CPR Online Portion Study Guide 2021 January

1. Early Recognition and Prevention 2. Activation of Emergency Response 3. High-Quality CPR 4. Defibrillation 5. Post-Cardiac Arrest Care 6. Recovery

-Verify scene safety -Look for no breathing and only gasping and check pulse -Check for responsiveness -Activate the emergency response system and get an AED -Begin CPR if no breathing or no gasping and no pulse felt

-Feel the pulse in the groove to the side of the trachea -Assess for a pulse for at least 5 but no more than 10 seconds -Use 2 or 3 fingers to locate the pulse

-Compression rate -Chest recoil -Compression depth

at the side of the victim

positive-pressure ventilation

1 breath over 1 second, while watching for chest rise

ventricular fibrillation

Resume CPR, starting with chest compressions

Head tilt-chin lift

1. Place the mask on the victim's face, using the bridge of the nose as a guide for the correct position. 2. Use the E-C clamp techinque to hold the maks in place while you life the jaw to hold the airway open 3. Squeeze the bad to give breaths (1 second each) while watching for chest rise

to analyze the heart rhythm and provide a shock

Resume CPR, starting with chest compressions

During analysis and before shock delivery

Left side of the back and Left side of the chest

Activate the emergency response system and get the AED

Check for breathing and a pulse

1 breath every 6 seconds, or about 10 breaths per minute

Immediately begin CPR and turn on the AED

Continue CPR until prompted by the AED to allow a rhythm check, the code team arrives, or the patient starts to move

Below the right collarbone and Side of the left nipple

Approximately 2 inches (5 cm)

100 to 120/min

Lower half; breastbone

100 to 120/min

10

fingers; nipple

thumbs

Ratio for 1 rescuer is 30;2 Ratio for 2 or more rescuers is 15;2

as indicated on the pad packages

for 5 to 10 seconds, look for no breathing or only gasping while simultaneously checking the carotid pulse

1 breath every 2 or 3 seconds, or about 20 to 30 breathers per minute

Get and use an AED

use the adult pads

cycles of 30 compressions and 2 breaths

For 5 to 10 seconds, look for no breathing or only gasping while simultaneously checking the brachial pulse

provide rescue breaths, with 1 breath every 2 or 3 seconds

power on the AED, follow the prompts, and use the child pads

complete cycles of 15 compressions and 2 breaths, and use the 2 thumb-encircling hands technique

Place 2 or 3 fingers on the inside of the upper arm, midway between the infant's elbow and shoulder

every 5 cycles or 2 minutes

timer/recorder

team leader

-clear roles and responsibilities -knowledge sharing -debriefing -constructive intervetion

-AED/Monitor/Defibrillator -Compressor -Airway

-intubation -compressor switches -defibrillation -rhythm analysis -pulse checks

compressor

monitor/defribillator

airway

clear roles and responsibilities

closed-loop communication

constructive intervention

debriefing

-1 rescuer: 30:2 -2 rescuers: 15:2

-pinch the nose and seal your lips around the victim's mouth -give one breath and blow for one second -watch for chest rise while giving the breath -give a second breath (blowing from about one second watching for chest rise)

when a barrier device is not aviable

minimize pause in chest compression

1; 6

no pauses for ventilations

1;6

1. perform a head tilt-chin lift 2. place your mouth over the infant's mouth and nose to create an airtight seal 3. give on breath, blowing for one second, watching for chest rise

give 1 rescue breath every 6 seconds

2;3

intramuscular intravenous intranasal

chest

inability to speak

upward

the airway is checked for the obstructing object

5;5

begin chest compressions

-if no shock is advised and after any shock delivery,, immediately resume high-quality CPR starting with chest compressions -continue with high-quality CPR until an AED prompt to clear -when 2 or more rescuers are present, one rescuer should continue chest compressions while the other prepares the AED

as indicated on the pad packages

check the airway for the obstructing object

-use smaller sized pas if available -a manual defibrillator is preferred for infants less than 1 year of age -if child pads are not included, use adult pads

leave the victim tp activate the emergency response system and get the AED

water excessive chest hair implanted defibrillators/pacemakers transdermal medicine patches

