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EMR - First on Scene - 9th Edition La Baudour - Bergeron > Resuscitation & AED Chapter 10 > Flashcards

Resuscitation & AED Chapter 10 Flashcards

1
Q

Define chain of survival.

A

The idea that the survival of the patient in cardiac arrest depends on the linkage of early access, early CPR, early defibrillation, and early advance life support.

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2
Q

Define cardiac arrest.

A

When the heart stops beating. Also, the ineffective circulation caused by erratic muscle activity in the lower chambers of the heart (ventricular fibrillation).

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3
Q

What are the 5 links in the new AHA ECC adult chain of survival?

A
  1. immediate recognition of cardiac arrest and activation of the emergency response system
  2. early CPR with an emphasis on chest compressions
  3. rapid defibrillation
  4. effective advanced life-support
  5. integrated post cardiac arrest care
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4
Q

Define chest compressions.

A

Putting pressure on the chest to artificially circulate blood to the brain, lungs, and the rest of the patient’s body.

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5
Q

Define defibrillation.

A

The application of an electric shock to a patient’s heart in an attempt to convert a lethal rhythm into a normal one.

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6
Q

Define advanced life-support (ALS).

A

Prehospital emergency care that involves the use of intravenous fluids, drug infusions, cardiac monitoring, defibrillation, intubation, and other advanced procedures.

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7
Q

Define automated external defibrillator (AED).

A

An electrical device that can detect certain abnormal heart rhythms and deliver a shock through the patient’s chest. The shock may allow the heart to resume a normal pattern of beating.

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8
Q

Explain the most common causes of cardiac arrest for adults and pediatric patients.

A

There are many things that can affect the proper function of the heart, including injury due to a trauma and heart attack.

In adults, one of the most common causes of cardiac arrest is a heart attack.

In pediatric patients the cause of cardiac arrest is most commonly caused by underlying respiratory problems such as choking or respiratory arrest.

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9
Q

What are the signs of cardiac arrest?

A

Unresponsiveness
No breathing
No pulse

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10
Q

Define pediatric patient.

A

Refers to infants and children. For the purposes of CPR, patients from birth to one year of age are considered infants. Patients from 1-year-old to the onset of puberty are considered children.

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11
Q

Define cardiopulmonary resuscitation (CPR).

A

Combined compressions and breathing techniques that maintain circulation and breathing.

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12
Q

Define resuscitation.

A

To revive

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13
Q

By performing CPR early, you can circulate oxygenated blood to the brain and help delay the onset of what?

A

Biological death

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14
Q

How and where do you locate a pulse when assessing an adult patient for CPR and for how long?

A

By using two fingers to locate the carotid pulse point in the neck for at least 5 seconds and no more than 10 seconds.

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15
Q

How and where do you locate a pulse when assessing an infant patient for CPR and for how long?

A

By using two fingers to locate the brachial pulse in the upper arm for at least 5 seconds and no more than 10 seconds.

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16
Q

What is the CPR compression site?

A

The sternum which can be found by placing the heel of one hand on the center of the patients bare chest, right between the nipples. This will result in hand placement on the lower half of the sternum.

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17
Q

During adult CPR you should deliver compressions at what rate?

A

At least 100 per minute.

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18
Q

What is the ventilation compression ratio?

A

Two breaths for every 30 compressions - deliver each breath over one second.

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19
Q

What is the depth of compressions in an adult patient?

A

At least 2 inches (5 cm)

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20
Q

What is the depth of compressions in a child patient?

A

One third the diameter of the chest or about 2 inches (5 cm).

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21
Q

What is the depth of compressions in an infant patient?

A

One third the diameter of the chest or about 1 1/2 inches (4 cm).

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22
Q

During infant/child CPR you should deliver compressions at what rate?

A

At least 100 per minute.

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23
Q

Provide a breath every ______ seconds for an adult CPR patient.

A

5 to 6

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24
Q

Provide a breath every ______ seconds for an adult advanced airway CPR patient.

A

6 to 8

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25
Q

Provide a breath every ______ seconds for a child CPR patient.

