General Concepts of Basic Life Support Flashcards
these life-saving techniques based on the most current research are organized into a systematic response called
Chain of Survival
improves a person’s chance of surviving until advanced care becomes available
BLS
steps in Adult Chain of Survival
recognize sx and activate EMS (emergency medical service)
perform early CPR
defibrillate with AED
advanced life support
post-cardiac arrest care
pediatric chain of survival
prevent arrest perform early CPR activate EMS advanced life support post-cardiac arrest care
emergencies in children are usually caused by
breathing problems that trigger cardiac arrest
the first and most important step of the Pediatric Chain of survival
prevention of arrest
Resuscitation research continues to show that _________ is increasing survival rates for hospital discharge
high-quality CPR
The characteristics that define high-quality compressions remain as pushing
hard and fast
CPR compression rate per minute
100-120 per minute
the increase in chest compressions (100-120/ minute instead of 100/minute) leads to
decrease CO due to incomplete cardiac filling during recoil
The 2015 guideline now defines the target depth for adult compressions to be between
2-2.4 inches (5-6 centimeters)
if the adult compressions are delivered beyond 2-2.4 inches (5-6 centimeters) this will result to
increased risk of resuscitation related injuries (rib fractures)
sequence of BLS for 2015 guideline
CAB = improved outcomes
Compressions
Airway
Breathing
ratio CPR: rescue breaths
for one rescuer CPR in all age groups
CPR 30
Rescue breaths 2
30:2
ratio CPR: rescue breaths
for two rescuer CPR
adult
same
CPR 30
Rescue breaths 2
30:2
ratio CPR: rescue breaths
for two rescuer CPR
in children + infants
15:2
are most valuable in saving a life
high-quality chest compressions
What is the intention of changing to CAV+B
encourage early CPR and avoid bystanders interpreting agonal breathing as signs of life and withholding CPR
Shallow breathing pattern that is often related to cardiac arrest and death
agonal breathing
High-quality CPR is key and consists of doing the following:
- Start compressions w/in 10 seconds of recognition of cardiac arrest
- Push hard and fast. Keep compression rate of at least 100 /minute for all persons.
- Keep compression depth of between 2-2.4 inches for adults and (2 in, 1/3 of the depth of the chest) children, and about 1.5 inches (4 cm) for infants.
- Allow complete chest recoil after each compression.
- Minimize interruptions in CPR, except to use an AED or to change rescuer positions. -limit interruptions to less than 10 seconds
Give effective breaths that make the chest rise
• Avoid excessive ventilate.
is cricoid pressure routinely performed
no
Cricoid pressure
other name
Sellick maneuver
what is the intention of doing cricoid pressure
technique used in endotracheal intubation to reduce the risk of regurgitation
how is cricoid pressure performed
application of pressure to the cricoid cartilage at the neck, thus occluding the esophagus which passes directly behind it
how long should you feel for a pulse
10 sec
if a pulse is absent/ not sure you feel a pulse
begin compressions
infant what type of defibrillator
manual
what if a manual defibrillator is not avail
If not available, an AED with pediatric dose attenuator should be used for an infant. If an AED with dose attenuator is not available, then use an adult AED, even for an infant.
after return of spontaneous circulation, all cardiac arrest victims receive
post-cardiac arrest care
is a group of procedure rooms ina hospital or clinic where specialized equipment is used to evaluate the heart and the BV around the heart and in the lungs
cardiac catheterization suite or laboratory (cath lab)
this procedure involves insertion of a catheter through an artery or vein into the heart to study the heart and its surrounding structures and fx
cardiac catherization
chain of survival for an adult who has cardiac arrest in the hospital are
P - surveillance, prevention, and tx of prearrest conditions
RA - immediate recognition of cardiac arrest and activation of the emergency response system
C - early CPR (emphasis on chest compressions)
D - rapid defibrillation
P - multidisciplinary post-cardiac arrest care
successful outcome for a cardiac arrest victim out-of-hospital
early bystander CPR and rapid defibrillation in the first few minutes after the arrest
chain of survival for an adult who has a cardiac arrest outside the hospital
immediate recognition of cardiac arrest and activation of the emergency response system
early CPR w/ emphasis on chest compressions
rapid defibrillation with an AED
effective advanced life support (rapid stabilization and transport to post-cardiac arrest care)
multidisciplinary post-cardiac arrest care
initial support for IHCA
depends on an in-hospital system of appropriate surveillance, monitoring, and prevention with responsive primary provider teams
initial support OHCA
depends on community and EMS providers for support
IHCA
resuscitation teams
hospital departments
professional providers
resuscitation teams
OHCA
lay rescuers - recognize ptx unresponsiveness, call for help, activate ERS, initiate CPR, use AED until team of EMS providers (transports ptx to ED and /or cath lab), before ptx transferred to ICU for continued care
usual etiology of adult cardiac arrest
cardiac cause
cardiac arrest in children is usually due to
shock and
respiratory failure
this is added in the pediatric chain of survival
prevention of arrest
pediatric chain of survival
prevention of arrest
early high-quality bystander CPR
rapid activation of the emergency response system
effective advanced life support (including rapid stabilization and transport to post-cardiac arrest care)
integrated post-cardiac arrest care
occurs when the heart develops an abnormal rhythm and can’t pump blood
sudden cardiac arrest
occurs when blood flow to part of the heart muscle is blocked
heart attack
rhythm problem
cardiac arrest
is a clot problem
heart attack
within seconds the person becomes unresponsive, and is not breathing/ is only gasping
cardiac arrest
its sign may appear immediately or last weeks or longer
severe discomfort in chest or other areas of the upper body
shortness of breath
cold sweats
n/v
heart attack
heart attack can lead to
heart muscle damage
abnormal rhythm - sudden cardiac arrest
heart attack s/x more likely in women
pain in the jaw, arms, back, or neck
light-headedness
n/v
CPR skill
chest compressions only
hands-only CPR
chest compressions + rescue breujaths
30:2 CPR
high-performance team CPR skill
multirescuer coordinated CPR
3 main components of CPR
chest compressions
airway
breathing
signs of poor perfusion
cool extremities, decrease in responsiveness, weak pulses, paleness, mottling (patchy skin appearance), cyanosis
position of the thumb and index fingers during bag mask ventilation
form a C to seal mask against the face
position of the three remaining fingers during bag mask ventilation
form an E
lifting both sides of the jaw into the mask
things to avoid with head tilt-chin lift
do not press deeply into soft tissue under the chin because it might block the airway
do not close the victim’s mouth completely
this technique is used in placement of bag-mask ventilation
E-C clamp technique
what to avoid during bag mask ventilation
do not press too hard on the mask because that could push the patient’s jaw down and block the airway
when giving compressions, rescuers should switch compressors after every
2 minutes
5 cycles of CPR
or if fatigued
if switching compressors, how many seconds to switch
less than 5 seconds to switch
what should be done during compression, so that the rescuer providing breaths can anticipate when breaths will be given and when time for switch is approaching
compressor counts out loud
is a lightweight, portable, computerized device that can identify an abnormal heart rhythm that needs a shock
automated external defibrillator
