OSCEs BLS DONE

Question 1

What is Basic Life Support? (BLS)

Answer 1

Maintaining airway patency and supporting breathing and circulation without the use of equipment other than a protective device.

Question 2

What is the main sign which indicates treatment for cardiac arrest in current BLS guidelines?

What do you no longer look for to assess whether a cardiac arrest has taken place?

Answer 2

The main sign which indicates treatment for cardiac arrest is the absence of normal breathing sounds.

You no longer check for a carotid pulse as this can be time consuming and unreliable.

Question 3

If you find a collapsed person, what is the overall BLS sequence you should follow?

Answer 3

Make sure you, the victim and bystanders are safe

Check for a response

If responsive, don’t move them, try to find out what is wrong.

If unresponsive shout for help

Open airway

If breathing normally, put into the recovery position

If not breathing normally, call 999

Start CPR: begin with compressions

30 chest compressions, 2 breaths

Question 4

When obtaining help in BLS, what should you ask for?

Answer 4

Ask for an automated external defibrillator, if one is likely to be available.

Question 5

Describe the chest compressions you should give in CPR

Answer 5

Compress vertically, in the centre of the sternum. Compress to a depth of 5-6cm, at a rate of 100-120 per min (Staying Alive).

Question 6

How long should a rescue breath take? Why?

Answer 6

A rescue breath should take about 1 sec, no more so that the pauses in chest compression is minimised.

Question 7

During CPR, when should you stop to check the victim, or discontinue CPR?

Answer 7

Do not stop to check the victim or discontinue CPR unless the victim starts to show signs of regaining consciousness, such as coughing, opening his eyes, speaking or moving AND then starts to breathe normally.

Question 8

What should you do with a responsive patient? (3)

Answer 8

• Leave them in the position in which you find them provided they are in no danger
• Try to find out what is wrong with them
• Reassess them regularly

Question 9

How do you open an airway

Answer 9

Turn the victim onto their back

Place a hand on the victims forehead and gently tilt his head back

With your fingertips under the point of the victim’s chin, lift the chin to open the airway.

Question 10

How do you check for breathing?

Answer 10

Keep the airway open

Look for chest movement

Listen at the victims mouth for breath sounds

Feel for air on your cheek

Question 11

How long do you check for breathing?

What do you do if you are unsure of breathing is normal?

What do first aiders sometimes mistake for normal breathing?

Answer 11

Check for no more than 10 seconds

If there is any doubt as to whether there is normal breathing, act as if breathing is not normal

In the first few minutes after cardiac arrest, a paitent may be barely breathing, or taking infrequent, noisy gasps. This is often termed agonal breathing and must not be confused with normal breathing

Question 12

What do you do with a patient who is unconscious, but is breathing normally?

Answer 12

Turn them into the recovery position

Call 999 from a mobile. If there is no signal, send a bystander to find a phone. Only leave the victim if there is no other option.

Continue to assess that the breathing is normal. If there is any doubt as to whether the breathing is normal, commence CPR.

Question 13

What is the first thing you do if you have a patient who is unconscious and not breathing normally?

Answer 13

Call 999/ask someone to call for an ambulance

Only leave the patient if there is no other option for summoning an ambulance

Ask a bystander to find an AED if this seems likely to be available

Then you should start CPR.

Question 14

How do you do a chest compression?

Answer 14

Kneel by the side of the victim

Place the heel of one hand in the centre of the victims chest (lower half of the sternum)

Place the heel of your other hand on top of the first hand, and interlock fingers. Ensure that there is no pressure on the ribs or abdomen.

Press down vertically and with your arms straight. Aim to press 5-6cm

After each compression release all pressure on the chest without losing contact with the patient

Compression and release should take the same amount of time

Question 15

How do you do a rescue breath?

Answer 15

Open the airway using head tilt and lift

Pinch the victims nose using the index finger and thumb of the hand on their forehead

Allow the mouth to open while maintaining chin lift

Take a normal breath and seal your lips to their mouth

Blow steadily into their mouth while watching the chest rise, take about 1 sec

Take your mouth away and watch for the air leaving the chest

Do one more breath, then return to the compressions straight away. 30 compressions:2breaths

Question 16

What do you do if the first rescue breath does not make the chest rise and fall?

Answer 16

Check the victims mouth, and remove obstruction

Recheck that there is adequate head tilt and chin lift

Do not attempt more than two breaths each time before returning to chest compressions.

Question 17

If there are two BLS trained first aiders there, how often do you change roles and why?

Answer 17

Swap compressions/breaths every one to two minutes to avoid fatigue

Do this as quickly as possible, trying to keep compressions uninterrupted.

Question 18

If you cannot face giving rescue breaths, what can you do?

Answer 18

Give compression only CPR. Continue for as long as you would with normal CPR

Question 19

Continue resuscitation until…

Answer 19

• Qualified help arrives and takes over
• The victim starts to regain consciousness AND starts breathing normally
• You become exhausted

Question 20

How do you put someone in the recovery position?

Answer 20

• Remove glasses and check pockets for anything bulky
• Kneel beside the victim and make sure that both legs are straight
• Place the arm nearest to you out at right angles to the body, elbow bent with the hand palm-up
• Bring the far arm across the chest and hold the back of the hand against the victims cheek next to you
• With your other hand, grasp the far leg above the knee and pull it up, keeping the foot on the ground
• Keeping his hand pressed against his cheek, pull on the far leg to roll the victim towards you on to his side
• Adjust the upper leg so that both the hip and knee are bent to 90 degrees
• Tilt the head back to make sure the airway remains open
• If necessary, adjust the hand under the cheek to keep the head tilted and facing downwards to allow liquid material to drain from the mouth
• Check breathing regularly
• If they have to be kept in the recovery position for more than 30mins, turn them onto the other side

Question 21

What is the main modification for CPR on a child?

How does the sequence of CPR slightly alter?

Answer 21

Main modification: Do chest compressions to one third of the depth of the chest. Use 2 fingers for an infant under 1, and use one or both hands for older children

Do 5 breaths before you start compressions

If you are on your own, do 1 min CPR before going for help

Question 22

What modification to CPR is useful for victims of drowning?

Answer 22

Do 1 min of CPR before going to get help

Question 23

What is the function of the spleen? (3)

Answer 23

The spleen acts as a resevoir for blood in case of hemmhorage, it is involved in the produciton of B lymphocytes and in the breakdown of old and damaged erythrocytes.

It also contains T lymphocytes.

Question 24

Where is the spleen located?

Answer 24

the spleen lies against the diaphragm, in the area of rib 9 to rib 10 in the left upper quadrant of the abdomen.