A

3 to 5

26
Q

Provide a breath every ______ seconds for an infant CPR patient.

A

3 to 5

27
Q

What is the ratio of compression to breaths for an infant with one rescuer?

A

30 to 2

28
Q

What is the ratio of compression to breaths for an infant with two rescuers?

A

15 to 2

29
Q

What is the ratio of compression to breaths for a child with one rescuer?

A

30 to 2

30
Q

What is the ratio of compression to breaths for a child with two rescuers?

A

15 to 2

31
Q

To minimize the effects of fatigue and ensure good chest compressions, rescuers should change positions after how long?

A

After every set of five cycles - approximately two minutes.

32
Q

For infant CPR how should you position the head?

A

In the neutral or sniffing position.

33
Q

For child CPR how should you position the head?

A

In the neutral or sniffing position.

34
Q

Once you begin CPR you should not stop until?

A
  • the patient regains a pulse. Then provide ventilations only.
  • spontaneous pulse and breathing begin
  • equally or more highly trained members of the EMS system can continue in your place
  • you turn over responsibility for patient care to a physician
  • you are exhausted and no longer able to continue
35
Q

Define fibrillation.

A

A disorganized electrical activity within the heart that renders the heart incapable of pumping blood.

36
Q

Define ventricular fibrillation (VF).

A

Disorganized electrical activity, causing ineffective contractions of the lower heart chambers (ventricles).

37
Q

Define ventricular tachycardia.

A

The abnormally rapid contraction of the heart’s lower chambers, resulting in very poor circulation. (Also called V-tach)

38
Q

Define asystole.

A

No electrical activity in the heart; cardiac arrest. (Also called flatline)

39
Q

Explain the purpose of an AED.

A

To assess a heart’s rhythm, determine if defibrillation is necessary, and deliver an electrical shock when needed.

40
Q

An AED starts a stopped heart. true or false?

A

False - the shock does not start a heart that has stopped completely, but will give the defibrillating heart a chance to spontaneously reestablish an effective rhythm on its own.

41
Q

What are the two abnormal heart rhythms that AED’s are capable of recognizing?

A

Ventricular fibrillation

Ventricular tachycardia

42
Q

AED’s are effective in the use of asystole. true or false?

A

False - in situations where there is no electrical activity within the heart, AED’s will not be effective.

43
Q

What are the seven basic warnings of using an AED?

A
  1. follow the same precautions that you would for operating any electrical device
  2. only place the AED on a patient who is in cardiac arrest
  3. do not place defibrillator patches over a patient’s medication patch or implanted pacemaker. With gloved hands, remove the medication patch and wipe the chest dry.
  4. make certain that no one is touching the patient during the analyze or shock phases
  5. do not attempt to assess or shock a patient who is moving or when the defibrillator or it’s leads are being moved
  6. do not attempt to defibrillate a patient who is lying in a puddle of water
  7. your medical director may have specific guidelines for defibrillating infants younger than one year old - know your protocols
44
Q

What four critical times are the goal of every EMS system to reduce in regards to defibrillation?

A
  1. EMS accessed time. This is the time from patient collapse until the EMS system is alerted.
  2. Dispatch time. This is the time from the call to the EMS dispatcher to alert the personnel who will respond and defibrillate.
  3. Response time. This is the time it takes for the rescuer or crew to reach the patient.
  4. Shock time. This is the time it takes from reaching the patient until the first shock is delivered.

Time is one of the most critical elements in the effort to save the life of a victim of cardiac arrest. Minimizing the time between collapse and the initiation of CPR, between CPR and the delivery of the first AED shock, and between defibrillation and the arrival of more advanced care is the goal of a strong chain of survival.

45
Q

To be a candidate for AED the patient must meet what criteria?

A

Be unresponsive, have no carotid pulse, and have no normal respirations.

46
Q

Define basic life support (BLS).

A

Externally supporting the circulation and respiration of the patient in respiratory or cardiac arrest through CPR.