1. prevention 2. activation of emergency response system 3. high-quality CPR 4. advanced resuscitation 5. post-cardiac arrest care 6. recovery

-Make sure the scene is safe for you and the victim -Tap the victim's shoulder. Shout "Are you OK?" -If the victim is not responsive, activate the emergency response system via mobile devices. Get the AED or send someone to do so. -Assess breathing and breathing and a pulse --To minimize delay in starting CPR, you may assess breathing and pulse at the same time. This should take no more than 10 seconds. ---To check for breathing, scan the victim's chest for rise and fall for no more than 10 seconds. ----If the victim is not breathing or is only gasping. Be prepared to begin high-quality CPR. Gasping is not normal breathing and is a sign of cardiac arrest. ---To perform a pulse check on an adult, feel for the carotid pulse: 1. Locate the trachea using 2 or 3 fingers 2. Slide fingers into the groove between the trachea and muscles at the side of the neck. 3. Feel for a pulse for at least 5 but no more than 10 seconds. If no pulse felt begin CPR, starting with chest compressions.

-Place the victim on a firm, flat surface, such as floor or backboard. -RATE: 100-120/min -DEPTH: at least 2 inches (5 cm) -HAND PLACEMENT: 2 hands on the lower half of the breastbone -CHEST RECOIL: allow complete recoil; do not lean on the chest -MINIMIZING INTERRUPTIONS: limit interruptions ot less than 10 seconds

1. Place one hand on the victim's forehead, and push with your palm to tilt the head back 2. Place fingers of the other hand under the bony part of the lower jaw, near the chin 3. Lift the jaw to bring the chin forward.

1. Position yourself at the victim's side. Place the pocket mask on the victim's face, using the bridge of the nose as a guide for correct positioning. 2.Seal the mask against the face. Using your hand that is closeaedr to the top of the victim's head, place your index finger and thumb along the top edges of the mask. Place the thumb of your other hand along the bottom edge of the masks. 3. Place the remaining fingers of your second hand along the bony margin of the jaw and lift the jaw. Perform a head tilt-chin lift to open the airway. 4.While you lift the jaw, press firmly and completely around the outside edge of the mask to seal the pocket mask against the face. 5. Deliver each breath over 1 second. Enough to make the victim's chest rise.

-Position yourself directly above the victim's head 1. place the mask on the victim's face, using the bridge of the nose as a guide for correct position. 2. Use the E-C clamp technique -Perform a head tilt. -Place the mask on the face with the narrow portion at the bridge of the nose. -Use the thumb and index finger of one hand to make a "C" on the side of the mask, pressuring the edges of the mask to the face. -Use the remaining fingers to lift the angles of the jaw, open the airway, and press the face to the mask. 3. Squeeze the bag to give breaths while watching for chest rise. Deliver each breath over 1 second. If there are 2 rescuers: -Rescuer 1: Positioned directly above the victim, opens the airway and positions the bag-mask device. -Rescuer 2: Positioned at the victim's side, squeezes the bag.

-An AED is a device that analyzes the heart rhythm to identify the presence of an arrhythmia that can be corrected by a shock. -Lightweight, portable device. -Simple to operate. -Uses voice prompts, lights, and on-screen messages.

1. Power on the AED if needed. Follow the prompts. 2. Choose adult pads for victims 8 years of age and older. Attach the adhesive AED pads to the victim's bare chest. 3. When the AED prompts you, clear the victim during analysis. Be sure that no one is touching the victim. Some AEDs will tell you to push a button to allow the AED to begin analyzing others will do that automatically. The AED may take a few seconds to analyze. 4. If the AED advises a shock: -It will charge and then tell you again to clear the victim. -Clear the victim before delivering the shock. -Press the shock button. -After any shock delivery, immediately resume CPR.

