1/3 chest diameter
Compressions rate and ratio for child cpr
100-120 bpm
30:2 one rescuer
15:2 two rescuer
Infant CPR indications and contraindication
Indication = atraumatic arrest < 1 year or < 60 HR with hypoperfusion evidence
Contra = DNR or exceptions
CPR spot for infants
Same as adults/child
How deep to compress for infant CPR
1/3 chest diameter
Compression rate and ratio for infant CPR
Rate 100-120
30:2 or 15:2
BVM indications and contra indications
Indication = resp insuffic/ failure / arrest or pre-oxygenation prior to ETT
Contra = none
Ventilation rate and duration
Rate = 12 to 16 bpm
1 breath over 1 second
How to measure OPA? NPA?
OPA = corner mouth to ear lobe
NPA = corner nose to ear lobe
How to ventilate medical patients vs trauma patients?
Medical = 12-16 bpm , ETCO2 35-45, good SPO2
Trauma = signs of herniation 20 BPM or ETCO2 30
How often to bag if signs herniation?
20 breaths per minute
Steps to adult BVM ventilations & airway adjuncts?
- open airway
- suction PRN
- insert OPA / NPA
- ventilate proper rate / technique
Pediatric BVM indications and contraindications
Indication = bad resp / resp failure / resp arrest
Contra = none
How to position airway of pediatric
Sniffing position
< 2 yr = sheet under shoulder blades
> 2 yr = sheet under occiput
How to measure OPA and NPA for ped?
Use handtevy
Medical vs trauma ped ventilation rate
Medical = 12-16 bpm, ETCO2 35-45, adequate SPO2
Trauma = signs of herniation = 20px , or ETCO2 30
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
Starting rate and adjustments for CPAP. Min and max
Start 5 cmH20
Titrate 2.5cmH20 every 3-5 min to max 10
During CPAP, what to monitor for and how often vitals
Monitor: BP, Resp, Alertness?
Check on your BRA-hs
Vitals per 5 min
What to do when giving CPAP and pt needs nitro?
Remove mask and administer when indicated
CPAP steps
- assemble / connect O2
- explain
- mask
- administer
-monitor / document
Nebulizer with CPAP and ETT indications & contraindications
Indication = When CPAP or ETT pt has bronchospasms
Contra = med allergy
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
What O2 rate for a nebulizer
8 lpm from a SECOND O2 source
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
Rate to BVM and O2 rate for BVM with ETT
15-20 Lpm with oxygen
12-16 bpm or ETCO2 35-45 mmhg
How to attach neb to ETT
ETT to superset tee piece, nebulizer, to BVM
How to attach a neb to a CPAP
T piece adapter
Wound packing, combat gauze, emergency trauma dressing indications contraindications
Indications = life threat bleed where cant use tourniquet & direct pressure doesnt work
Contra = the abdomen
What 2 precautions for trauma combat gauze
- Difficult at non-compressible sites
- Avoid contact w/ eyes
Combat gauze / trauma dressing steps
EPDR
Expose
Pack
Direct pressure
wRap it up
Tourniquet indication contraindication
Indication = direct pressure fails
Contra = cant place proximal to wound
What precaution with tourniquets
Incorrect placement can increase venous bleed
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
What happens if tourniquet doesnt work
Second one
When SHOULD tourniquets be removed?
Only by receiving facility
Chest Seal indications contraindications
Indications = penetrate chest / ab wounds
Contra = none
What precautions with chest seal
Difficulty with excess blood, moisture and debris
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
You want to increase the pressure on a CPAP pt. What must you always do prior?
VITALS
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
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
in the systematic approach, what’s included in your scene sizeup?
- see hear smells
- safety? BSI?
- patient location & environment
- cultural / social concerns
- communication
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
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
What parts are in the secondary assessment of the systematic approach?
Vitals / Diagnostics
History (Sampler & OPQRST)
Head to toe
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)
what does the R in SAMPLER mean?
risk factors
What do you check in a head to toe exam?
head
holes (eyes, ears, nose, mouth)
throat
neck
chest
abd
pelvis
extremities
back/butt
What extra thing MUST you do when bagging a kid or baby?
Open to the pop-off valve (releases extra pressure = prevents barotrauma)
You get ROSC on a pt after cpr. What must you press on the MRX?
“Stop CPR” button
Silence vs acknowledge alarm
Silence shuts off all alarms and you need to restart the monitor to reset it
Acknowledge = silences alarm x2 min
How long to suction an airway? Do you suction going in or out?
<10s going OUT
