Chapter 13- BLS Resuscitation Flashcards
Basic life support (bls)
A noninvasive emergency life-saving care that is used to treat medical conditions, including airway obstruction, respiratory arrest, and cardiac arrest
What sequence is used if a patient is in cardiac arrest
CAB sequence (compressions, airway, breathing)
Cardiopulmonary restorations (CPR)
used to establish a circulation and artificial ventilation in a patient who is not breathing and who has no pulse
What are the steps to Cpr?
- Restore circulation by performing chest compressions to the body
- Perform 30 high quality compressions at a depth of 2 to 2.4 inches in an adult at the rate of 100-120 a minute. Then open the chin with a jaw thrust of head tilt chin lift maneuver
- Then restore breathing by providing rescue breaths via mouth to mask or bag valve mask. Administer 2 breaths, each over one second while visualizing chest rise
Advanced life support (als)
Involves advanced life-saving procedures, such as cardiac monitoring, administration of intravenous fluids and medications, and the use of advanced airway adjuncts
Return of spontaneous circulation (ROSC)
The return of a pulse and effective blood flow to the body in a patient who previously was in cardiac arrest
What are the five links in the chain of survival?
Recognition/activation of ems Performing high quality cpr Rapid defibrillation Basic and advanced ems als and postarrest care
Recognition and activation of the emergency response system (Number one of the chain of survival)
This step assures that emergency responders are dispatched to the scene quickly
Immediate high quality cpr (second link in chain of survival)
Immediate CPR by a bystander is essential for success for resuscitation of a person in cardiac arrest
Rapid defibrillation (third link of chain)
Early defibrillation offers the best opportunity to achieve a successful patient outcome. They have become readily available in many schools, fitness clubs, sports arenas, and other gathering places
Basic and advanced life support (fourth chain link)
This link in the chain describes care provided by EMTs and ALS providers before the patient arrives to the emergency department
Advanced life support and postarrest care
This is the caretaking for the person once they’ve been brought to the hospital. It ensures that they get the correct therapy to fully recover
What is considered an Infant?
Anyone under 1 year old
What defines a child
Anyone between the age of 1 and the beginning of puberty (facial/body hair for boys and breast development for girls)
What is ventricular fibrillation (v-fib)
The disorganized quivering of the ventricles, resulting in no forward bloodflow and a state of cardiac arrest
What is ventricular tachycardia (v-tach)
A rapid contraction of the ventricles that does not allow for normal filling of the heart
When do you apply the AED to infants or children?
After the first five cycles of CPR have been completed
What should you do if you notice an AICD (automated implanted carioverter defibrillator) on a patient?
You should place the AED pad at least 1 inch away from the device
What do you do if there is a medication patch on a patient and you need to give them AED?
You take off The patch with a gloved hand, wipe away any excess medicine and place the pad on
What do you do right after you have determined that a patient is unresponsive?
You quickly check for breathing and a pulse, it should take no longer than 10 seconds
What depth of compressions should you give an adult?
2-2.4 inches
How many chest compressions does it take to reestablish effective blood flow to the heart?
5 to 10 compressions
Head tilt chin lift maneuver
An affective way for opening the airway and most patients when there is NO indication of a spinal injury
Jaw thrust maneuver
If a spinal injury suspected, use this maneuver. Place your fingers behind the angles of the patient’s lower jaw and then move the jaw upward
How do you do the head tilt chin lift maneuver?
Place one hand on the patients four head and apply for and backward pressure with your palm to talk to head back, then place the tips of your index and middle fingers under the lower jaw and lift upwards
Recovery position
If the patient is breathing adequately or on his own and has no signs of injury to the spine, hip, or pelvis, then place them in this position. This position helps to maintain a clear airway of a patient with a decreased LOC with no traumatic injuries
Hyperventilation
Ventilating too fast or with too much force
Ventilation
The physical active air moving in and out of the lungs. Required for adequate respirations.
Gastric distention
The result of the stomach becoming filled with air, may happen with too much artificial ventilation
Aspiration
Vomitus or other foreign materials in the lungs
How often do you switch partners during CPR?
After five cycles of CPR (should be around 2 minutes)
What is a pit crew approach to the management of cardiac arrest?