Anterolateral placement -Place one pad directly below the right collarbone -Place the other pad to the side of the left nipple, with the top edge of the pad a few inches below the armpit. Anteroposterior Placement -Place one pad on the left side of the chest, halfway between the tip of the breastbone and left nipple. -Place the other pad on the left side of the victim's back, beneath the shoulder blade, next to the spine

When 2 or more rescuers are present: -One rescuer should continue chest compressions while the other operates the AED. Rescuers should continue high-quality CPR: -Unitl the AED delivers a prompt to clear the victim for analysis. If no shock is advised: -Immediately resume CPR, starting with chest compressions.

-Early Recognition and Prevention -Activation of Emergency Response -High-Quality CPR -Advanced Resuscitation -Post-Cardiac Arrest Care -Recovery

Check the brachial artery pulse in an infant 1. Place 2 or 3 fingers on the inside of the upper arm, between the elbow and shoulder. 2. Then press the fingers to attempt to feel the pulse for at least 5 but no more than 10 seconds. If you do not feel a pulse within 10 seconds, or the heart rate is 60/min or less, begin high-quality CPR, starting with chest compressions. Check the femoral artery pulse: 1. Place 2 or 3 fingers in the inner thigh, midway between the hip bone and the public bone and just below the crease where the leg meets the torso. 2. Feel for a pulse for at least 5 but no more than 10 seconds. If you do not feel a pulse within 10 seconds, or the heart rate is 60/min or less begin high-quality CPR, starting with chest.

-Verify scene safety -Check for responsiveness. ----Tap the victim's shoulders and shout, "Are you OK?" ----If the victim is not responsive, shout for nearby help ----Activate the emergency response system via mobile device. ----Get the AED or send someone to do so. -Look for no breathing or only gasping and checks the pulse (simultaneously). Is a pulse definitely felt within 10 seconds? -Normal breathing, pulse felt ----Monitor until emergency responders arrive. -No normal breathing, pulse felt ----1 breathe every 6 seconds or 10 breaths/min. ----Check the pulse every 2 minutes ----If no pulse, start CPR ----If possible opioid overdose, administer naloxone if available per, protocol. -No normal breathing or only gasping, pulse not felt ----Start CPR ----Perform cycles of 30 compressions and 2 breaths ----Use AED as soon as it is available -Once the AED arrives, check the rhythm: --Shockable rhythm ----Give 1 shock and resume CPR immediately for 2 minutes (until prompted by AED to allow rhythm check). --Nonshockable rhythm ----Resume CPR immediately for 2 minutes (until prompted by AED to allow rhythm check). -Continue CPR until ALS providers take over or the victim starts to move.

RATE: 100 to 120/min DEPTH: Approximately 2 inches (5 cm) HAND PLACEMENT: 2 hands or 1 hand on the lower half of the breastbone CHEST RECOIL: allow complete recoil; do not lean on the chest. MINIMIZING INTERRUPTIONS: Limit interruptionsto less than 10 seconds

RATE: 100 to 120/min DEPTH: Approximately 1.5 inches (4cm) HAND PLACEMENT: -1 rescuer places 2 fingers in the center of the chest, just below the nipple line -2 rescuers use the 2 thumb-encircling hands technique in the center of the chest, just below the nipple line. -1 rescuer may also use the 2 thumb-encircling hands technique or the heel of 1 hand. CHEST RECOIL: allow complete recoil; do not lean on the chest MINIMIZING INTERRUPTIONS: limit interruptions to less than 10 seconds

Witnessed Collapse: -If you are along with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR. Use the AED as soon as it is available. -If you are not alone, send someone to get the AED and begin CPR immediately. Use the AED as soon as it is available. Unwitnessed Collapse: -If you are alone, start CPR with cycles of 30:2 -If you are not alone, send someone to get the AED and begin CPR immediately. Use the AED as soon as it is available. -After about two minutes, if you are still along, activate the emergency response system and get an AED if not already done. -Use the AED as soon as it is available.

