CFR-A Flashcards
An infant is defined as
a patent between the ages of 4 weeks and 1 year old inclusive
A child is defined as
a patient between the ages of 1 year and 15 yers old inclusive
Steps in FBAO (Paediatric CPG)
- “are you choking”
- determine if it is severe or mild (if they can cough = mild, if they can’t = severe)
- if it is severe and they are unconscious, request ALS
- if it is severe and they are conscious preform 1-5 back blows
- If this is effective ensure they are breathing adequately
- It is is not effective preform 1 to 5 thrusts (abdominal thrusts to a child and chest thrust to an infant)
- If this is effective continue to ensure adequate breathing
- If this is not effective repeat 1-5 back blows and then 1-5 thrusts until effective
8.If the FBAO is mild and they can cough, encourage coughing and ensure adequate breathing - If patient becomes unresponsive at any time, request ALS
- After requesting ALS (open mouth and look for object, if object is visible make one attempt to remove it, preform 5 rescue breaths, complete one cycle of CPR, if effective continue to ensure adequate breathing, if ineffective complete one more cycle of CPR, if uneffective continue to BLS).
AFTER EACH CYCLE OF CPR, OPEN MOUTH AND LOOK FOR OBJECT - If patient is breathing adequately consider oxygen therapy
- If patient is not breathing adequately preform positive pressure ventilation (12-20 bpm) and continue to oxygen therapy
- Transport
FBAO (Adult CPG)
- “Are you choking?”
- determine if it is severe or mld (if they can cough = mild, if they can’t = severe)
3.if it is severe and they are unconscious, request ALS - If it is severe and the are conscious preform 1 to 5 back blows followed by 1 to 5 abdominal thrusts as indicated
- If it is mild, encourage the patient to cough
- If continuous back blows and abdominal thrusts are effective and coughing is effective, move to ensure there is adequate breathing
- If continuous back blows and abdominal thrusts are ineffective, and patient is conscious repeat cycle of back blows and abdominal thrusts. If patient becomes unconscious, request ALS
8.When requesting ALS preform 1 cycle of CPR, if effective move to ensure adequate breathing, if ineffective preform one more cycle of CPR, if ineffective, move to BLS CPG
AFTER EACH CYCLE OF CPR, OPEN MOUTH AND LOOK FOR OBJECT, IF VISIBLE MAKE ONE ATTEMPT TO REMOVE - If there is adequate breathing, consider oxygen therapy
- If there is no adequate breathing, preform positive pressure ventilations 10 per minute, then consider oxygen therapy
- transport
For abdominal thrusts of obese/pregnant patients
preform chest thrusts rather than abdominal thrusts
Myocardial infarction (MI)
-Plaque in coronary artery ruptures
-Clot forms around rupture blocking the artery
-Myocardium “downstream” of the blockage is starved of oxygen casing ischemia and cellular death
-When a part of the heart can’t pump because its dying from lack of blood flow, it can disrupt the pumping sequence for the entire heart
-That reduces or even stops the blood flow to th rest of the body, which can be deadly if it isn’t corrected quickly
Signs (you can see) and symptoms (what the patient tells you) of a myocardial infarction
-Chest pain - can be mild and feel like discomfort or heaviness, or it can be severe and feel like a crushing pain
-It may start in the chest ad spread (or radiate) to other areas like the left arm, shoulder, neck, jaw or back
-Constant pain, nothing eases it
-Shortness of breath or trouble breathing
-Nausea or stomach discomfort. (heart attacks can often be mistaken for indigestion)
-Heart palpitations
-Anxiety or fear of “impending doom”
-Sweating
-Feeling lightheaded, dizzy or passing out
Stroke (Cerebral Vascular Accident CVA)
-may be caused by a blocked cerebral artery in the same manner as a myocardial infarction - tissue downstream starts to die due to cerebral hypoperfusion
-ischaemic stroke
- plaque in diseased carotid artery
- Blood clot (thrombus) breaks off
- Blood clot in cerebral artery blocks blood flow
CVA/stroke can also be caused by
Cerebral Haemorrhage (Haemorrhage stroke)
-acute onset of worst pain ever - often described as a “Blow to the back of the head”
-pain in occipital region
-High mortality rate
difference between ischemic stroke and hemorrhagic stroke
ischemic stroke - area is deprived of blood (n obstruction blocks blood flow to the brain)
hemorrhagic stroke - area is bleeding (weakened blood vessel wall ruptures causing bleeding in the brain)
Stroke assessment
FAST assessment (only need 1 positive marker for stake to be considered)
F - Facial weakness (can the patient smile? Has their mouth or eye dropped? which side?)
A - Arm weakness (Can the patient raise both arms and maintain for 5 seconds?)
S - Speech problems (Can the patient speak clearly and understand what you are saying? encourage the patient to repeat a short phrase “ the sky is very blue today”)
T - Time of onset
Stroke CPG (Acute neurological symptoms)
- Complete a FAST assessment
- Maintain airway
- oxygen therapy
- Check blood glucose levels
- If blood glucose levels are less than 4 or greater than 20 mmol/L go to glycemic emergency CPG
- If blood glucose levels are between 4 and 20 mmol/L monitor ECG and SpO2 levels
- Consider paramedic
- Transport
Oxygen cylinders
CD cylinder (lightweight with built in regulator) (WHITE)
-Capacity 460 litres
-Duration 30 minutes at 15 LPM
F size cylinder (securely stored in ambulance) (BLACK WITH WHI9TE SHOULDERS)
-Capacity 1360 litres
Oxygen delivery devices
-Nasal cannula
-Simple face mask
-Venturi mask
-Non-rebreather mask
Nasal cannula
Uses COPD patient and patients unable to tolerate a face recovering mask
Capable of delivering between 24-44% oxygen
1LPM 24%
2LPM 28%
3LPM 32%
4LPM 36%
5LPM 40%
6LPM 44%
Non re-breather
-Delivers high concentration oxygen
-60-90%
-Flowrate 10-15 LPM
Simple face mask
-No reservoir
-40-60%
-Flow rate 6-10 LPM
Venturi mask
made up of interchangeable adaptors for specific percentage of oxygen delivery
Bag valve mask
Adult tidal volume = 500-600ml
used to provide positive pressure ventilations to a patient
Abnormal work of breathing
breathing that is insufficient to support life or normal functions of the body
following respiratory assessment and a patient is in respiratory difficulty it may be necessary to assist a patient breathing
Bag mask ventilations rates
ADULT = 10 maximum ventilations per minute
PAEDIATRIC = 12-20 ventilations per minute
Airway management
It is vital we maintain a clear and patent airway, the most common cause of airway obstruction in an unresponsive patient is a flaccid tongue
Airway management option 1
Th recovery position
if a patient is unconscious but breathing and has no other life-threatening conditions, they should be placed in the recovery position. Putting someone in the recovery position will ensure the airway remains clear and open. It also ensure that any vomit or fluid will not cause an obstruction
Airway management option 2
Head tilt chin lift (lifts tongue off the back of the throat)
