Immediate Resuscitation

Question 1

Factors affecting defibrillation success:

Answer 1

1. Transthoracic impedance
2. Electrode position
3. Shock energy
4. Shock sequence

Transthoracic impedance - resistance of thorax to flow of electric current

Question 2

Alternative types of electrode positions:

Answer 2

1. Antero-posterior
2. Postero-lateral
3. Bi-axillary

Question 3

Position of Antero-Posterior electrode:

Answer 3

1st:
1. Over L. precordium

2nd:
1. On the back
2. Behind the heart
3. Inf. to L. scapula

Question 4

Position of Postero-lateral electrode:

Answer 4

1st:
1. Standard apical position (L. MAL)

2nd:
1. On the back
2. Over R. scapula

Question 5

Position of Bi-axillary electrode:

Answer 5

1st:
1. R. MAL

2nd:
1. L. MAL

Question 6

What to do to ensure defibrillation safety?

Answer 6

1. No one touching bed or pt.
2. Don’t hold IVF equipment
3. Wipe fluids from pt’s chest before defibrillation

Question 7

How to reduce risk of fire when defibrillation with O2?

Answer 7

1. Remove any O2 mask or nasal cannulae & place 1 m away from pt’s chest
2. Leave self-inflating bag connected to ETT
3. Leave ventilator tubing connected to ETT

2. Leave self-inflating bag connected to ETT - no increase in O2 concentration occurs in zone of defibrillation

Question 8

Adult in-hospital resuscitation guideline:

Answer 8

Question 9

How to open airway in pt. with suspected C-spine injury?

Answer 9

1. Jaw thrust

Patent airway takes priority over C-spine injury

Question 10

What is the correct hand position for chest compressions?

Answer 10

1. Middle of lower half of sternum

Question 11

What are high-quality chest compressions?

Answer 11

1. Depth 5-6 cm
2. Rate 100-120 bpm
3. Complete chest recoil
4. Equal time for compression & recoil
5. Mimimise interruptions

Question 12

How to ventilate pt’s lungs?

Answer 12

1. Inspiratory time 1 sec
2. Produce visible chest rise
3. Avoid rapid breaths
4. Avoid forceful breaths

Question 13

How often should rhythm checks take place?

Answer 13

1. Every 2 min

Use clock/timer to keep track of time during resus

Question 14

How to Dx resp. arrest?

Answer 14

1. Pulse present
2. Not breathing
3. Other signs of life - warm, well perfused, normal CRT

Question 15

How to Rx pt w/ resp. arrest?

Answer 15

1. Ventilate pt’s lungs
2. Check pulse every 10 breaths - every 1 min