CPR

Question 1

CPR script paediatric part 1 (coming up to patient)

Answer 1

• PPE and check for danger
• Conducting a dynamic risk assessment now and throughout this scenario
• Will gain 360-degree access to the patient if possible
• check for response verbal and pain
• check for C spine damage
• Airway
• Breathing
• Any pulse (circulation) and if any major haemorrhage

Question 2

CPR script paediatric part 2 (start of cardiac arrest)

Answer 2

• in cardiac arrest, using BVM give 2-5 breathes to see if you can get the heart to start beating
• call back up to confirm cardiac arrest
• it is 15/2 and using 1 hand or 2 thumbs/fingers depending on if and infant/child (everytime giving 2 breathes stop compressions and hold for 1 sec before next breathe)
• state ECG on screen and ask for agreement
• continue compressions, everyone else clear
• inspect the patient to check all clear
• charging to what the (weight x 4 is), check ECG again and ask for agreement
• tap the assistant’s hand and say stop compressions (they need to reply with ‘clear’)
• state ECG on screen and say shocking or disarm (most likely will be a PEA or asystole as VT/VF are uncommon as they are due to heart problems not breathing problems)
• continue compressions

Question 3

When to start CPR on paediatrics

Answer 3

HR < 40bpm (<3 beats in 3 seconds)

Question 4

When to start CPR on infants

Answer 4

HR < 60bpm (<2 beats in 3 seconds)

Question 5

Paediatric defibrillation pad application should be placed as close as possible to adult placement

Answer 5

true

Question 6

CPR feedback pads should be used in patients

Answer 6

≥12 years old

Question 7

Standard adult defibrillation pads should be used in patients - weight and age

Answer 7

> 15kgs and >12 years old

Question 8

Paediatric defibrillation pads should be used in patients - weight

Answer 8

≤15kgs

Question 9

refrain from shaving as this can cause electrical arcing

Answer 9

true

Question 10

should you clip chest hair only when coarse, dense, and wiry?

Answer 10

yes

Question 11

should you use betadine or alcohol wipes

Answer 11

no, because they can cause burns and interfere with pad adhesion

Question 12

should you wipe moist or sweaty skin with a dry towel only?

Answer 12

yes

Question 13

If the monitor’s “Ready for Use” (RFU) indicator continues flashing or showing the circle symbol

Answer 13

the defibrillator is unserviceable and should be replaced

Question 14

If the monitor’s “Ready for Use” (RFU) indicator is flashing or displaying a circle with a diagonal line through it

Answer 14

install a fully charged battery and recheck

Question 15

damage therapy cables must be replaced (dry, damaged, faulty, or expired) and do not need to be changed

Answer 15

false

Question 16

should you use a defibrillator on or near water or on metal surfaces?

Answer 16

no

Question 17

should you use a defibrillator around flammable agents, oxygen-rich atmospheres or anaesthetics

Answer 17

no

Question 18

Zoll X Monitor equipment required

Answer 18

Zoll X monitor

Question 19

Zoll X Series Monitor/defibrillator clinical precautions

Answer 19

none

Question 20

Zoll X Series Monitor/defibrillator contraindications

Answer 20

none

Question 21

Zoll X Series Monitor/defibrillator indications

Answer 21

Start of shift or acquisition of new monitor following resuscitation

Question 22

CPR script part 3 (continuation of compressions)

Answer 22

• count to 15, 15-1 with nil pauses for ventilation
• we are approaching the end of a 2-minute cycle
• state ECG on screen and ask for agreement
• continue compressions, everyone else clear
• inspect the patient to check all clear
• charging to 200, check ECG again, and ask for agreement to partner
• tap the assistant’s hand and say stoop compressions (they need to say ‘clear’)
• state ECG on-screen and say shocking or disarm
• continue compressions

Question 23

CPR script part 2 (start of cardiac arrest)

Answer 23

• in cardiac arrest, start compressions 100-120 per minute, 5cm depth with a full chest recoil
• call back up to confirm cardiac arrest
• state ECG on screen and ask for agreement
• continue compressions, everyone else clear
• inspect the patient to check all clear
• charging to 200, check ECG again and ask for agreement
• tap the assistant’s hand and say stop compressions (they need to reply with ‘clear’)
• state ECG on screen and say shocking or disarm
• continue compressions

Question 24

CPR script part 1 (coming up to patient)

Answer 24

• PPE and check for danger
• Conducting a dynamic risk assessment now and throughout this scenario
• Will gain 360-degree access to the patient if possible
• check for response verbal and pain
• check for C spine damage
• Airway
• Breathing
• Any pulse (circulation) and if any major haemorrhage
• Fix airway/breathing before going to start CPR

Question 25

depth of chest compression

Answer 25

5cm with full chest recoil

Question 26

compression rate

Answer 26

100-120 per minute

Question 27

After the first 2-minute cycle, what do you do next
Adult

Answer 27

• Supra-glottic airway (CPR ratio 15:1 post insertion)
• IV access/normal sale TKVO
• Adrenaline 1 mg IV repeat every second cycle (or 4 minutely)
• flush all medications with 20-30 mL normal saline
• where time permits ECTO2 monitoring and insert OG tube through SGA

SPECIAL CIRCUMSTANCES
If hypovolaemia/anaphylaxis/asthma:
- normal saline 20 mL/kg IV

Question 28

After the first 2-minute cycle, what do you do next
Paediatric

Answer 28

Insert an SGA
- cannot give medication adrenaline or get IV as a paramedic needs to be MICA