Peds BLS - Single Rescuer Flashcards
Name the first step in the algorithm
Verify scene safety
After scene safety is verified, what are the three things you do right away before checking for breathing and pulse?
1) Check for responsiveness - check for response to “Are you alright?”
2) Shout for nearby help
3) Activate the emergency response system with cell phone (if appropriate), and if possible, call out for or retrieve an AED
After the initial things (verifying scene safety then checking for response, shouting for help, and calling 911/getting AED), what are the two vitals to check that send you into 3 branches of decisions?
1) NORMAL breathing (ie, gasping is NOT “normal”)
2) Pulse DEFINITELY felt within 10 seconds - so you DO take 10 second initially, before doing any CPR or rescue breaths, to get a really quality pulse check
Normal breathing and pulse definitely felt within 10 seconds. Action steps?
Monitor until emergency responders arrive
NO normal breathing, but YES pulse definitely was felt within 10 seconds. Action steps?
JUST rescue breaths (NO compressions) at 1 breath every 2-3 seconds, or 20-30 breaths per second (faster than what feels right when you think about it!)
Keep your finger on the pulse while giving JUST rescue breaths.
Officially it says “assess pulse rate for no more than10 seconds”, but if possible I think it wise to keep 1 hand on the pulse at all times. Main take away is to take NO l
Anatomical location of PULSE CHECK per age of child?
Infant: upper arm (brachial pulse)
Child: Neck or groin (carotid or femoral pulse)
You are already in the YES pulse but NO normal breathing pathway. What specifically are you looking out for?
Already giving 2-3 breaths/sec (20-30 breaths/min) fyi.
You’re looking for HR < 60 bpm + signs of poor perfusion! If so, START CPR
When do you do chest compressions?
When the heart’s not working.
Specifically, start chest compressions if the child has NO breathing (or only GASPS) AND:
- a pulse is NOT felt, OR
- HR < 60 bpm + signs of poor perfusion
Child isn’t breathing and has no pulse. What’s one qualifier that would make you take 1 action before just starting CPR?
If there was a WITNESSED SUDDEN COLLAPSE, you suspect a malignant arrhythmia is very likely, thus you would first GET AN AED and (if not already done so) activate emergency response system so that EMS could bring a life-saving AED
1 rescuer performing CPR for no breathing + no pulse. What is the chest compression to breath ratio?
30:2 for chest compressions to breaths
1 rescuer performing CPR for no breathing + no pulse. Do you STOP the chest compressions to give the breaths?
YES, unfortunately you just can’t do both at one by yourself. Otherwise you’d only ever stop chest compressions (whether any ACLS or BLS scenario) for a 10 second pulse chest q2 min
Describe proper chest compressions for CHILDREN (not infants)
Sometimes 1-handed, often 2-handed technique (like adults) to achieve 100-120 compressions/min at a depth of ≥ 1/3 the depth of the chest. For children ≥ 1 years old want 2” (5cm) depth of compressions
allow complete chest recoil obvi
single rescuer = 30:2 compression to breath ratio
two-person rescuer = 15:2 compression to breath ratio (30:2 for ADULTS)
Describe proper chest compressions for INFANTS
Single rescuer = 2-Finger Compression Technique:
- Two fingers center of chest, at or just below nipple line
- ≥ 1/3 the depth of the chest (~1.5 inches / 4 cm).
- single rescuer = 30:2 compression to breath ratio
Two rescuers = 2 Thumb Encircling Compression Technique:
- Thumb side by side on lower sternum
- Squeeze front and back and allow complete chest recoil
- two-person rescuer = 15:2 compression to breath ratio (30:2 for ADULTS)
1 rescuer performing CPR for no breathing + no pulse. When would you use an AED?
As soon as it is available!
Do you stop chest compressions while the AED is analyzing?
Basically YES. Really you just do what the AED tells you to do, and it will say “stop chest compressions” when it wants you to so it can analyze. It will also tell you when to restart chest compressions.
1 rescuer performing CPR for no breathing + no pulse, and a second rescuer arrives. What do you do?
Start Multiple Rescuer peds BLS. If it hasn’t been 2 minutes of single rescuer CPR yet, you’d change from a 30:2 compression to breath ratio and start 15:2 compression to breath ratio, with NO STOPPAGE OF COMPRESSIONS FOR BREATHS. Just stop compressions every 2 min for a 10 sec pulse check.
I looked into the stoppage vs no stoppage of chest compressions during rescue breathing. You definitely stop chest compressions for rescue breaths for one rescuer 30:2 ratio just because you have to, but i think you might also stop it during two rescuer 15:2 ratio just so you can allow the lungs to fill with air instead of exhaling it all! Both decreasing the ratio AND stopping compressions seems kind of backwards since in adults the compressions are SO important, but i think that in peds the hypoxia is such a bad thing that you want more frequent breaths and more effective breaths, so you decrease the ratio AND pause compressions during those important breaths.
1 rescuer performing CPR for no breathing + no pulse. It’s been 2 min of CPR now. What do you do now?
Activate emergency response system and retrieve AED, if not already done so.
If you’re the only one there (ie, single rescuer BLS), when should you leave the pediatric patient?
In both of these two reasons to leave the child, it is in order to active emergency response system or get an AED!!
1) It was a witnessed SUDDEN COLLAPSE and you’ve done a 10 second pulse and breathing check to verify they have neither. Ie, leave them to activate EMS and get an AED before even starting chest compressions!
2) You’ve done a full 2 min of CPR and they’re still not breathing and have no pulse. You then leave to activate EMS and get an AED if you haven’t done so yet!
I honestly don’t know how this applies to adults.
Are gasping breaths good enough to count for regular breathing, thus no rescue breaths should be given?
NO. Gasping or irregular breathing is not good enough and you should still give rescue breaths
You have an AED. When should you use it?
1) Immediately apply AED once it’s there, turn it on, and if it tells you to stop CPR for rhythm analysis you do so. Ie, stop CPR to get the AED set up. If it tells you to shock, you do so. Do NOT delay anything pertaining to getting AED on or following AED instructions for any reason.
When will an AED tell you to shock?
For a shockable rhythm
It must be a shockable rhythm, because the AED says to shock. So you do shock. What do you do next?
IMMEDIATELY resume CPR! do NOT check for a pulse before resuming chest compressions!
The AED just shocked the kid. Do you check for a pulse now?
NO, you IMMEDIATELY resume CPR!
After the AED has shocked and you have resumed CPR immediately, when do you shock again?
basically just when the AED says to shock again! you just resume CPR and do another 10 second pulse check in 2 minutes.
