Foundational Concepts Flashcards
What is the significance of Surveillance and Prevention for the adult in-hospital cardiac chain of survival?
Hospitalized patients often show changes in vital signs and other clinical parameters in the minutes and hours leading up to cardiac arrest.
What action is in the in-hospital cardiac chain of survival that is not included in the out-of-hospital chain of survival?
Surveillance and Prevention
What action is in the out-of-hospital chain of survival that is not included in the in-hospital cardiac chain of survival?
Advanced life support (early support provided by EMS at the scene and en route)
What actions are included in the in-hospital chain of survival?
Surveillance and Prevention
Recognition of a cardiac emergency and activation of the emergency response system
Early high-quality CPRl
Early defibrillation
Integrated post-cardiac arrest care
Recovery
What are the actions included in the out-of-hospital chain of survival?
Recognition of cardiac emergency and activation of the emergency response system
Early high-quality CPR
Early defibrillation
Advanced life support
Integrated post-cardiac arrest care
Recovery
What are the first two steps to providing high quality CPR?
Position the patient appropriately
Expose the chest
What is the proper rate and depth for providing chest compressions?
Rate: 100-120 compressions per minute
Depth: 2-2.4 inches (5-6 cm)
How long does it take to complete 30 compressions at a rate of 100-120 compressions per minute?
15-18 seconds
Why is it important to let the chest recoil fully after each compression?
To prevent impeding venous return, which prevents the heart from filling completely, which decreases cardiac output.
What is Coronary Perfusion Pressure (CPP)?
A reflection of coronary blood flow.
The difference between the pressure in the aorta and the pressure in the right atrium during diastole.
The maintenance of what CPP value has been shown to increase the likelihood of ROSC & survival?
CPP > 20 mmHg
How long should it take to administer each ventilation?
About 1 second.
What is a normal tidal volume in adults?
400-700 mL (about half a squeeze on the BVM)
What is the concern with provide excessive ventilation during CPR?
Excessive ventilations leads to…
Increased intrathoracic pressure, which leads to…
Decreased venous return, which leads to…
Decreased cardiac output, which leads to…
Decreased likelihood of ROSC
Also leads to gastric insufflation, which leads to…
Regurgitation and aspiration
How often should providers switch off giving compressions?
Every 2 minutes.
Earlier if compressor is fatigued.
What is the Chest Compression Fraction?
A key indicator of CPR quality.
A representation of the percentage of time during the resuscitation effort that is spent performing compressions.
Compression time divided by total resuscitation time.