CPR Flashcards
What should be checked on the resuscitation trolley?
Portable oxygen
Portable sanction
Defibrillator
Automated external defibrillators
Defibrillation pads
ECG electrodes
Laryngoscopes - straight or curved, straight blade for children under age of 1 and is used to lift the epiglottis to view cords. Curved blades are used to move epiglottis forward by lifting it from in front
Self-inflating bag
Emergency medicines
Intravenous devices and fluids
What size of bag (mL) is used for a child weighing under 2.5kg?
250 mL
What size of bag (mL) is used for a child of an age term to 5 years
500 mL
What size of bag (mL) is used for an older child?
> 1 litre
How to stimulate an infant
Gently stimulate by the shoulders, do not shake, shout if they are all right and call out their name
How to stimulate an older child
Gently stimulate by touching them and loudly calling their name
Look for eye opening or making sounds
For infants under 1 how do you open the airway?
Perform a head-tilt/chin-tilt manoeuvre by placing 1 hand on the forehead and a finger on the bony part of the chin
Maintain the head in a neutral position
Important to avoid hyper extension of the neck which will increase airway obstruction
For children how do you open their airway
Perform the head-tilt/chin-lift placing the head in a sniffing position
Gently tilt patients head back by placing 1 hand on forehead, while lifting the chin with the fingertips of your other hand
This position will lift the tongue off the back of the throat and pull the epiglottis away from the laryngeal opening which opens the airway
What does the head-tilt/chin-tilt position do?
This position will lift the tongue off the back of the throat and pull the epiglottis away from the laryngeal opening which opens the airway
If you suspect a neck injury or have difficulty opening the airway what should you do?
Perform a jaw thrust by standing behind the child and place your hands on either side of a child’’s head
Depending on the size of your fingertips in relation ld’s face, place 2 or 3 fingertips under both angles of child’s lower jaw
Gently rest your thumbs on child’s face then lift jaw upwards
What is the look, listen and feel technique
Look for chest/abdominal movements
Listen for breath sounds
Feel for breath on your cheek
When should you begin rescue breaths and how?
If child is not breathing normally or making agonal breathing
Use a protective face shield or pocket mask of an appropriate size if a bag-valve-mask isn’t available
Place your mouth over the infant’s nose and mouth and give 5 rescue breaths. Deliver breath slowly over 1 second. Give sufficient breath to allow the chest to rise
What does it mean to occlude the nostrils in children over 1?
Squeezing the sides of the nostrils together
When should you deliver chest compressions and how? INFANT
If the infant or child has no signs of life
Deliver chest compressions over the lower half of the sternum
Estimate a finger’s breadth above the xiphisternum and position 2 fingers, begin chest compressions by compressing the sternum
Compress sternum by at least 1/3 of depth of the chest (4cm)
What is the ratio of compressions to breaths?
15:2
How to locate the xiphisternum?
Trace along lower ribs and draw fingers together
How to give chest compressions? CHILD
Estimate a finger’s breadth above the xiphisternum and place the heel of your hand on the child’s chest.
Raise the fingers of the hand that is on the chest away from the chest wall as you will only exert pressure through the heel of your hand onto the sternum.
In children over age of 1, use heel of one hand to compress the sternum by 1/3 of the depth of the chest (5cm)
In larger children use both hands with fingers interlocked
What happens to the tounge when a child becomes unconscious?
Becomes flaccid and drops back, blocking the airway
What is a Yankauer suction catheter used for?
To clear thick or excessive secretions or vomit from the mouth
What does an oropharyngeal airway do?
Keeps the airway open without having to tilt the head
What to do before inserting an oropharyngeal airway?
Position child/infant on their back, easier to insert when standing behind the patient’s head
Wash hands and put on clean gloves
Hold oropharyngeal airway adjacent to the face with the flange at the level of the incisors. The tip should stop the angle of the jaw
Method 1 inserting upside down (oropharyngeal airway)
Tilt the head using head-tilt/chin-lift movement, pull jaw down gently to open the mouth, keep airway device upside down as you gently insert it with the end pointing to roof of mouth.
The convex spoon shape of airway depresses the tongue as you advance the airway
Once halfway inside the mouth, at the end of the heart plate rotate it by 180 degrees
Finish by gently easing the device into position
The flange will rest on the lips
Method 2 depress the tounge (oropharyngeal airway)
If unfamiliar with inserting oral airways, it may be easier to insert airway the right way up
Depress the tounge using a tounge depressor
Insert the device with the curved part of the tube towards the hard palate
Slide airway carefully over the tongue and gently ease into position
Flange will rest on the lips
How to deliver mouth-to mouth ventilation for child
Position child and open airway using head-tilt/chin-lift manoeuvre, check for any obstructions in the mouth
Place head in sniffing position, pinch nose to stop air escaping
Take a normal breath, ready to deliver this to the patient, place your mouth over their mouth ensuring a good seal around the mouth
Breath out steadily for 1 second, remove mouth and check that chest falls, repeat this sequence 5 times
How to deliver mouth-to-mouth ventilation in infants
Keep head in neutral position, open the infant’s mouth and place your mouth over their nose and mouth
Ensure you have a good seal around infants nose and mouth
Breath out steadily for 1 second, remove mouth and check that chest falls, repeat this sequence 5 times
How to apply defibrillation pads?
When applying, chest compressions should not be interrupted for more than 5 seconds
Check the expiry date and open the packet
Place one pad on the chest over the apex of the heart
Turn infant over and apply the posterior pad to the upper back
Connect pads to defibrillator and turn it on.
Calculate energy required at 4 Joules per kilogram of the infant’s weight
Whilst chest compressions continue, charge the defibrillator ‘Stand clear’ and remove oxygen delivery devices
Press shock button
Resume CPR
Continue chest compressions and ventilation for 2 minutes at ratio of 15:2
Check defibrillator after 2 mins to assess the rhythm
How to use an automated external defibrillator
Turn it on, listen to voice prompts from AED and follow instructions
Continue CPR whilst preparing AED and defibrillation pads
Check dates on electrodes and then open, peel off backing from sticky pads.
Place one pad just below the right clavicle, to the right of the sternum
Position the second pad on the left-side of the chest wall, pads shouldn’t touch
Connect defibrillation pads to AED machine, automated voice announces that a shock is indicated and device is charging
When charging shout ‘stand clear’, deliver shock and say ‘shocking now’ then continue CPR at 15:2 ratio