Following this model, each resuscitation team member is assigned a specific role before beginning care of the cardiac arrest patient
For example EMT 1 will be team leader, EMT 2 and EMT 3 will perform CPR, EMT 4 will operate the AED
What is a left ventricular assist device? (LVAD)
A mechanical pump that is implanted in the chest and helps pump the blood from the left ventricle to the aorta. If it is working, you will hear a hum when listening to the Chest through a stethoscope
What do you do if there is a pulse present, but breathing is absent or in adequate?
You start rescue breathing, administer one breath every 5 to 6 seconds
Active compression – decompression CPR
A technique that involves compressing the chest and then actively pulling it back up to its neutral position or beyond it. This can allow even more blood to fill in the heart which creates a stronger contraction when the rescuer pushes back down
Impedance threshold device (ITD)
A valve device placed between the ET tube and a BMV. It is designed to limit the air entering the lungs during the recoil phase between chest compressions. This can result in negative intrathoracic pressure and may draw more blood to the heart, resulting in improved cardiac filling.
Mechanical piston device
A device that depresses the sternum via a compressed gas powered or electric powered plunger mounted on a backboard
Load distributing band (LDB)
A circumferential chest compression device composed of a constricting band and backboard
Ischemia
Decreased oxygen supply
What is the primary focus with cardiac arrest in infants and children?
You want to focus on opening the airway and providing artificial ventilation, because most cardiac arrest events follow respiratory arrest with children and infants
What are the causes for children or infants to have respiratory issues, leading to cardiopulmonary arrest?
- Injury, both blunt and penetrating
- infections of the respiratory tract or another organ system
- submersion (drowning)
- electrocution
- poisoning or drug overdose
- sudden infant death syndrome (SIDS)
What can you do to avoid a child hyperexing his/her neck on a backboard, therefore blocking the airway?
You can place a pad underneath the upper chest and shoulders (torso)
What should you do if a child isn’t breathing adequately, but they have a pulse?
You should do rescue breathing. One breath every 3-5 seconds
Chest compression fraction
The total percentage of time during a resuscitation attempt in which chest compressions are being performed
What are the obvious signs of death?
- rigor Mortis
- dependent lividity
- putrefaction
- evidence of not survivable injury, such as decapitation, dismemberment, or being burnt beyond recognition
Rigor mortis
Stiffening of the body after death
Dependent lividity
A discoloration of the skin caused by pooling of blood
Putrefaction
Decomposition of Body tissues
When do you not perform cpr?
- If the scene is unsafe
- If they are obviously dead
- If they have a DNR
What is the pneumonic for knowing when to STOP cpr?
STOP
What does the pneumonic STOP stand for?
S-the patient STARTS breathing
T-patient care is TRANSFERRED to another provider or equal or higher training
O-you are OUT of strength or too tired to continue
P-a PHYSICIAN who is present or providing online medical direction assumes responsibility for the patient and directs you to stop cpr.
What should you do with a mild airway obstruction?
Leave them alone! Do NOT do abdominal thrusts. Encourage them to cough or to keep coughing. Give supplemental oxygen if needed and provide prompt transport to ed
Stridor
A high pitched sound created by minimal air movement. Occurs when an object is not fully blocking the airway, but the small amount of air entering the lungs is not enough to sustain life
When should you suspect in airway obstruction in an unconscious patient?
If the standard maneuvers to open the airway and ventilate the lungs are ineffective
How do you remove a foreign airway obstruction from a CONSCIOUS adult or child?
Abdominal thrusts
How do you remove foreign airway obstructions from a unconscious adult or child?
Chest compressions
Do you remove an airway obstruction in a responsive infant?
Perform backslaps and chest thrusts to try to clear a severe airway obstruction
What do you do with a patient overdoses on opioids?
Always start with cpr, administer naloxine if necessary, but don’t wait for it to kick in. Begin resuscitation
What are your priorities for a pregnant patient in cardiac arrest?
To begin high quality cpr, and to relieve pressure off the aorta and vena cava. Remove aortacaval pressure by performing manual displacement of the uterus to the patients left
What can be done after resuscitation has stopped that can be helpful?
- take the family to a quiet, private place
- introduce yourself and anyone with you
- speak in a clear, warm and sensitive tone
- try to exhibit calm reassuring authority
- use the patient name
- use eye contact and appropriate touch
- while still on scene, be supportive but don’t hover
- expect a variety of emotions from the family
- and if a friend or family member can be there to support them
- when you need to leave. Turn the family over to someone else;
