CPR Flashcards
Clinical Death
patient breathing and heartbeat stop
Biological Death
brain cells die, this usually occurs within 10 min of clinical death and is not reversible
Brain cells begin to die after 4 to 6 minutes
Sequence for a pt with no pulse
CAB
first thing you do is check for responsiveness
activate EMS
If the pt is a child or infant activate EMS after 2 minutes of resuscitation
Assessment for Unconscious Patient
- as you approach the patient, observe for signs of life: rise and fall of the chest, moaning, wheezing, coughing or other sounds or movements.
- When you reach the patient, assess for unresponsiveness by tapping the patient on the shoulder and shouting.
- Palpate the carotid pulse at the same time that you put you head close to the patients mouth to observe more closely for chest movement and listens for sounds of breathing
- if the patient has signs of life prosed in the ABC sequence
- open the airway with the head tilt, chin lift or jaw thrust
Management of the Unconscious Pulseless Patient
If there are no signs of life and no pulse (or questionable pulse) activate the EMS system
If no AED administer 30 chest compressions
open the airway -2 ventilations
30:2 ratio
If the patient is a infant or child perform 2 minutes of resuscitation before activating EMS
Differences in reasons for pulselessness in adult and child
Adult - likely a disturbance in the hearts electrical activity
Child - respiratory issue
What position should the patient be in for CPR
supine
Airway issues and CPR
most issues are caused by the tongue
perform head tilt or jaw thrust
ventilation rate and time
adult 10-12 min
child and infant 12-20 min
gastric distention
airway may be blocked
improper head position
ventilations too large and quick
slight bulge is okay but
- air filled stomach reduces lung volume by forcing the diaphragm upward
- patient may aspirate gastric contents
if the patient does vomit roll on side and be prepared to suction
equipment I want on a cardiac arrest call airway kit AED Suction oxygen
If a patient regains consciousness what position should he be placed in
recovery
Compression Depth in an Adult
at least 2”
allow for full chess recoil
50 % compression / 50% release
Compression Depth in a Child
1/3 to 1/2 depth of the chest
2” inches
Compression Depth in a Infant
1/3 to 1/2 depth of the chest
1 1/2” inches
Compression to Ventilation rate in an Adult
30:2
Compression to Ventilation rate in a Child
30: 2 one rescuer
15: 2 two rescuer
Compression to Ventilation rate in a Infant
30: 2 one rescuer
15: 2 two rescuer
3: 1 newborn
Reasons for interrupting CPR
- move a pt onto a stretcher
- move a pt down a flight of stairs or through a narrow corridor
- move a pt on or off the ambulance
- suction to clear vomitus or airway obstruction
- allow for defib or ALS measures
- switch positions every 2 minutes to minimize fatigue
When not to begin or when to Terminate CPR
- obvious mortal wounds - extensive enough that CPR can’t be performed
- Rigor Mortis -occurs within 4-10 hours
- Obvious Decomposition
- A line of lividity
- Stillbirth -blisters on skin, soft head, bad odor
In all cases seek a physicians advice. You must continue CPR until
- spontaneous circulation occurs
- spontaneous circulation & breathing occur
- another trained rescuer takes ove
- turn over to higher level of care
- you are too exhausted
- you receive a no CPR order from a physician
Three criteria accurate in determining when it is reasonable to stop CPR:
- The arrest was not witnessed by EMS or first responders
- no return of spontaneous circulation after three rounds of CPR and rhythm checks
- AED did not detect a shockable rhythm and so did not deliver any shocks
CPR - Adult
Phase 1 - high quality CPR for 5 cycles
Assess for response / Breathing
Activates Emergency Response
Checks Pulse 10 sec
High Quality CPR
- correct compression hand placement
- adequate rate: at least 100 min / 30 compressions 18 sec
- adequate depth: at least 2”
- allows complete chest recoil (23/30)
- minimized interruptions (2 breaths with pocket mask in less than 10 sec)
Second Rescuer arrives with AED
- 2nd rescuer turns on device, applies pads
- 1st rescuer continues with compressions
- 2 rescuer clears victim - analyze - switch
- if shockable rhythm clear and deliver shock
First Rescuer BVM
- resume high quality CPR immediately after shock
- 2nd rescuer - 30 compressions immediately after shock for 2 cycles
- 1st successfully delivers 2 breaths with BVM
CPR infant
Phase 1 - high quality CPR for 5 cycles
Assess for response / Breathing
Activates Emergency Response
Checks Pulse 10 sec
High Quality CPR
- correct compression FINGER placement
- adequate rate: at least 100 min / 30 compressions 18 sec
- adequate depth: at least 1 1/2”
- allows complete chest recoil (23/30)
- minimized interruptions (2 breaths with pocket mask in less than 10 sec)
Second Rescuer and Switch
During 5th set 2nd rescuer arrives with BVM, rescuers switch roles
- 2nd rescuer gives 15 compression’s in 9 sec or less using the 2 thumb encircling hand technique
- 1st rescuer delivers 2 breaths with BVM
After 2 cycles switch for 2 more cycles
Questions Review for test
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