-verify scene safety -check for responsiveness ----Tap the victim's shoulders and shout, "Are you OK?" ----If the victim is not responsive, shout for nearby help ----Activate the emergency response system via mobile device. -Look for no breathing or only gasping and checks the pulse (simultaneously). Is a pulse definitely felt within 10 seconds? -Normal breathing and a pulse is felt ----Monitor until emergency responders arrive. -No normal breathing and a pulse is felt ----Give rescue breaths every 2 or 3 seconds (20 to 30 breaths per minute). ----Assess pulse rate for no more than 10 seconds. -Heart Rate<60/min with signs of poor perfusion ----Start CPR -Heart Rate > 60/min ----Continue rescue breathing ----Check a pulse every two minutes ---If no pulse, start CPR -Once the AED Arrives, check the rhythm: -Shockable rhythm ----Give 1 shock. Resume CPR immediately for two minutes (until prompted by the AED to allow a rhythm check). -Nonshockable rhythm ----Resume CPR immediately for two minutes (until prompted by the AED to allow a rhythm check). -Continue CPR until ALS providers take over the child starts to move.

-verify scene safety -check for responsiveness ----Tap the victim's shoulders and shout, "Are you OK?" ----If the victim is not responsive, shout for nearby help ----First resuer remains with the child ---- The second rescuer activates the emergency response system and gets the AED. -Look for no breathing or only gasping and checks the pulse (simultaneously). Is a pulse definitely felt within 10 seconds? -Normal breathing and a pulse is felt ----Monitor until emergency responders arrive. -No normal breathing and a pulse is felt ----Give rescue breaths every 2 or 3 seconds (20 to 30 breaths per minute). ----Assess pulse rate for no more than 10 seconds. -Heart Rate<60/min with signs of poor perfusion ----Start CPR -Heart Rate > 60/min ----Continue rescue breathing ----Check a pulse every two minutes ---If no pulse, start CPR -No breathing or only gasping, and no pulse is felt ----Begin CPR ----The first rescuer begins CPR with a 30:2 ratio ----When the second rescuer returns, use a 15:2 ratio -Use the AED as soon as it is avaible. --Once the AED Arrives, check the rhythm: -Shockable rhythm ----Give 1 shock and immediately resume CPR. -Nonshockable rhythm ----Immediately resume CPR for two minutes. -Continue CPR with a ratio of 15:2 until ALS providers take over or the vicitm starts to move.

-hairy chest ----If your AED has 1 set of pads and razor quickly shave the area and then apply the pads ----If your AED has two sets of pads use the first set to remove the hair. Apply the first set of pads, press them down so they can stick as much as possible and quickly pull them off. Then apply the new second step pads. - Water ----If someone is lying in water quickly move the victim to a dry surface --------If the victim is lying in snow or small puddle use the AED ----If the chest is covered with water or sweat wipe the chest before attaching the pads -Transdermal medicine patch ----do not place the pad directly over medicine patch ----take the patch off and quickly wipe the chest before you put on the patch -Implanted defibrillator or pacemaker -If you see a lump inside a device, avoid placing the pad directly over it -Defibrillation for infants less than one year of age -A manual defibrillator is preferred weather than an AED. -If a manual defibrillator is not available, an AED with a pediatric dose attenuator is preferred. -If it is available you may use an AED without a pediatric dose alternator.

-mouth-to-mouth breathing is a quick and effective way to provide oxygen to a victim when a Barrier mask is not available. -each Breath You Take contains 21% oxygen. When you provide a rescue breath, the air you breathe into a victim contains about 17% oxygen. 1. Hold the victim's airway open with a head tilt-chin lift. pinch the nose close with your thumb and index finger. 2. Take a regular breath and sugar lips around the victim's mouth creating an airtight seal. give one breath and blow for one second. Watch for the chest to rise as you give each breath. 3. Give a second breath (blowing for about 1 seconds) while watching for chest rise.

