CHAPTER 13 Flashcards
The preferred method to dislodge a severe airway obstruction in adults and children; also called the Heimlich maneuver
abdominal-thrust maneuver
A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond (decompression); 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
active compression-decompression CPR
Advanced lifesaving procedures used to treat medical conditions such as cardiac monitoring, administration of IV fluids and medications, and the used of advanced airway adjunct. EMT’s may be trained in some of these areas
ALS -advanced life support
Noninvasive emergency lifesaving care that is used to treat medical conditions, including airway obstruction, respiratory arrest and cardiac arrest
BLS - basic life support
The combination of chest compressions and rescue breathing used to establish adequeate ventilation and circulation in a patient who is not breathing and has no pulse
CPR - cardiopulmonary resuscitation
The total percentage of time during a resuscitation attempt in which active chest compressions are being performed
Chest compression fraction
Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death
dependent lividity
A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation
gastric distention
A combination of two movements to open the airway by tliting the forehead back and lifting the chin; NOT used for trauma patients
head-tilt-chin lift maneuver
rapid or deep breathing that lowers blood carbon dioxide level below normal; may lead to increased intrathoracic pressure, decreased neous return, and hypotension when associated with BVM use
hyperventilation
A valve device placed between the endotracheal tube and a bag-valve mask that limits the amount of air entering the lungs during the recoil phase between chest compressions
impedance threshold device (ITD)
A lack of oxygen that deprives tissues of neccessary nutrients, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury has not yet occured
ischemia
Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have cervical spine injury
jaw-thrust maneuver
A circumferential chest compression device composed of a constricting band and backboard that is either electrically or pneumatically driven to compress the heart by putting inward pressure on the thorax
laod-distributing band (LDB)
A device that depresses the sternum via a compressed gas-powered or electric-powered plunger mounted on a backboard
mechanical piston device
A side-lying position used to maintain a clear airway in unresponsive patients who are breathing adequately and do not have suspsected injuries to the spine, hips, or pelvis
recovery position
The return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest
return of spontaneous circulation (ROSC)
Stiffening of the body muscles; a definitive sign of death
rigor mortis
A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope
stridor
Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT
ventilation
ABCs
CABs
Airway, breathing, circulation
Circulation/compressions, airway, breathing
How much time should pass between the time you recognize a patient needs BLS and the start of treatment
1 second
How long can the brain be without oxygen before permanent brain damage is possible
4-6 minutes
Time is crticial, fill in the blanks for the time clock 0-1 min:\_\_\_\_\_\_ 0-4 min:\_\_\_\_\_\_ 4-6min:\_\_\_\_\_\_ 6-10min:\_\_\_\_\_\_\_ More than 10 min:\_\_\_\_\_\_\_
0-1: cardiac irritability 0-4: brain damage not likely 4-6: brain damage possible 6-10: brain damage is very likely 10+: permanent brain damage
CPR steps:
- Restore circulation (chest compressions)
- Open the airway
- Restore breathing (provide rescue breathing)
System Components of CPR
Recognition/Activation of EMS Immediate high quality CPR Rapid defibrilation Basic and advanced EMS ALS and postarrest care
AHA’s chain of survival
Recognition and activation of the emergency response system
Immediate, high-quality CPR
Rapid defibrillation
Basic and advanced emergency medical services
Advanced life support and post-arrest care
If any are missing, the patient is likely to die
Although cardiac arrest in adults usually occurs before respiratory arrest, the reverse is true for __________
infants and children.
CPR protocol for Children
Apply after first five cycles of CPR.
Manual defibrillator preferred for infants 1 month to 1 year
If unavailable, use pediatric-sized pads and dose-attenuating system.
If neither is available, then use an AED with adult-sized pads with anterior-posterior placement.
Special situations (contraindications of AED)
Pacemakers and implanted defibrillators
Wet patients
Transdermal medication patches
For CPR to be effective, patient must be _____ on firm, flat surface. _____ patient onto __________
supine
Log roll
long backboard.
If you determine that the patient is adequately breathing, and there are no signs injury to the head, spine, hip, or pelvis, what should you do?
Place the patient in the recovery position. This maintains clear airway, allows vomitus to drain from mouth, roll the patient as a unit.
What is the rate of compressions and ventilation for a single rescue CPR with 1 EMT?
30:2
With two EMS CPR, how often should you switch duties?
Every 2 min
Cardiac arrest in infants and children ______ respiratory arrest.
follows
Airway and breathing are the focus of pediatric BLS.
Causes of child respiratory problems:
Injury Infections Foreign body Submersion Electrocution Poisoning/overdose SIDS
Infant and Child CPR
Not breathing and has a pulse: _______________
Not breathing and no pulse:_____________
1 breath every 3 to 5 seconds
2 breaths after every 30 compressions
Chest compression fraction: The total percentage of time during a resuscitation attempt in which chest compressions are being performed should be
at least 60%
Contraindications of CPR
If the scene is not safe If the patient has obvious signs of death Rigor mortis (stiffening of body) Dependent lividity (livor mortis) Putrefaction or decomposition of body Evidence of nonsurvivable injury DNR orders
Once you begin CPR, continue until (STOP acronym):
S Patient Starts breathing and has a pulse
T Patient is Transferred to another provider of equal or higher-level training
O You are Out of strength
P Physician directs to discontinue
Airway obstruction in adults may be caused by:
Relaxation of throat muscles Vomited or regurgitated stomach contents Blood Damaged tissue Dentures Foreign bodies
Abdominal-thrust maneuver (Heimlich) is recommended in ______________________
responsive adults and children older than 1 year.
Instead of abdominal-thrust maneuver, use chest thrusts for the following responsive patients
Women in advanced stages of pregnancy
Obese patients
When do you aply an EAD on a child?
After 5 cycles of CPR
Devices and techniques to assist circulation
Active compression-decompression CPR Impedance threshold device (ITD) Mechanical piston device Load-distributing band CPR or vest CPR Manual chest compressions remain the standard of care.
Foreign Body Airway in Infants
Instead, perform back slaps and chest thrusts (compressions).
