CPR

Question 1

Clinical Death

Answer 1

patient breathing and heartbeat stop

Question 2

Biological Death

Answer 2

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

Question 3

Sequence for a pt with no pulse

Answer 3

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

Question 4

Assessment for Unconscious Patient

Answer 4

• 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

Question 5

Management of the Unconscious Pulseless Patient

Answer 5

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

Question 6

Differences in reasons for pulselessness in adult and child

Answer 6

Adult - likely a disturbance in the hearts electrical activity

Child - respiratory issue

Question 7

What position should the patient be in for CPR

Answer 7

supine

Question 8

Airway issues and CPR

Answer 8

most issues are caused by the tongue

perform head tilt or jaw thrust

Question 9

ventilation rate and time

Answer 9

adult 10-12 min

child and infant 12-20 min

Question 10

gastric distention

Answer 10

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

Question 11

If a patient regains consciousness what position should he be placed in

Answer 11

recovery

Question 12

Compression Depth in an Adult

Answer 12

at least 2”
allow for full chess recoil
50 % compression / 50% release

Question 13

Compression Depth in a Child

Answer 13

1/3 to 1/2 depth of the chest

2” inches

Question 14

Compression Depth in a Infant

Answer 14

1/3 to 1/2 depth of the chest

1 1/2” inches

Question 15

Compression to Ventilation rate in an Adult

Answer 15

30:2

Question 16

Compression to Ventilation rate in a Child

Answer 16

30: 2 one rescuer
15: 2 two rescuer

Question 17

Compression to Ventilation rate in a Infant

Answer 17

30: 2 one rescuer
15: 2 two rescuer
3: 1 newborn

Question 18

Reasons for interrupting CPR

Answer 18

• 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

Question 19

When not to begin or when to Terminate CPR

Answer 19

• 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

Question 20

CPR - Adult

Answer 20

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

Question 21

CPR infant

Answer 21

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

Question 22

Questions Review for test

14 Questions test this fall

Answer 22

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