- Pad choice ---- if your aed include smaller size pads that are designed for children under 8 years of age use them ---- if not use the adult pads while making sure they do not touch or overlap ---- do not use the children's pads for an adult. The shock does is too small for an adult - replacement ---- some AED pads recommended placing one pad on the chest and one pad on the back of the infant and child ----follow the pictures on the pad packages for proper placement

1. open the infant's airway with a head tilt-chin lift. 2. place your mouth over the infant's mouth and nose to create an airtight seal. 3. give one breath, blowing for about 1 second. Wacth for the chest to rise as you give the breath.

Adults -give one breath every 6 seconds (10 breaths/min) -Give each breath over 1 second and make sure there is visible chest rise with each breath -during rescue breathing, check the victim's pulse every 2 minutes Children and infants -give 1 breath every 2 or 3 seconds (20 to 30 breaths/min) -Give each breath over 1 second and make sure there is visible chest rise with each breath -during rescue breathing, check the victim's pulse every 2 minutes

A laryngeal mask airway, supraglottic airway device, and endotracheal tube are types of advanced airways. -when an advanced airway is in place: ---perform continuous compressions at 100 to 120/min ---give 1 breathe every 6 seconds for adults ---give 1 breath every 2 or 3 seconds fo a child or infant ---no pauses in compressions to give breaths

-opioid-associated life-threatening emergency is a condition that can cause a person to stop breathing but still have a pulse. -Naloxone is a medication that can temporarily reverse the effects of an opioid overdose. ---common routes of administration for naloxone include intravenous, intramuscular, and intranasal -for a person who is unresponsive and not breathing normally but had a pulse: ---give 1 rescue breath every 6 seconds in an adult -give 1 rescue breath every 2 or 3 seconds in a child or infant -then, if your local protocol allows, give nalocone. do not delay breathe to give naloxone.

high-quality CPR can increase the mother's and the infant's chance of survival -perform compressions and use an AED as you would for any cardias arrest victim. Shock form the AED will not harm the infant. -If additional rescuers are present and rescuers are trained, perform continuous lateral uterine displacement, in addition to high-quality BLS -if the women is revived. Place her on the left side. this may help improve blood flow to her heart and therefore to the infant

-with a severe airway obstruction the victim will show signs of poor air exchange and difficultly breathing such as ---silent cough ---inability to speak or breath ---cyanosis (turning blue) -an adult or older child may clutch the neck with both hands, making the universal chocking sing. If the victim nods that they are chocking you mist act

-if chocking victim becomes unresponsive send someone to activate the emergency response system -lower the victim to the ground -perform CPR with 1 expectation; each time you open the airway to give breaths, look for the obstructing object -if you see an object that can be easily removed, carefully remove with your finders. Do not do a blind finger swap

1. First sit or kneel with the infant in your lap. hold the infant facedown and resting on your forearm, with the head slightly lower than the chest. Support the head and jaw with your hand 2.rest your forearm on your thigh to provide support. Deliver up to five back slaps forcefully between the infant's shoulder blades, using the heel of the hand. -deliver each slap with sufficient force to attempt to remove the foreign body 3. place your free hand on the infant's back supporting the head with the palm of your hand. tis will cradle the infant as you turn the infant over faceup. keep the infants head lower than the chest and deliver up to 5 quick downward chest thrusts. -do this at a rate of about 1 per second each with the intention of creating enough force to dislodge the foreign body repeat the sequence until the object is removed or the infant become unresponsive

if the infant becomes unresponsive: -shout for help and send someone to activate the emergency response system -place the infant on a hard, flat surface -begin CPR with 1 expectation: each time you open the airway to give breaths, look for the obstructing object -if you see an object that can be easily removed, carefully remove it with your fingers. do not do a bling finger swap - if you are alone, after 2 minutes or 5 cycles of CPR, activate the emergency response system.