47
Q 
The approximate rate of compressions during CPR is \_\_\_\_\_ per minute.
A. 80 to 100
B. no faster than 80
C. at least 100
D. no faster than 120
A

C. at least 100

48
Q 
You were caring for an adult patient who was found unresponsive. You observe only gasping respirations. What is the most appropriate next step?
A. open the airway and give a breath
B. call 911 and get an AED
C. begin chest compressions
D. attach the AED
A

B. call 911 and get an AED

49
Q 
The recommended location for assessing the presence of a pulse on a child is at the \_\_\_\_\_\_ artery.
A. brachial
B. carotid
C. radial
D. femoral
A

B. carotid

50
Q 
What is the recommended rate of compressions for infant CPR?
A. at least 100 per minute
B. as fast as possible
C. 80 to 100 per minute
D. 60 to 80 per minute
A

A. at least 100 per minute

51
Q 
What is the recommended ratio of chest compressions to ventilations for an adult patient in cardiac arrest?
A. 30 to 2
B. 15 to 2
C. 5 to 1
D. 3 to 1
A

A. 30 to 2

52
Q

You were caring for an adult victim of sudden cardiac arrest. To give this patient the best chance for survival, you should provide immediate:
A. CPR and no defibrillation
B. defibrillation without CPR
C. CPR with the fibrillation within 10 minutes
D. CPR with the fibrillation within three minutes

A

D. CPR with the fibrillation within three minutes

53
Q

Which one of the following is the best reason to provide rescue breathing to a non-breathing patient?
A. it is an effective way to provide oxygen to the patient
B. it can clear a block airway with little effort
C. it can defibrillate the heart if done quickly enough
D. it helps to circulate blood to the brain and lungs

A

A. it is an effective way to provide oxygen to the patient.

54
Q 
You were caring for a child who has a good pulse but is not breathing on her own. You should provide rescue breaths for this patient once every \_\_\_\_ seconds.
A. 3 to 5
B. 5 to 6
C. 6 to 7
D. 10 seconds
A

A. 3 to 5

55
Q 
Which one of the following statements best describes the appropriate ventilation volume for a non-breathing child?
A. twice that of an infant
B. the weight minus the age
C. enough to cause the chest to rise
D. exactly half the volume of an adult
A

C. enough to cause the chest to rise.

56
Q 
After assessing responsiveness, you must check for the presence of normal breathing. Do this by:
A. shaking the patient
B. looking for chest rise
C. observing pupil response
D. sweeping the mouth for obstructions
A

B. looking for chest rise.

57
Q

You were caring for an unresponsive adult patient who is not breathing but has a pulse. You should:
A. provide finger sweeps
B. begin chest compressions
C. give five back blows
D. provide rescue breaths every 5 to 6 seconds

A

D. provide rescue breaths every 5 to 6 seconds.

58
Q

You are alone when you discover and remove a four-year-old child from a public pool. When should you call 911?
A. after providing two minutes of CPR
B. immediately after removing him from the pool
C. after 10 minutes of CPR with no response
D. after rescue breaths but before compressions

A

A. after providing two minutes of CPR.

59
Q 
Which one of the following represents the most appropriate handle location for chest compressions on an adult?
A. at the lower half of the sternum
B. at the top of the sternum
C. over the left side of the chest
D. on the very bottom of the sternum
A

A. at the lower half of the sternum.

60
Q

You were caring for an infant who is unresponsive and not breathing. Your initial attempt to deliver a rescue breath is not successful. Which one of the following is most likely the cause?
A. the child has asthma and cannot breathe
B. the airway is likely blocked by an airway spasm
C. the child is choking on a foreign object
D. you probably did not open the airway properly

A

D. you probably did not open the airway properly

61
Q 
You are at a Little League baseball game and see a parent collapse onto the ground. You're the first person to the woman. What is the first thing you should do?
A. place her in the recovery position
B. send someone to call 911
C. check for responsiveness 
D. give two slow breaths
A

C. check for responsiveness

EMR - First on Scene - 9th Edition La Baudour - Bergeron (26 decks)

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